Lung volume reduction surgery (LVRS) in 181 Thoracic surgery clinics in Asia

I had an ongoing ear infection. I was seen by one the Ear, nose and throat doctor. I had a follow-up appointment at 10am, I had a confirmation text the day before. I took the day off work as I also had another doctor appointment at 11.30 not in the same hospital. Anyway, at 9.55am I got a call from Acibadem, someone speaking Turkish, I said in English please and then they hung up. Then at 9.57am I had another call from the hospital, this time someone speaking English saying that my appointment had changed to 11am, because my doctor arrived at that time. 3 minutes before the appointment and then I had to wait one hour, no explanations given, nothing. This is not a free hospital, I'm paying as an international patient more that I would pay back in my home country. Why do they feel like they can play with my time, no apologies. Nothing

Last week, I was at the hospital with my relative . We did a PET-CT and MRI scan. The oncologist wasn’t there that week, but we discussed with the hospital that we would do the interpretation of the results remotely with the doctor because we live in Tirana, Albania. However, it’s been 3 days, and they haven’t responded. I turned to your hospital with the idea that I might find a solution there. It is crucial to start treatment as soon as possible and you need to understand that the days that go by are not in his favor. I urgently need a meeting with the oncologist

You would have to be an absolute idiot to use this hospital, especially if you are not a Turk! I called today for an appointment and was told I would have to pay in Euro because I was not Turkish, but if I was from another Middle East country I would pay the same as the Turks. I have lived in Turkey for years, and married to a Turkish man. We make the Turkish LIRA! This is not the first bad experience we have had with this Hospital. This hospital will do everything they can to cheat you out of a dollar. If you are looking for terrible Doctors that don’t listen to your concerns, and to be treated like a walking bank, then it’s the hospital for you!!

Unfortunately, i have encountered biased towards forwigners attitude here. I had an appointment at Hasan Ünlütürk on october 6th 14.40. We were late, but registration was completed, payment made and we were waiting in front of doctor's room at 14.55. Doctor was not there, the woman that works with doctor (i will call her hostes) said since we were late he went to another side of the building to treat another patient. I said ok, then doctor came at 15.07. Hostes said that since we were late, she cannot accept us to doctor's room and took TWO other patients in front of us. This was unfair and rude attitude which resulted in us waiting for almost 40 minutes.

I don’t recommend this place for foreigners at all. Their staff are very rude and kind of racist. After reception didn’t help, we asked their information desk and they sent an English translator (a very good person) with us. In reception the staff again start fighting with the translator and especially one of them, a woman with hijab, start yelling at us. I asked the translator the reason and she said they are saying”Turkish people are priority!!!” A very regular doctor appointment and a blood test took us 4 hours to wait and we were very exhausted. I’ve been leaving in turkey around 5 years and that’s first and the only time I’ve seen such a bad behavior from Turkish people.

Should be avoided by foreigners. Irresponsible reception service. My sick son and I visited this hospital at night (3am) in emergency because of high temperature (40 degrees). No one person at reception knew English, no one knew how to apply insurance, no one was interested to help my son quickly - they offered me to wait at reception 2 hours, when pediatrician arrives. Only after pressures by insurance support service they took us to the doctor (very good one, to be honest). If you need to emergency help and professional organisation, chose another hospital.

This hospital is very bad. They don’t know what communication is. This is not Medicana (International) but MediKill Turkey. Stay away from Selin Merih Urlu and Ugur Sahin. these two are not doctors but butchers. They killed my best friend with cancer treatment. Gary from Holland.

Had an operation at the orthopedics department and stayed for a day. The close attention of the medical staff (especially Ms. Ece, my nurse) and the competence level of my doctor, Prof Dr. Şadan Ay were amazing. I don't recommend anybody to get sick but if you are sick this hospital is the right chouce to receive the best treatment

I was really disappointed about the service,my wife had to wait for more than 30 minutes to perform a PCR test even we were the only ones looking for the PCR test. The day after I went to get the results they couldn't even have the results paper in an envelope. They just gave us the paper. I hope you will improve your services and pay attention on those observations.

Disrespectful and unprofessional Long waiting time (3 hours) after which the Opthomologist decided he will not perform any additional test since this is a follow-up visit. He is rude, unprofessional and deserves to be notified for his unhumane behavior.

I went along with my antibiotic medication. Despite having private health insurance, they charged me 150 TL for just one injection. Other private hospitals are charging only 45 TL. I will definitely not choose this place next time.

I went through a horrible botched surgery at this hospital by Prof. Dr. Necmettin Kutlu. I am left with necrosis, ischemia, and skin ulcers. Yellow liquid does not stop coming out. I can't move, walk nor sleep. He caused a permanent damaged to my skin so I have to redo another plastic surgery to fix all those issues up. He left me with no surgical corset as he did not have my size so after healing, my skin will be wavy, I was near death and God kept me alive. Do not go there please. Besides translation team makes fun of patients. Very poisoned environment.

Literally the most frustrating experience ever. They asked me so many questions before an appointment was made and they said I was cleared and everything was set for the day they'll see me. I arrive to my appointment and was turned away and was told something completely different than what they told me on the phone. They even had the audacity to say come next week instead than we can check you. Worst place. Don't go there especially if you're a foreigner.

souls fly loose. Feeling to the like now. We flew, here forever.

Ewha women's university hispital emmergency service is the most disgusting hospital in seoul.my baby was failed from table and injured on his forehead,teeth and tounge and i went to this emmergency to check if brain trauma happened to my baby or not.but,amazingly they said first test corona but he has no any sign and they sent us to quarantine room and locked it.....waiting there longgggg time with this little baby who was hungry and sick.so am so upset and left the hospital.what kind of hospital is it?howmany time should i wait in that locked room alone?

Because this is a bigger hospital, I had a endometrial polyp removal surgery here. The male doctor (Ji Byeong Cheol) however, botched up my surgery and I continued to be in pain and bleed for months. His attitude was extremely rude and vague when asked questions and claimed I was the only patient to have issues. He then suggested we arrange an endoscopy. I decided not to go with the endoscopy with him as I already had trust issues. In the end I had to get a second surgery from another hospital four months later. It turned out my polyps were not removed and bacteria had spread inside my womb causing an infection. Hence the pain and why I had to wait a longer time to recover before I could get the second surgery. I didn't even see Ji Byeong Cheol’s face before or after my surgery nor receive any explanation and was dismissed right away, so to be honest, I don't even know whether he performed it. The worst and most traumatic experience of my life.

Large hospital in excellent condition, it gets crazy busy during the day. They definitely need more parking, elevators and pretty much everything else.

Nurse station in the department of dermatologist they have no manners when u talk to them they just watching their phone no any reply and their behavior is so rude. i experienced on 20221219 around 12 noon. i will give 0 point. And also doctor's has no experience they just remember some medicines name and prescrib those everytime no matter what problems patient have everytime they are just sale their some cosmetic products. I recommend them to open cosmetics shop instead of treats patient.

Travelled here for ankle arthroscopy from Canada and all I can say is great things about this hospital. All the staff(especially the international department) were very supportive and welcoming. Thank you for making this trip very easy for me!

I want to give a warm tribute to the incredible team at Lokman Hekim İstanbul Hastanesi, a place that exceeded all my expectations. Special thanks to Dr. Atilla Akova, my remarkable surgeon, and Dr. Selma SEZER, anesthetist, both professionals with extreme care for my life. On the 4th floor, I witnessed a level of care that goes beyond excellence. The attendants, true heroes, are available 24/7, providing continuous support and impeccable health care attention. This hospital not only treats medical conditions but demonstrates a real commitment to the holistic well-being of patients. My successful journey began with the recommendation of Sueli, a friend who also went through here. Initially apprehensive, I was enveloped in a sense of security witnessing the professionalism and care that permeate every interaction in the hospital. Special thanks to Mrs. Juliana Freitas, who facilitated the entire process with kindness. I highlight the dedicated attention to the Brazilian community on the 4th floor. The attendants, with admirable effort, seek fluent communication, including in Portuguese. The presence of an interpreter and constant support in understanding instructions create a welcoming and inclusive environment. To the attendant checking my progress and the doctor making attentive visits, my sincere thanks. The Lokman Hekim İstanbul team shows an unwavering commitment to every life under their care. I express deep gratitude for the exceptional standard of care provided by everyone in the hospital. This is more than a hospital; it is a haven of care and compassion.

I recently had a hair transplant for Lokman Hekim hospital. I travelled from Australia Melbourne. I had the help of Medeni Kaya who helps international clients. She helps with VIP transportation and 5 star accommodation. She greets with you with a warm welcoming smile the moment you walk in and is with you. She is with you for your consultation operation, follows up with everything you are untitle for. Lets not forget the doctors I’ve had many operations at different hospitals around the world but the team at Lokman Hekim Istanbul Hastanesi by far is the best i have worked with. Thank you to all the staff and doctors and special thank you to Medeni Kaya for all her help ❤️

as the translator Mona dialect was different (as arabic speaker), but her dealing with me was very good and so cooperative and helpful.. the doctors are good (yasemin kiraç/ahmet duran/aynur aliyeva)but the nurses are bad except the senior nurse on floor 0/ next to the kids room💐💐

I was coming to this hospital for a long time and Iam so happy to share my thoughts with the world. The service the doctors and also the international department team was always helpful and kind to me specially thanks to miss Sabah hassan for being such a hardworking and well spoken interpreter.

I was very satisfied with the help that the translator Ms. Mahnaz gave me during the treatment process in this hospital. She was very polite and very responsible, even when the hospital system was having trouble giving receipts, she helped me to get the payment receipt, also for other information like insurance.

Soroka University Medical Center, a part of the Clalit Health Services Group, is the general hospital of Beersheba, Israel, it serves as the central hospital of the region and provides medical services to approximately one million residents of the South, from Kiryat Gat and Ashkelon to Eilat. I am from Bhutan 🇧🇹 and they give me a grt treatment till now they are helping me recover soon.Great hospital! The staff is professional and kind.They help ma a lot🫰🏻🫰🏻I

The very best care and treatment my son could have received after being in a terrible road accident. The staff are so talented, knowledgeable and caring. Outstanding! A huge thank you to everyone involved in his nearly 7 weeks there.

Great hospital! The staff is professional and kind. They saved my grandmother (she was having a stroke). From the Esther Zarka family.

Very dirty hospital I've been seen in Israel. I told to the nurse that one of the patient sat down on the chair and left it with human dirt. But nurses ignored me. One come but instead to clean they put a sheet to cover it. So i decided to clean it because it's hard for me to breathe. Telashomer and ichilov was more recommended.

On behalf of my employers family( elyahu cohen),I would like to express my sincerest thanks and gratitude for the quality and outstanding service we recieve during our 12 days stay in the hospital. My snappiest salute and respect to the WHOLE HEALTH CARE TEAM of Building 141. From Doctors, nurses, physiotherapist,nurse aids, and auxilliaries Thank you Thank you Thank you. If only all health professionals are like them,hospitals will just like a home away from home. #Caring.#Compassionate#Competent. Once again, in philippines we say MARAMING SALAMAT!!! Thanking you all gratefully, ROLDAN ZEAN SUBIA and Elyahu Cohen Filipino Metapel Building 141

On our to a much awaited holiday on the dead sea, my mum fell and broke her hip at arrivals in Tel Aviv. She required emergency surgery. The level of care at this hospital was superb. The staff were kind, attentive and empathetic and made our week stuck in a hospital room as pleasant as it could possibly be. We want to extend another warm and heartfelt thank you to all the surgeons, doctors and especially nursing staff that took care of us a few weeks ago. You are all amazing - thank you.

Not everything is perfect like breakfast for example but secretarial staff, doctors and nurses I think are the best I've ever seen! I really recommend Dr. Kamal Khativ! A man with golden hands!

Unprofessional, paid 150 NIS for a 5 minute meeting where absolutely nothing was established, Dr. Nir Hoss seemed disengaged and just looking to finish the appointment, secretary proceeded to call me after I had finished my appointment and tell me I left without paying beacause she forgot to print the receipt. Save your money and go somewhere else.

A quality hospital with professional staff.

Staff were very unhelpful and seemed to not know what they were doing everything took way too long and was too dragged out.

They took very good care of my Special Needs daughter. Thank you How ever when my son broke his leg we were treated bad, told to check out my son daily to return for a surgery that NEVER happened, just causing more heart ship on my special needs family. One Shabbat we had to sleep in the lobby because they checked out my son after Shabbat started and there aren't wheelchair cabs running on Shabbat. Very bad treatment for my special needs family!!!

Wonderful hospital - had to visit whilst on holiday in Israel. The staff were so kind and helpful. We were seen and treatment in the emergency department within 2 hours of arrival. Highly recommend

I ended up with an unnecessary c section because of negligent and uncaring staff. Bring a midwife or doula with you to advocate for you because the staff will do what's convenient for them not what's best for you.

Even when not busy, waiting 8+ hours, no one answers questions, absolutely terrible care and service! The vital signs monitors have leads that become disconnected and alarms go off for hours and yet no one checks the monitors. Disgrace! Each time we ask the staff for help they walk by and ignore us. The nurses literally sit around laughing and joking as patients call for help. At the check in desk employees can't be bothered to look way from their phones. No interest in helping people. I am literally horrified. As someone else said, better to stay home and die than come here.

Terrible place. In emergency we was more than 4 hours, and we was alone. My wife was in condition when she can be only in horizontal position. But personal says that we can't use bed. This clinic and clalit - never again!

Because the nurses were nice enough to let me * steal* milk from the orthopedic ward? Cauae after trauma n ..stuffstuff? They knew how to get me back home. So now i go as DNR.

Your average hospital. But worse!!! Sometimes, if u get extremely lucky u won't need to wait 4+ hours for your turn, the staff are not the friendliest, it's an extremely old beat up place, nothing like I've ever seen before. The place looks and feels like it has not been renovated in maybe 3 or 4 decades As u can see in the picture below Nasty, very dirty, and not clean at all. I don't know how they are legally open🤔 I guess it's the only place available in the area. There is a mini mall practically connected to the place, so its easy access for food and other stuff like clothing and other shopping needs

Amazing hospital and stuff! I’m very satisfied with my experience in Wolfson Medical Center. First of all I wanna say that Main nurse Boris from ICU, social workers Valery and Ola are extraordinary and outstanding professionals. They are truly angels who surrounded me and my family with so much support, kindness, patience, understanding and compassion. I never experienced something like this in my life. I live in USA and work in medical field and had different experiences too, so I can tell that looking from the inside point of view, I can definitely say that these people work really hard and go above and beyond their human powers to do everything to help patients and their family. I’m writing this because I wanna share my good experience and send kind message since I feel that, a lot of people who get good experience always forgot to share positive energy and reviews. My mom was in critical condition in Intensive Care Unit and I was coming from USA to see her to say my last goodbye and was pleasantly surprised how good she was taken care of! Medical stuff let me and my family stay inside with her as long as I needed, didn’t rush me at all, always patiently answered all my questions, supported me and always was there for me. With that being said I also wanna say that everyone there knows how to do their job, and I’ve seen so much kindness and compassion from total strangers there, and I can confidently say that Wolfson Medical Center did everything possible to save my mom. I truly appreciate their help! They threat patients and their family with a lot of respect and professionalism no matter how hard people from family can be, and they always do their best to help and save patient life.

Probably the worst hospital I have ever been in! The nursing staff generally is rude and extremely unhelpful! DO NOT COME HERÈ....GOTO ANY OTHERHOSPITALlyou can...dirty and disgusting

Disgusting place. Five days at the maternity ward, room was not cleaned once. We cleaned the bed from blood and dirt. I'd call that a scandal!

I would not recommend to seek medical treatment at the Galilee Medical Centre in Nahariya. It is old, dirty and the Russian doctors & nurses are unkind & cruel. My daughter was in the covid unit so we could not visit with her, she was very poorly and was left in tears and begging for pain relief on many occasions. She was under the care of an ENT specialist who said she needed to stay in hospital until she could swallow food and drink but some of the doctors kept telling her that she shouldn’t be there and needed to go home. Thank God I could get through to the department by telephone and would be persistently calling for the staff to attend to my daughter. The area where my daughter was put only had 2 other patients, so it was not busy. The ENT specialist advised that she drink very cold water or suck ice and to eat very soft cold food like ice-cream or yogurt, she was not given anything. They took another covid test which came up positive but because it had been 5 days since her first test they discharged her from the covid unit and transferred her to the internal medicine ward for observation. The ward was very small with 4 old beds, broken equipment and the toilets were dirty with no toilet rolls, but the doctors were friendly and helpful, even though my daughter was never given the food that she asked for. The other patients in her ward had relatives staying all night so it was noisy and my daughter could get no rest with all the loud talking and videos being played out on their phones throughout the night. She had been on intravenous fluids and the doctors left the needle in her arm which caused severe bruising and was very painful. The release procedure was relatively short and we were thankful to get her home and never to return there again!

Family hospitalization: Guardian review^^ Transportation: Connected to Balsan Station subway. very convenient Procedure: As of 4 weekdays, there were not many people so there was no waiting time. Hospital: The new building is really nice. So pretty. Especially the 4th floor garden.... If you act like a guardian in a hospital room while feeling like you're in a gallery, you're bound to get depressed. I didn't feel depressed as I walked around the buildings with the patients, exercised, and looked at the pictures. Personally, it was better than when I stayed at a 5-star hotel in Seoul. ;; lol Especially at 5 o'clock? There are no people after 6 o'clock, so it's really quiet and nice. Hospital room: I've been to various hospitals and have been a guardian several times, and this is the cleanest. There isn't a single hair in the hallway!! The patient said the bed was very comfortable. Doctors, nurses, staff: in my case, they were all very kind. Convenience store: It is large and has a lot of variety, so it is very convenient. Restaurant/Cafe: Not bad. It's good because there aren't many people on the 4th weekdays. ☆☆☆Be sure to visit the 4th floor garden☆☆☆

Beautiful Hospital. FAST SERVICE. Clean and secure private rooms. State of the art facilities.

A big fan of Hospital Playlist. This is the filming location. The escalator, cafe & walkways are the exact spots. The garden & emergency area are at other locations. So dont go for wild goose chase.

Internal medicine dept מחלקת פנימי Staff barely gave me and other patient in my room attention. Room was filthy !!!! I hope I never return to this department. And ! 0nly 2 out of 5 elevators in one section of the hospital building was working !

Avoid this place if you care about your health, time and nerves. Unprofessional, filthy and show u attitude when you complain for waiting 3 hours for a 2 minute procedure. Simply terrible.

Absolutely disgusting, overall horendous people which gets worse the higher the rank of the staff. I come from a family with a background in medicine and am no stranger to hospitals and I already have a son in Holland so am familiar with the ins and outs of childbirth and a C-section. Now when my daughter was born my wife had her water break 38 weeks without going into labor. They kept trying to induce labor over and over and my wife ended up severely weakened and depressed. Only when I pointed them to their website that boasted their percentage of natural labour and put my foot down stating that my wife is not a statistic for the hospital they decided to proceed with a C-section. Now with my second son this only became a bigger joke. my wife have false labour for weeks on end she spent almost all her time going in and out of hospital because of that. through all that the decision to do a C-section at 38+5 was upheld. Also a lot of staff kept reminding her that natural birth was still a good option even though she mentioned roughly 20 times before that she was not interested. On top of that, by now Corona is a thing so children aren't allowed in the maternity ward. Well... That just depends who you really talk to because depending on who's working they really don't give a flying f#ck or start screaming at you. But meanwhile the room is covered in black mold which is apparently better than Corona and not an issue. Meanwhile they have no good solution for meeting the mother's kids except for 4 chairs outside the ward. Well I can't find any babysitter right now so we'll have to juggle who goes in and who watches my daughter. Get it together guys, your hospital and hospitality is horrendous.

The positive feeling we get when we see each staff's smiling face is indescribable. Good facility good service good interaction👌

I share my experience of yoga with aster Nurture is very nice. Our yoga instructor is very good. They teach us lots of things breathing yoga n all.. thank u aster nurture.

A memorable experience for me, my wife and our lovely baby. Nature of medical concern: Baby Delivery, pre and post experience. For context, my wife delivered our baby here but we came endorsed by other clinic once my wife was nearing her due date since her insurance converage is limited only. Having stated this, once we started coming to aster after being endorsed by our previous clinic, I could say it was a pleasant experience. The checkups were hassle free as you can make appointment through their well established system and the receptionist will guide you through. Doctor Jisha Pradeep was our assigned gynecologist who helped us throughout the process. She was well known and always recommended and I can attest as to why. However, I would like to mention also Doctor Sabitha, she was the first doctor before Doc. Jisha who also attended to my and honestly she was very nice and sincere to us. Both Doctor Jisha and Doctor Sabitha answered all our questions with sincerity and care. Additionally, our gratitude also to Doctor Thanuja who was the doctor in the ER/maternal delivery section (i hope i am right) - she was the one who attended my wife during the actual delivery. She speaks calmly, assuring and with sincerity which helps both me and my wife be at ease during a very unerving situation. Special thanks also to all the attending nurses who assisted us all the way, I made sure to get all their names to express my gratitude: Nurse Deepa, Tijii, Rincy, Anjaly, Sonia, Ajini and Tina. I would like to mention also the janitorial staff that night, Ms. Prema, she always assisted me whenever I need help opening the access doors - with a smile. Post delivery, all the staff from the Baby Unit was very courteous and caring. They will check up on my wife every now and then and give us a lot of valuable points/tips for the baby. Our thanks to Nurse Anabelle and Veena. Additionally, the birth certificate section for our baby was very helpful and concise. It was a hassle free process thanks to the assistance of Ms. Shahla. Lastly our overall gratitude to Aster Hospital Mankhool, I would like to point out the cleanliness of every corner of the hospital which is very essential. Also their overall process was seemless especially considering a lot of document works, they will help and assist you all throughout the process. Worth the mention also was the presence of water station and coffee vending machines to every areas which helped me survive throughout the night :) Did I mention that Aster Nurture department through Ms. Shiela gave us a gift package in celebration for our baby. It was an unexpected warm gesture which we really appreciate, our baby says thank you :) Overall, me and my wife recommends Aster Mankhool Hospital.

Great experience every time I do my routine follow-up with Dr. Taori and his team. Nurse Minci always ensures I am well attended and the process is smooth until I am completed, and Nurse Pinku Ann has a tender care hand when collecting blood samples especially in my case, she performs skillfully in a way I will always feel secured. Dr. Taori has been my doctor for more than 5 years who not only has outstanding knowledge of my treatment options but also provides the quality of medical care I require. He has the ability to connect so you know where you are, leaving no fear what the next steps look like. Highly recommended.

I trust this message finds you well. Im writing to express my sincere appreciation for the outstanding service and care I received during my recent visit to aster hospital Al Qusais. I had seen by Dr arun (orthopedic) he is excellent doctor a down to earth person and the level of professionalism, compassion, and efficiency exhibited by the hospital staff was truly commendable. It is apparent that the positive and supportive environment fostered by the management team plays a significant role in ensuring such high standards of care. I got a huge help from Ms Saloni Her seamless coordination among different departments, the attentiveness of the medical and administrative staff, and the overall dedication to patient wellbeing have left a lasting impression on me Dr arun and Ms Soumya (physiotherapist )Your expertise, professionalism, and compassionate approach have been instrumental in my journey toward recovery. Your ability to diagnose and explain the intricacies of my condition in a clear and supportive manner has made a significant impact on my understanding and confidence. Please accept my heartfelt thanks for outstan Service your dedication to field is commendable and I’m grateful for the pod impact you’ve on my health Special thanks to Dr arun (orthopedic) Ms soumya (physiotherapist ) Ms Saloni (patient experience department) Warm regards

I am so grateful for the excellent care that I received at your hospital. Everyone was kind, knowledgeable, and professional. The facilities were clean and modern, and I felt completely safe during my stay. I am truly thankful for all of the hard work your staff has done to provide quality care to us and our baby.

Even if you have appointment, you wait too long. This is ridiculous. Time is precious.

Visit the hospital for a dermatologist that was recommended by a family member. Transaction was smooth, the doc gave all the information I need and explained what was going on. The hospital nice an clean and looks like a 5 star hotel more than a hospital. I paid $120 for the examination and they accept cc. You need to book an appointment ahead of time. Their mobil app is a hustle and has bugs. Book through website or call them for an appointment. This is why I give them 4 stars. After you book they call you for reminder and inform you the amount you will be paying. Arrive at least 15 minutes early as the building is big you need to walk and take elevator to get the section where you will have your examination. There will be paperwork before the doc examine you.

I've consistently chosen this hospital for several years, and it consistently excels in all aspects. I particularly want to highlight the excellence of Dr. Harika Bodur Öztürk, a caring and patient-centered professional who maintains her professional boundaries impeccably. I also received the Gardasil 9 vaccine and am happy to report that I experienced no side effects. Furthermore, I highly recommend Dr. Mete Dalbeler as a dentist for his professional and efficient approach.