In early 2025, two partners in an Oklahoma medical practice must reconcile their booming urology business with declines in practice cash flow. The case highlights the difference between cash flow and accounting profits, as well as the common negative effects of growth on cash flow. It provides a straightforward introduction to simple financial-statement modeling and an opportunity to develop intuition on the importance of cash flow to business owners. The case is tailored to an audience with a professional business-practice perspective.