So Bob emails what do you say? Yes. So this email is from patron Christina who DMed me on Patreon.

She says, Hello Dr. Kirk, you talk about therapists having problems with paperwork,

but you don't expand on that too much. I worked for a clinic that has lots of Medi-Cal

billing. I'm guessing that's like the Medicaid of California. Have you heard of that before? Medi-Cal,

okay. I worked for a clinic that had lots of Medi-Cal billing requirements and staff were not paid

over time, but expected to bill up to 100% of their work hours and incentivize to bill more.

Yeah, so let me sift through this. Okay, so I worked for a clinic that did lots of Medi-Cal. So

I'm guessing the inclusion of the Medi-Cal in there is that they're not getting reimbursed a lot

for the services, typically from Medicare and Medicaid. Yeah. And because we have legislatures

that don't allocate enough funds to reimburse mental health clinicians and other clinicians'

physicians for their work because we live in a country that has the most wealth that's ever been

amassed in the entire known universe. And yet we don't give a shit about human beings. And we just

keep funneling money into CEOs who can pay for millions of doctors to help millions of people,

particularly when we talk about other countries. And we just keep voting for the same stupid politicians

over and over again. You say it like it's a bad thing. And so anyway, so we have that it worked

for a clinic. And so what that does to a lot of these agencies is it strains things because

they want to provide a service. And sometimes it might be kind of required to provide a certain

amount of service to a community. And so you at least internally or externally have this pressure

on you to see to do a certain to have a certain amount of production. And then you don't pay them

enough. And then what ends up happening is these agencies scramble to figure out how they're going

to make it work. And one of the things they can one of the levers they can pull is to

pressure labor to work harder. Yeah. Meaning that they as patron Christina saying is expected to

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