Starting a cash pay podiatry practice

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Creflo

time to eat
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Podiatrist
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I'm a full time government podiatrist, and decided to experiment with starting a part time cash pay, house call practice, will share my experiences here on SDN for anyone who is interested. A plastic surgeon did a similar thread on sdn several years ago, so wanted to do something similar. His was more entertaining...

A little background, my practice has been active for just over 5 weeks. I've seen 7 patients so far.

It all started with an idea soon after I started working for the government. My first goal was to get permission from my employer. I started a form that had to be signed off by everyone from my department head to the head person of the hospital, and about 4 people in between. Once this was done I applied for my state license. I happen to be stationed in the state that is known as one of the most cumbersome in the country to obtain a license. I sent the application in, then finally got the license about 10 months, lots of paperwork, multiple tests, and over $1,000 later. This is just another example of podiatrists making life more difficult for each other.

Then I picked a free EMR, researched the feasibility of a podiatry practice that doesn't participate in insurance (not very feasible according to most), built my own website, and printed business cards from Staples. I knew it was going to be a gamble, but my investment was minimal, and I had a stable job.

I called the local paper, convinced them to write a free article about me, then got reprimanded from my employer for not having permission for off duty employment (which I had already obtained, 10 months ago). So I re-processed the form and obtained all the signatures again. Then I saw my first patient, who ironically was referred by a local podiatrist who had seen my article in the paper.

Since then I have been strategizing on how to make a cash pay practice work, believing that by bypassing insurance, the patient who has a high deductible can pay much lower fees. I applied and got accepted on the SERMO thread for doctors, so I could research more. They required copies of my hospital badges to prove I am a physician. I got approved. Then I posted, stating I was a podiatrist, and promptly got kicked off the forum because I wasn't a physician.

I printed color flyers and hand delivered them to local medical practices, pretty much to be told that they wouldn't be able to send me patients if I didn't take insurance.

I saw one patient for candied apples, these things cost $8 each and I promise are the best candied apples anywhere. One day when buying some apples I told her that if her feet hurt I'd treat her for apples. The next week she called and I ended up with two bags of candied apples for evaluating her heel pain.

Another patient was uninsured, had an ingrown nail. I did his ingrown for $100 cash. I asked him how he heard about me, and he said my online reviews were good, he had found me on google. He said no other podiatrist would see him for under $400, hard for me to believe but that's what he said.

I dropped a card off at a vascular surgeon's office, and they told me that you aren't considered legitimate in this part of the country if you don't take insurance. I wondered how you aren't legitimate if you regularly perform surgeries at two local hospitals, but I smiled and said let me know if I can help.

I mailed some postcards recently to home health agencies, and printed the wrong phone number on them. I wondered how I could fix this, and the best I came up with was to remail them with phrase "new easy to remember phone number" above the corrected number. So far no calls from them though.

I started google adwords yesterday, and my ad got denied. The explanation was very vague so I logged a support ticket.

I've reached out to some local papers to see what their advertising fees are...
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So my Google ad is back up, turns out it was some glitch on their end and all is well now. I've had two clicks on my website from Google ad they say, the bill totals about 80 cents so far. They say my ad has had about 500 views, hard for me to believe that many people are searching podiatry/foot stuff in such a small area over about 3 days.

Got a call from a nursing home, they have a patient who will pay cash. I asked how they heard about me, they got a flyer from somewhere, apparently it was one with the correct phone number.
 
So some coworkers got word of my side practice, next thing I know they are reporting I don't have permission, may be stealing clinic supplies, and seeing private patients in clinic.

I got a call from a Mary Kay salesperson tonight, saying one of my car magnet signs flew off today, she met me to give it to me. She had a car sign too, she knew what they cost. Nice to know the Mary Kay lady was looking out for me. Of course my coworkers said they were looking out for me as well...

Mary Kay lady 1, Pods 0
 
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Creflo said:
So some coworkers got word of my side practice, next thing I know they are reporting I don't have permission, may be stealing clinic supplies, and seeing private patients in clinic.
Click to expand...

WTH? Are these your military coworkers?

Keep up the effort. It took some bravery to try something unconventional like that.
 
Wrote my first prescription a week or so ago, urea cream. The retail pharmacist called me, said I'm not in their system, doesn't show me as licensed. I said I am licensed, so he said he will submit a ticket with their software system. It finally processed. Now am about to write my second prescription (Jublia) with another pharmacy, will see how this one goes...

Meeting a patient this week who has some talus pathology, am proposing hyaluronic acid injections to try to avoid surgery. Will charge $75 for visit, do some $15 lidocaine injections. If they work, will give weekly hyaluronic acid injections at $40 per injection plus cost of the hyaluronic acid. Probably undercharging, but patients aren't exactly flocking to me to pay cash just yet. Thankfully I have a day job.
 
One of my car signs flew off again. When I had them made I asked for the biggest size that would fit on my car door, maybe not the best idea as it can catch more wind. Nobody has called to report they found the sign, wonder if one of my coworkers picked it up.

Saw the patient with talus pathology, they decided to proceed with the hyaluronic acid injections. My diagnostic ankle injection gave her relief for the first time in years, she cried. Then she paid me $75 more than I asked for. Hopefully the injections will help, will start next week.

I gave the local paper my credit card number today, will run one ad this weekend, one next week, and then one in a couple of weeks in a specialty publication from the same paper in some areas where elderly people live. Cost is about $160 for all of this, I'm in a pretty small town and the ads are the smallest size they offer. No new patient calls in a week or so, hopefully the ads will generate some calls. Google adwords cost is up to $19.00 so far, for 15 clicks and 5.7 thousand views, still seems like a lot of views.
 
Google adwords has generated 17 clicks, at a cost of $30. The cost was $19 for 15 clicks, so the cost per click is rising fast.

Was at dinner with my wife this weekend and my phone rang, to set up a follow up visit for my very first patient, a retired, homebound internist. That was encouraging because to be honest the only calls I've been getting lately have been sales calls, regularly. I respect salespersons making calls, its their job and they are just trying to make a living, but when it's a computer calling me, it's really annoying. I block the number, then they call from another number.

The ad ran in the paper this past Sunday, no calls on Monday. Then today the nursing home where I recently saw a patient called to book another patient. Then another nursing home called today offering me about 50 patients, said they saw my ad in the paper. But they want me to sign up with medicare and medicaid. I'm tempted as it would be nice to see more patients and break even and maybe even make some profit, but I don't do billing at my day job and am really hesitant to get into the medicare/medicaid game. Still tempted...

Will be mailing a new batch of postcards in the next couple of days, will target physician offices and nursing homes again. $10 for 50 one sided postcards from Staples, not a bad deal.

Gave hyaluronic acid injection #1 today, follow up will be in about a week or so for injection #2.
 
Creflo said:
to set up a follow up visit for my very first patient, a retired, homebound internist.
Click to expand...

Upon skimming I first read your sentence as, "retired homosexual internist" and wondered where you were going with that detail. Oops, mea culpa.

Creflo said:
I don't do billing at my day job and am really hesitant to get into the medicare/medicaid game. Still tempted...
Click to expand...

If you can make it cash pay only, it could save you a ton of headache in the future. I just got the following from a coding/billing specialist:

Looks like Medicare is going to be changing on how they pay physicians in the future.

...there are also rumors about payments are going towards ICD10 codes instead of CPT code. It's called Hierarchical Condition coding HCC.

In a Notice of Proposed Rulemaking, released April 27, the Centers for Medicare & Medicaid Services (CMS) took one giant step toward modernizing how Medicare pays physicians. The proposed rule sets out to establish the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups paid under the Medicare Physician Fee Schedule (MPFS).

As required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (legislation that repealed the sustainable growth rate methodology formerly used to calculate Medicare payments), MPFS payment rates will remain at the 2019 level through 2025. Starting in 2019, payments to eligible clinicians will be subject to adjustment through one of two mechanisms: MIPS or Alternate Payment Models (APMs). Eligible clinicians or groups with eligible clinicians may participate in MIPS or an APM, but not both.

Note: Section 1848(q)(1)(c)(i) of the Social Security Act, as added by section 101(c)(1) of MACRA, outlines the general definition of an “eligible clinician” for the MIPS program. This term replaces “eligible professional.”

 
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Thanks NatCh, working on it. Last night was at Dairy Queen, a guy at a nearby table was telling his tablemates how he hurt his foot yesterday and it swelled really big. I walked over after I finished my ice cream and told him I'm a foot doctor, gave my card to him, asked if I could help. I sort of felt like an ambulance chasing lawyer, but I think it made for a good laugh for everyone, let's just say that's not what they were expecting to happen at the dairy queen.

Picked up one more patient at the nursing home this week.

Talking to some billing companies, will ponder more about going on medicare while on vacation next week.
 
Yesterday was a good day. Booked two new patient visits from the nursing home, and was asked to come speak at their family day next month to advertise my services. Also booked a talk in early June at the local health department during their free clinic to educate their patients about foot health.

No call from the dairy queen guy.
 
What state are you in?
What was your salary before this? and what is it now? you can PM instead if u want to
 
Very close call today - found a 2015 MacBook Air online at b&h for $799. It only has 4gb ram but I figured it would be a significant upgrade over my 9 year old macbook that got me through pod school, residency, and this far. So I go to get my charge card, and when I go online the price went up by $39. I called, said the price went up literally while I was getting my credit card, so they put me on hold to see what they could do. Crisis averted, they honored the old price.
 
Just getting back from vacation. While on vacation bought four dollars worth of lottery tickets. Didn't win, so will continue my practice.

Decided to pull the trigger on medicare. I may be required to submit the claim on medicare patients even if I'm not a participating provider, so I figure why not join. Will still stay off medicaid and private insurance.

My biller says expect $54 per visit average from medicare, others say a higher number. The whole thing is confusing, the learning curve will be steep for a while.
 
Very interesting, and I admire your efforts. A true concierge practice is tough to pull off in today's times. It also depends on what you want to do with your career. Having no office creates many concerns. It virtually eliminates a surgical practice at any level. Are you going to change dressings, remove sutures, apply casts and other surgically related tasks in the patient's home? If you have 5-10 house calls or nursing home patients on a given day, how are your instruments being sterilzed? After you perform that nail avulsion, do you have an autoclave at home? If you are performing a nail avulsion or any small procedure and the patient has a reaction to the medication, etc., do you have anything available to assist prior to calling 911? Are you prepared to bring all types of needed supplies with you during house calls? Where do you dispose of your dirty syringes after giving an injection? What about X-rays?

I sincerely commend your efforts, and although I don't believe many cash for services podiatric practices can thrive, IF you are going to have a home visit type of practice, you must understand that the practice will likely be a palliative practice, because going to the home will greatly limit the amount of pathology you can truly treat in a home.

As long as you've taken all this into consideration, then it's a decision well made. If you haven't considered the comments above, please think it over.

We all have to pick and choose how we practice and what makes us happy. I just received a call from a friend who's sister is CEO of a nursing home company. I can immediately pick up 3 nursing homes, but I have no desire to go bed to bed clipping nails. Just isn't what I want to do with MY career, but if that's what you seek, go full steam ahead.

Good luck with your decision.
 
Excellent points to consider by Experienced DPM. Creflo, I wonder if you would benefit from contacting other DPMs with concierge practices to see how they deal with the issues cited above?

Dr. Segler in the Bay Area has a housecall type practice. I've seen him speak at a few of the west coast conferences. Maybe he has time to chat.

http://www.docontherun.com
 
NatCh said:
Excellent points to consider by Experienced DPM. Creflo, I wonder if you would benefit from contacting other DPMs with concierge practices to see how they deal with the issues cited above?

Dr. Segler in the Bay Area has a housecall type practice. I've seen him speak at a few of the west coast conferences. Maybe he has time to chat.

http://www.docontherun.com
Click to expand...
Thanks NatCh and experienced dpm, will definitely call doc on the run!
 
Got a visit from an investigator who is conducting the investigation for allegations I am seeing private patients at work, using work supplies, and not having permission to do my side practice. I waived my right to an attorney.

Pretty excited about the new laptop that works wothout the power cord, and also bought a pair of double action nail cutters, went with the gill brand, apparently made by miltex, and cost about 25% less. They are much better than my old pair that I had to use in residency because my director was too cheap to get theirs sharpened. Wasn't a problem for my director until he had to trim some nails one day-
he borrowed mine.
 
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Creflo said:
Got a visit from an officer who is conducting the investigation for allegations I am seeing private patients at work, using work supplies, and not having permission to do my side practice. I waived my right to an attorney.

Pretty excited about the new laptop that works wothout the power cord, and also bought a pair of double action nail cutters, went with the gill brand, apparently made by miltex, and cost about 25% less. They are much better than my old pair that I had to use in residency because my director was too cheap to get theirs sharpened. Wasn't a problem for my director until he had to trim some nails one day-
he borrowed mine.
Click to expand...

How do you clean/sterilize your one double action (you said you bought a pair, not multiple cutters) nail cutter between patients? If you accidentally nick a patient and the nipper gets blood on it, how is it sterilzed? I'm not being critical or sarcastic, but we owe our patients the assurance that instruments are free of contaminants. If it has blood on it and not properly sterilized (it needs more than a disinfectant), then you need to rethink some things. As corny as it sounds, treat all patients as if they are family and it'll improve the quality of care you provide (with the exception of thoughts of my mother in law).
 
People use a car sign so they can write off their vehicle as a company car. I wonder if car signs ever bring in business for anyone.

Creflo said:
Got a visit from an officer who is conducting the investigation for allegations I am seeing private patients at work, using work supplies, and not having permission to do my side practice. I waived my right to an attorney.
Click to expand...

Is that "officer" as in "not an enlisted person," or "officer" as in "law enforcement?"
 
It's been a slow week, but did see my ankle hyaluronic acid injection patient. Her husband came to the visit, in a significantly modified 2015 supercharged mustang gt. I couldn't resist asking for a ride after the injection. So we go into a parking lot, he locks the front wheels, does a burnout, then turns on the supercharger and adjusts positive traction, then shows me what it will do. I swear that thing could outrun a nascar. They gave me $100 more than I asked for, said I wasn't charging enough.
 
So I made my bookkeeping journal entries for my laptop purchase, had to do a little research. Unfortunately it doesn't qualify for an expense, but must be depreciated. So I put it into an asset account. However, I can expense it this tax year under section 179, if I make enough net income from my business. Bills received in the mail recently include APMA renewal, state license renewal, state business license renewal.
 
Completed the fifth and final hyaluronic injection on my patient this week, yesterday she cried saying she was able to exercise on the elliptical for the first time in years.

The ethics investigation at my day job is ongoing, the investigator interviewed a patient who works at my day job, who I performed an ingrown nail for. The investigator asked the patient if I discussed his MRI during my clinic hours at my day job. He informed the investigator that no MRI was performed for his ingrown.

I have signed on with a billing service, they offered to let me fax a summary sheet of the visit, they then enter it into the EHR, and file the medicare claim. I'm not on medicare yet, but did see a cash patient this week and gave the system a try. The billing service will invoice the patient for me, take 4.5%, and deposit into my account. I get access to MediTouch through the billing service. I faxed the summary sheet (HPI, PE, Dx, plan etc) handwritten, they got most of it right with the exception of a few errors, and invoiced the responsible party. This was a dementia patient and the responsible party is in another state. It's worth 4.5% for me not to have to print out an invoice, mail it, deposit the money. Hopefully it works out in the long run with the billing company.

The patient who I used the billing service on, I had seen her one month ago to trim her nails. The family asked that I see her, I thought one month sure was soon. I phoned them and they said even if its just minor trimming, come every month. OK, cool.

Have been getting tired of using my 9 year old printer. It prints a test page every time I turn it on. It prints a blank page between every page I print. It has a ghost inside it that makes all kinds of noise even when I'm not printing, and pages will just spit out with random text on them. After a lot of research, I got an Epson Workforce 3620. Had a 10% off coupon for Staples, and they have a 14 day return policy. $86 out the door when I showed them that Best Buy was offering it for less and they price matched. Plus 5% of that to my Staples rewards account, and mileage tax deduction for the trip to the store. I've never had a home printer that didn't have to be plugged into the computer, this is pretty nice. And it doesn't print test pages throughout every print job.

I got in touch with the mobile podiatrist that NatCh recommended, actually he has written a book. I got a copy from Amazon, its a Kindle book. It's got some helpful info, but is somewhat lacking on the biggest challenge of starting a cash practice, and that's getting patients. The best I can tell he did it through running connections. Thanks again Natch for the referral, glad I found the book.
 
Creflo said:
Completed the fifth and final hyaluronic injection on my patient this week, yesterday she cried saying she was able to exercise on the elliptical for the first time in years.

The ethics investigation at my day job is ongoing, the investigator interviewed a patient who works at my day job, who I performed an ingrown nail for. The investigator asked the patient if I discussed his MRI during my clinic hours at my day job. He informed the investigator that no MRI was performed for his ingrown.

I have signed on with a billing service, they offered to let me fax a summary sheet of the visit, they then enter it into the EHR, and file the medicare claim. I'm not on medicare yet, but did see a cash patient this week and gave the system a try. The billing service will invoice the patient for me, take 4.5%, and deposit into my account. I get access to MediTouch through the billing service. I faxed the summary sheet (HPI, PE, Dx, plan etc) handwritten, they got most of it right with the exception of a few errors, and invoiced the responsible party. This was a dementia patient and the responsible party is in another state. It's worth 4.5% for me not to have to print out an invoice, mail it, deposit the money. Hopefully it works out in the long run with the billing company.

The patient who I used the billing service on, I had seen her one month ago to trim her nails. The family asked that I see her, I thought one month sure was soon. I phoned them and they said even if its just minor trimming, come every month. OK, cool.

Have been getting tired of using my 9 year old printer. It prints a test page every time I turn it on. It prints a blank page between every page I print. It has a ghost inside it that makes all kinds of noise even when I'm not printing, and pages will just spit out with random text on them. After a lot of research, I got an Epson Workforce 3620. Had a 10% off coupon for Staples, and they have a 14 day return policy. $86 out the door when I showed them that Best Buy was offering it for less and they price matched. Plus 5% of that to my Staples rewards account, and mileage tax deduction for the trip to the store. I've never had a home printer that didn't have to be plugged into the computer, this is pretty nice. And it doesn't print test pages throughout every print job.

I got in touch with the mobile podiatrist that NatCh recommended, actually he has written a book. I got a copy from Amazon, its a Kindle book. It's got some helpful info, but is somewhat lacking on the biggest challenge of starting a cash practice, and that's getting patients. The best I can tell he did it through running connections. Thanks again Natch for the referral, glad I found the book.
Click to expand...

I really enjoy your updates. Do you also mind posting the book? I'd be interest in giving it a read.
 
Creflo, I applaud your efforts and I'm truly not trying to start anything with you. However, in two prior posts I addressed some issues that you've never answered. My major concern is how you are disposing of needles and sharps that you use while in a patient's home and how do you sterilize your instruments? I am not asking to bust your stones. I am asking to protect you. There are expected and standard protocols, and dipping a blood tainted instrument in a solution is not the standard of care. The state and medical boards take this stuff very seriously. If you are sterilizing instruments at your military job, I'm sure that has the potential to get you in trouble since you're using their equipment for personal use. I'm not sure the government would be happy with that situation. Similarly, if you are disposing of sharps at your military job, you are also possibly jeopardizing your position.

These are legitimate concerns you need to address. I have a classmate who was employed at a hospital and was moonlighting similar to you. He lost his job when they realized he was bringing in his moonlighting instruments, having them placed in sterile packs and bringing in a Tupperware filled with sharps to place in their sharp containers.

Every patient deserves sterilized instruments. It's the standard of care and isn't an option.

Hopefully you are using sterilized (not just disinfected) instruments when doing anything even remotely invasive.

Please be cautious for the sake of your patients and career.
 
I'm rooting for you creflo. Haters gonna hate, but if you're enjoying the ride, then keep it up.
 
g squared 23 said:
I'm rooting for you creflo. Haters gonna hate, but if you're enjoying the ride, then keep it up.
Click to expand...

I don't know if you're even referring to me, so just to set the record straight, IF you are referencing my post, I'm afraid you missed my points. Read the posts again and you'll see that I've applauded creflo for his efforts (or her efforts) but simple expressed concern regarding the disposal of sharps and how instruments were being sterilized.

Not using proper protocol sterilizing (not disenfecting) instruments or disposing of sharps properly, puts patients at risk and the doctor's career at risk. If his instruments are being sterilized at his military job and/or his sharps are being disposed of at work, this MAY be a workplace violation and put creflo's job at risk.

Offering advice or having conflicting opinions whether it's me or someone else, does not equate to being a hater. I'm just offering an opinion based on past observartions and experience.
 
Easy, I was 0% referencing your post. I was referring to his coworkers who tattled on him.

ExperiencedDPM said:
I don't know if you're even referring to me, so just to set the record straight, IF you are referencing my post, I'm afraid you missed my points. Read the posts again and you'll see that I've applauded creflo for his efforts (or her efforts) but simple expressed concern regarding the disposal of sharps and how instruments were being sterilized.

Not using proper protocol sterilizing (not disenfecting) instruments or disposing of sharps properly, puts patients at risk and the doctor's career at risk. If his instruments are being sterilized at his military job and/or his sharps are being disposed of at work, this MAY be a workplace violation and put creflo's job at risk.

Offering advice or having conflicting opinions whether it's me or someone else, does not equate to being a hater. I'm just offering an opinion based on past observartions and experience.
Click to expand...
 
Practice has evolved into more nursing home visits, I keep picking up one or two more patients at the same nursing facility that I've been going to. Saw three new ones this week. Not on medicare yet. I'm getting close to having an adequate base patient load to break even financially by the end of the first year in business even if I don't add any more new patients, so this is encouraging. But I should be able to add more patients as time goes by, resulting in some profit, time will tell how much.

Should be active on medicare in the coming couple of months, which will change things.
 
Creflo, could you please address ExperiencedDPM's concerns?

I don't know how well you want to protect your privacy but I was able to identify you within five minutes of starting a Google search - FYI.
 
Creflo said:
Practice has evolved into more nursing home visits, I keep picking up one or two more patients at the same nursing facility that I've been going to. Saw three new ones this week. Not on medicare yet. I'm getting close to having an adequate base patient load to break even financially by the end of the first year in business even if I don't add any more new patients, so this is encouraging. But I should be able to add more patients as time goes by, resulting in some profit, time will tell how much.

Should be active on medicare in the coming couple of months, which will change things.
Click to expand...


I'm not sure why you won't or haven't addressed my concerns about disposal of sharps, sterilization, etc. Niw that you are providing care at nursing homes and plan on billing Medicare, I sure hope your documentation is perfect, including the medicsl need for palliative care, class findings, etc. Nursing homes are heavily scrutinized.
 
Accusations to date:
-no permission to do this from day job
-not properly sterilizing instruments
-stealing supplies from day job
-treating private patients at day job
-not handling sharps properly
-using day job to sterilize instruments
-MRI for ingrown not properly handled
-disposing sharps at day job
-imperfect documentation for nursing home palliative care
-my website is searchable

Still pressing on...
No, won't address the above.
 
Creflo said:
Accusations to date:
-no permission to do this from day job
-not properly sterilizing instruments
-stealing supplies from day job
-treating private patients at day job
-not handling sharps properly
-using day job to sterilize instruments
-MRI for ingrown not properly handled
-disposing sharps at day job
-imperfect documentation for nursing home palliative care
-my website is searchable

Still pressing on...
No, won't address the above.
Click to expand...


Creflo,

There's a huge difference between an accusation and a question. I have no dog in this fight, but have seen a lot in my career. What I've seen is:

Housecall doctors who go from home to home with one set of instruments in a solution tray.

Nursing home docs who go bed to bed with one set of instruments

Nursing home docs who don't properly document

House call docs who throw blood soaked dressings and syringes in a trash can

How do I know this? I know this because I've served on the state board and have been an expert witness against these practices.

Once again, I didn't accuse, I simply asked. And since you haven't supplied an answer to two simple questions (how you sterilize your instruments and how you dispose of sharps), but instead you act like a child and write that people are picking on you. The way to "win" the discussion is to answer the questions. But by refusing to answer, you've in essence answered the questions.


You also mention that you don't accept insurance and can perform the surgery at a local hospital. Do you understand that the majority of the time if a doctor doesn't participate, the patient will also be responsible for all hospital fees?

Would YOU have a doctor perform surgery on you if that doctor didn't even have an office? Especially when there are surrounding doctors with nice offices who do accept insurance.

Starting a home care practice is fine, but you can't take shortcuts. I don't know if you have taken shortcuts because you've chosen not to answer, which makes no sense to me.

Also remember that providing phone consultations for free or for a fee creates a doctor/patient relationship, and you will be held responsible for the advice you give. And getting paid for advice without the ability to examine a patient opens an entire new can of worms.

I don't get a warm and fuzzy feeling about many things you're doing. But you're too defensive to realize I'm not accusing you of anything, I'm just providing you with words of caution.
 
You guys are killing this thread. @Creflo has no need to defend himself to anyone on this forum and none of us has any right to demand explanations from him. Offering advice is one thing, but demanding explanations on an internet forum like this is just ludicrous. This thread has been very popular and beneficial, and let's try to keep it headed in a positive direction
 
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