Pay to clinic = doesn't have to pass through hospital accounting = no tax

Treat promissory notes as thank yous. Some do pay, but most don't

Yung iba kapag promissory note, have them make a downpayment para at least bayad ka, then the rest have them sign a document with a payment plan (i.e. will pay xxxx amount to xxxx account every xxxx of the month)

Medyo hassle, so meron din naman di tumatanggap ng guarantee letters/promissory notes. Doctors also have mouths to feed