he has patients who come here from that country to do just that to get their care so let's ask dr keith smith he's our gas managing partner medical director for the surgery center of oklahoma so dr smith let's just kick off with that why would a patient come from canada to get a hip replacement with you as opposed to their country which has single payer a single payer system that that amazed me i know when we first put our prices online the first people that showed up were the canadians and they they're in long lines they they have this right to health care whatever that means but it is it's a right for care. it's a place in line i mean that's all that's all that they have so when they saw our prices they realize for a reasonable amount of money they could buy their way out of line. the whole cottage industry places for these canadians to escape all along the border i think our prices were significantly different and low enough that it made sense for them to travel a little farther and do that so let's get a little bit more into why you developed this this practice what made you and your asso