r. r. ortiz stretched so thin and the supply nationwide is far short of where demand is. coming up with the right compensation model being able to reward doctors and give them the flexibility to work the hours they won the ships they want and in our case from where they want whether home or the clinic is also important that when it comes to the clinics in the payer's we have got to focus on reimbursement and i think that's often something left out of the conversation on innovation in health care. can you find a pathway to reimburse because without services you only have a limited shelf life for sustainability. grant funding pilot programs can only take you so far. our focus on medicaid population has driven by the cutie of the neat but also 40 medicaid programs to reimburse for telepsychiatry this country so it allows us to expand at a pretty aggressive pace. >> from my gift i have been with with -- for a total of three years. my ah-hah moment came when i was try to figure out whether i was interested in interviewing for some of the ceo positions. having been through a nu