[laughter] >> john hirsch. i'm not a medical doctor, but i work with them. listening to some and are so far, i have heard a clear motivation of movement away from fee-for-service payment. from what i've seen in working with medical doctors, personalities issue associated with that, which is an motivation to work hard. the more you do, the more you get. i'll take that call at 7:00 p.m. on friday night. if the compensation structure is changed, that's probably old news, sent to you been thinking about. there is a second that all aspects but i think warrants some discussion and that is that innovation in medicine takes place both in academic institutions and in private is with people tinkering because if they tinker it gives them a competitive advantage in their practice will be rewarded. what they give you a simple dirty second example from ophthalmology. he used to be with cataract operation, it is common to have the type perforated in the course of a procedure and a patch. ophthalmologist in private is tinkering figured out rather than making a puncture woun