Up to now, my office has taken medicare and medicaid because we're new and needed all that we can get. That said, it's now incredibly frustrating. I live in a part of the state with a very high medicaid population and frequently feel like I'm running a "clinic" instead of an actual office. I do feel an obligation to provide services for those who need them, but it gets tiring when your whole life is charity and you don't always feel like patient's truly appreciate the fact that they are getting medical care for free. To make matters worse, we now have an HMO planning to enter our area who will be reimbursing at a rate less than Medicare. This group is currently our largest commercial payor, and we really don't know if we will be able to make an adequate living at all anymore. My husband and I have started talking about moving to another area. The entire system is incredibly frustrating for me right now.