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The Birth of The Medical Manager

Personalized Programming had grown into a successful, one-man company. In 1980, my brother-in-law, Harvey, suggested that I incorporate the business for liability purposes. I remember how unnecessary it seemed to incorporate yet another business. Still, I accepted his advice and registered Personalized Programming with the State of Florida. The State sent me a stock certificate for the business, which I stuck in my safety deposit box at the bank. The certificate had a beautiful official-looking seal on it, but it had no real value to anyone but me. Nonetheless, Personalized Programming, Inc. was now a legal corporation in the State of Florida.

I really loved the work I was doing with Personalized Programming. If anything, my passion for computers had grown stronger since that first day in Radio Shack. Each computer I installed was like a dear friend I left behind to serve my clients. I may have looked like a one-man company, but in reality I had left my workers at every one of my clients’ sites. They worked for free day and night, and they never complained.

Once I started selling and supporting full system solutions for my clients, Personalized Programming began generating more than a hundred thousand dollars a year. That was a far cry from the five thousand I was earning at Santa Fe just a few years earlier. In addition, Built with Love was still earning a decent living. Through all this, I had hardly changed my lifestyle. The money the businesses were earning got donated to the Temple to support land purchases and the expenses incurred serving the community. The perfection of how everything was unfolding was enough to silence the personal mind. It was around that time when I noticed that my mental concepts separating worldly and spiritual had finally dissolved. Everything began to appear as the miraculous perfection of the flow of life.

If I’d had my way, I would have continued my life in that direction. But somehow it seems that in my experiment with surrender—I never have my way. So it was in early 1980 when I received two phone calls on the same day that would end up initiating the next stage of my phenomenal journey. The calls seemed innocent enough; they were from people looking for a medical billing system. What they wanted was the ability to do patient and insurance billing using a personal computer. I didn’t have a system that could do that, but I told them I would look around and get back to them.

After some searching, I found a system through a contact I had in Miami. It was supposed to be a nationally distributed software package with successful installations. I should have checked references. I got literature and pricing on the system and got back to my prospective clients with a bid. I had no idea what I was getting into. Once I started testing the software, it didn’t take long to realize that the package was absolute garbage. There was no way I was going to represent that software.

When I called my clients to give them the bad news, they each had the same response. They said they had heard that I was a very reliable programmer who had written custom software for numerous businesses. Why couldn’t I write software for their medical practice business?

I remember I was sitting on the floor of my small office. The little voice in my head was going on about how it took so long to write software versus selling someone else’s. Writing a patient and insurance billing system would be a much larger project than anything I had ever done. I told my clients that it could take as much as two years to finish such a system. Unfortunately, they both said they were willing to wait if they could give input along the way. I definitely didn’t want to get into a programming project of that size. But though there was no definitive agreement with these clients, there was my agreement to honor life’s flow. My mind became still as I realized that I really had no choice but to surrender to the situation life had put me in. It was just like all the other times I let go when I didn’t want to. I took a deep breath and told both clients that I would try my best to write a billing system for their medical practices.

The moment I hung up from these phone calls, I reached over and picked up the standard insurance claim form that was lying on the floor next to me. I had obtained it earlier to see what an insurance bill looked like. I began thinking about how I was going to structure a program that would collect and store the diverse data necessary to fill out this form. Little did I know that those first thoughts were the start of a journey into the computerization of the medical industry that would span almost three decades. People have often asked me how back in 1980 I had the foresight to focus Personalized Programming on the medical industry. Now you see that the answer is simple: I didn’t do a thing except serve with all my heart and soul what life brought before me. But the scope of the task I had been given this time was way beyond anything I had ever faced.

There were no meetings, or budgets, or project plans. There was just me. I immediately started to code the software that would come to be called The Medical Manager—a product that would end up revolutionizing the U.S. medical practice management industry. I know it is difficult for people to understand, but to me writing code was the same as having a conversation with another human being. I didn’t have to think about what I wanted to say or how to say it. There was just a natural flow directly from the stream of my thoughts into the machine. When I was writing a program, the voice in my head would speak in the computer language I was using. I didn’t think in English and then convert to the language; my primary thoughts were in the computer language to begin with. Because of this, I could just sit down at the computer and write perfectly structured code. We are back to our earlier discussions of inspiration and where it comes from. Beethoven heard music and he wrote it down. Artists have creative visions and they manifest them. I never saw The Medical Manager all at once in some grand vision. Nonetheless, every day the constant flow of inspiration let me know exactly where the program needed to go. I simply sat at the computer and wrote down the spontaneous stream of inspired thoughts in the form of code.

I wrote and wrote with a fervor and passion that was almost frightening, first the patient record, then the medical procedures that needed to be billed. Everything I did, I did to the absolute best of my ability. I was not only writing a program for these two clients; I was writing the best program I possibly could as my gift to the universe. The flow of inspiration was such that I was not allowed to cut a single corner. This commitment to detail would end up distinguishing The Medical Manager from almost all competitive medical billing systems on the market. In short, this thing wanted to be as close to perfect as possible regardless of how long it took or how unreasonable it appeared from a business perspective.

The fact is, there never really was a business perspective. I figured I could probably sell the program to some other doctors in town, but I never once thought about broader distribution. I was able to cover the cost of program development out of my own pocket because of the perfection of how events had unfolded. And I don’t use the term perfection lightly. During the time I was writing the medical billing system, a subdivision opened up in the woods just one mile down the road from Temple property. Built with Love landed a number of contracts for custom houses in that subdivision, which meant I didn’t have to go anywhere to handle the jobs. In addition, Personalized Programming had its existing clients. I hired a young man part-time to help me do some of the small custom programming jobs for those clients. I trained him on the old programs I had written, and I reviewed and tested his code. Without realizing it, while I thought I was training him, it was really me who was getting trained on how to manage programmers. That was a skill I would definitely need in the near future. Turns out, I was destined to manage hundreds of highly skilled software developers.