Samuel N. Hazen - Chief Operating Officer
Management
Well, let me say that other operating expenses, generally, stay about the same from the fourth quarter to the first quarter. We did see a little bit of a trend change last year where it actually trended down a bit in the first quarter. But in general, when I look back over three years, four years, it stayed about the same and that's what we saw this year. The fourth quarter and the first quarter were almost identical. But when you look at it compared to the first quarter of last year, the execution of our service line initiatives, primarily trauma and then secondarily, graduate medical education, is driving professional fee expense growth for the company. We saw some deterioration in margin, primarily because of professional fee expense. And there were three things that drove that. First, we did an acquisition of a physician network in Northern California last year, where most of the costs of that particular acquisition are in other expenses. And that drove a piece of the margin erosion. The second piece and probably the more important piece and more connected to the company's strategy is around trauma program development, where we have to invest in professional fees to support our trauma programs. And again, we've added significant amount of trauma programs, some are in their early stage startup modes, so you see a little bit of a disproportionate load of other operating expenses as a result. And then the third piece was in our graduate medical education programs, where we've added graduate medical education programs for residents and so forth at a number of our facilities which required some level of professional fees for faculties and such so that we can support those programs. All in all, we think there will be some growth in these numbers over the remaining portion of the year, but not in any way where it changes our trend and our expectation on the margin levels that Bill laid out. If you look at some of our components, like our ER physician call per ER visit, or ER call pay-per-ER-visit, those are generally in line with what we expected, slightly up, again, because of these program changes. So that's the biggest driver of our other expenses on a year-over-year, but it's very consistent, like Bill said, with the fourth quarter and even the third quarter, so the run rate is really not that materially changed.