For the South Texas border town of McAllen, it's unwanted criticism.
First it came from an article in the New Yorker that highlighted the area's sky-high medical costs, and now, reports CBS News correspondent Don Teague, it's coming from President Obama who today suggested McAllen's doctors are part of a national problem of physicians ordering unnecessary treatments.
"Treatments they don't really need," said Mr. Obama, "treatments that, in some cases, can actually do people harm by raising the risk of infection or medical error."
Doctors here say the criticism is grossly unfair and have written an open letter to the president, asking him to meet McAllen's doctors face to face.
"I don't think anybody wakes up in the morning saying they're going to defraud the Medicare system or Medicaid system," said Dr. Carlos Cardenas of South Texas Gastroenterology. "Come to McAllen, Texas and come visit us. I would love to show him this facility. I would love to show him the people of the Rio Grande valley."
But doctors say McAllen faces unique healthcare challenges.
It sits in the poorest metro area in the nation with the lowest number of doctors per capita. It also has one of the unhealthiest populations with high rates of obesity, diabetes and heart disease.
Add to that a large number of uninsured patients - from Texas and Mexico - and medical costs soar.
Still researchers say other cities face similar challenges and their doctors manage to keep costs down while still providing quality care.
"We need to think about reforming the payment system to start rewarding providers for providing better value not just for doing more services," says Dr. Elliott Fischer.
Back in McAllen, Ruben Ramirez, who sees four different doctors per month, says he should have all the care he needs for his bad back, diabetes and erratic blood pressure.
He told Teague he wants more care, not less.
"That's what I would like," he says.
Where to draw the line between enough health care and too much - with a Texas border town at the forefront of the debate.