We have a wide variety of patients who come and many patients are local patients and they like to stay near home and have their surgery done. Some people come from a distance. We have had engineers come from Germany. We have had patients from Canada, from Mexico, from Australia, from a distance and usually the reason that people were coming from a distance is that they value a certain expertise that I have and they want me to do their particular type of surgery. Having said that, in virtually all the major cities of the world there are talented, conscientious, hard-working physicians and that is a choice that people have to make personally. Some people come to Santa Barbara because they want to have the Santa Barbara experience, by that I mean they would like to be recovering down by the beach and listening to the waves in a pleasant place that is sunny most of the time as opposed to in a hotel room somewhere in a big city. So those are sort of personal choices and it has to do also with the spouse or the friend that is coming to be with him and it is sometimes more fun for them if they can be in a resort area than in a city situation. So there are lots of ways to look at it and we have as I say local patients, patients from all over California, the West and then we have you know occasionally patients who come from Europe as well.

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