What do small business owners struggle with most?

Being a small business owner is a difficult endeavor and the issues vary from business to business.  Here are a few common issues which we will address over the next few weeks:

1. Understanding, managing and improving cash flow
2. Finding good outsourced service providers such as accountants and attorneys
3. Keeping up with laws and compliance issues
4. Dealing with employees if you don't have human resources person
5. Developing and maintaining an ongoing marketing strategy
6. Prioritizing tasks and delegating

Are there any issues I am missing?