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In January 2006, eClinicalWorks (eCW) had an acquisition opportunity that could fundamentally change the way they had done business since the inception of the company in 1999. eClinicalWorks was a privately run business in the healthcare information technology field that took in $25 million in revenue in 2005. Revenues for 2006 were projected to reach $40 million. This successful electronic medical record (EMR) company had grown thanks to their reliable software and responsive customer service. The company had achieved this growth without the help of any outside financing. The five co-founders of eCW, who treated each other like an extended family, invested years of sweat equity and hard work to shape eCW as they wanted. They were also proud of their company culture, which de-emphasized traditional company hierarchies and encouraged independent thinking and cooperative working arrangements across departments. Keeping the company private, in their view, had helped them to maintain this culture. The opportunity to acquire another EMR company offered eCW the chance to grow quickly in an industry that is estimated to take in more than $40 billion in overall revenues in 2007. But this acquisition would require outside financing of some sort. Was this the moment to accelerate the rate of growth to which eCW had become accustomed-catching up with, rather than anticipating, how their customer base would expand? Or should they maintain the same approach that had worked so well since 1999?