Comparing to prior year means nothing, PAOG was not around in 2016, 2016 represents a different company so the periods are not comparable.
Quarter over Quarter growth is what is critical for a new starting business, if you cannot sustain growth over multiple quarters it brings to question the viability of the clinics on a long term basis. If people just come to get their card and don't come back to the clinics ever then they will eventually go out of business