I had the great pleasure of practicing medicine in an Emergency Department setting for the first 18 years of my practice. Treating both common illness and serious life-threatening disease and injuries gave me the experience to be successful at this new adventure. Many in my community struggle to understand the cost associated with medical care. Amish, conservative Mennonite, and "English" with large co-pays all are frustrated and often find it difficult to justify the cost of care with the se