Hip labral tear treatment in 25 Orthopedic surgery clinics in Spain

I want to thank the surgical pavilion, second floor, for how they behaved with the patient Pilar Sánchez Moreno (room 18) until her last moments. Thank you to the doctors, nurses, assistants and all the staff, not only for their professionalism, which is impressive, but also for their humanity and empathy. WE HAVE TO THANK THEM AND APPLAUD THEM NOT ONLY IN A PANDEMIC. It's a shame we forget so soon THANK YOU BIG

I am very grateful for the treatment my father has received in the surgical ward of this hospital. All the staff have been exceptional.....this is QUALITY HEALTH! Thank you!!!

I wanted to express my enormous gratitude. to the colonoscopy and endoscopy team who worked today 09/26/23 for the treatment received by the doctor, anesthetist, and nursing staff. Etc. I wouldn't want to leave anyone without congratulating them. Thank you so much everyone

A shame from the moment you enter, I was splitting with pain, the woman who was at the reception had 0 empathy, like the nurse who treated me, I used to find more service vocation in a veterinarian. A question that came from the pain that I couldn't even stand on my feet, this woman at the reception doesn't even flinch but tells me THAT THE MASK IS MANDATORY (we're already off to a bad start) she had me for 10 minutes asking me questions, she gives me the ticket to wait for triage, The place already had 20 people waiting..... 10 minutes pass, my husband still comes to triage saying that I couldn't take any more of the pain, and to my surprise it wasn't even in the system. I wish to the nurse who treated me that I never have anyone in charge because with that empathy even a cactus dies.... a question that, thank God, I have mutually (and this should not be like this, because we all pay the price). public hospital so that it works well), I went to a clinic and they treated me in a matter of minutes. This hospital is really a shame, I imagine that these people are oppositional, so they would have to review the requirements to give them employment.

We have been able to inaugurate all the new infrastructure of the hospital, just on October 9 in a far from easy operation. No complaints! Thank you all!! They take care of us, they pamper us. Cheer up, you are doing very well and we need you. A thousand thanks 🫂 to all the hospital staff, to everyone without exceptions. PUBLIC HEALTH ALWAYS ♾️

Yesterday I was with my daughter for an ultrasound in the mother's unit, room S-17. My appointment was at 11:48. I was treated by an excellent professional. I was greatly surprised by his professionalism, empathy, and gratitude for his treatment of my daughter. Same as nurses and other professionals. This is the real reason for being doctors to put themselves in the patient's shoes. I don't know what the doctor's name was, thank you for being such a great professional. !!!!Thank you so much!!!!.

Super

Excellent care by the cardiologist and the ancillary staff. Very professional, knowledgeable and humane. Up to date equipment and facilities.

For foreigners, a real ripoff. I came in with a trivial problem, they did the trivial thing, and charged me 400 euros for something that is not even worth 150. I would have paid less than 150 in Switzerland, where I come from. They just took advantage of me being in pain during my holidays and coming to them with foreign insurance. A shameless ripoff.

The hospital itself seems to be good, they have all the machines in place. When I was hospitalized the communication wasn’t good (and I don’t mean the language). Treatment plan was changing couple of times per day and I wasn’t updated. I also wasn’t informed what kind of medical tests I would get. The stuff wasn’t informed too. E.g. I got a breakfast served before the test that required me to be on an empty stomach. And it happened several times. Prices are twice or triple higher than in other hospitals. I came via emergency and directly was hospitalized. Despite after one day it was clear that my condition doesn’t require me to be in the hospital 24 hours, I was still not allowed to leave it and supposed to just wait for 2 days for test results in the hospital. I assume it wasn’t made to keep me safe but rather to capture more money from my insurance. I left voluntarily until test results are available. Also, when I came back for treatment I was charged €3000 deposit that I was promised to be back after the insurance confirms they would pay the bill. Even though insurance confirmed, I haven’t received the deposit until the bill is fully paid. (I am still waiting. 3 months passed)

I had been going to Quiron since the beginning of my pregnancy and I always had the best care and support from all the gynes and OBs. Once i went into labour, all the Midwives and actually all staff on the maternity floor were extremely supportive too. The labour room and maternity ward are amazing. I unfortunately had a complicated birth but I am extremely greatful me and my baby were in the caring and professional hands of Dra.Blanco 🙏 and the rest of the team in Quiron. My husband was allowed in the operating room with me during my emergency C Section which isn't usual for Spanish hospitals. Overall I am so happy we decided to have our first born baby at this hospital and would recommend them to anyone and everyone. Thank you Quiron team 💙

They cancel appointments you have done months earlier, book multiple patients at the same time, which results in that even if you think you are the first one and have no waiting time, of course you are not the first one and have unknown waiting time. And to add to tje charm they charge you in advance, so even if you have/want to leave you cant without losing your money. My advice, and what i will do going forward is STEER AWAY FROM THIS PLACE .

A veery good hospital.. And the doctor speak English

Awful hospital and ER! I came in at about 3 AM as a foreigner (EU citizen) in need of some antibiotics as I had forgotten to bring them with me on vacation in Madrid. Despite not even being close to being overfilled, the average wait time for this ER was about 4 hours, or even more. I sat there alongside a woman whimpering and crying out in pain, an old lady struggling to breathe, etc. - Sick people having to resort to sleep on uncomfortable old chairs and not in the slightest paid any attention to! Kind of dehumanizing, to be perfectly honest. Thank God I did not have something actually more serious. After about an hour, the nurse came to the waiting area to check on me. Two hours have gone by and I was getting impatient. Nurses told me they had alerted the doctor. Another hour goes by, still no doctor in sight. At that point, we were all sitting there waiting for the paint on the wall to dry. Finally, at about 6:30 AM (!!!) a doctor came to fill my prescription. Yet it was not until about 7 AM that I could finally go home. The others still had to wait… Never go to the ER of this hospital unless you like to be ignored. Or if you like to look at the sunrise even though you went to the hospital in the middle of the night for antibiotics. Such a shame…

Was passed around to 5 different nurses (only one of which seemed to care) over a 6 hour wait time, all to eventually be told that nothing was wrong with me despite having near-crippling abdomen pain and the only solution offered was more painkillers. Still trying to determine my ailment but I'm horrified at the "oh well good luck" attitude many of the staff have. If 0 stars were possible that's what I'd be giving here

The surgery area and staff were great, the room was clean, and the doctor and nurses were very efficient. The rest of the ground floor public area was dirty, especially the toilets, where there was no toilet paper and no hand drying facilities. There was no hand sanitiser throughout.

Went after a hart attack and needed a triple bypass. Everthing was no problem and staff very frendly three days of tests opration on the fourth taken home by amblance a few days later. Would highly recomend if your are having a hart attack.

Great experience with the oncology department at Hospital Del Vinalopo. I was diagnosed with a breast cancer by Dr Lucia Hernandez Sanchez who was sensitive and knowledgeable. The surgery went well and appears to have been successful. All the support staff was very helpful and professional. They ensured I had a smooth preparation for a surgery. I appreciate that my oncologist, Dr Pablo Salches Ortiz, not only speaks English language but also listens to my concerns, taking time to go over the diagnosis and treatment options clearly. I felt comfortable and relaxed throughout all my treatment. I would highly recommend this hospital.

Top notch emergency facility.

We been in hospital for over 4 years and we are verry happy and satisfied with everything the doctors the nurses the ladys who are cleanining we are like a family but ,is a big But ,in San ildelfonso the chair for familly to sleep over the night need urgent change.is impossible to sleep.we have back pain, legs pain, over so many days in hospital is hard for us to rest .please help us ,on behave of familys

Before the reform this hospital was so unnerving that it looked like it came out of a horror film. After the reform it is much more colourful and has much more life. From what I have seen kids are way less scared of going to the hospital thanks to the reform. My only complaint is that with all the paintings navigating it has gotten a bit annoying. Overall if I had to take any children to do anything at a hospital near me this would be my first pick.

Not as professional and friendly as they promote, all about earning money from you or your insurance but with very little care or treatment. All year with appointments and specialist for cancer an tumours ,scan after scan but not any diagnosis or treatment and suffering with swollen eye, colour change, nose and cheek burning pain and insane pressure on head and face but still no help , even though colour change on scan for my rights side of brain , cyst inside my face and gigantic problem at the back of my head and they say no problem and haven’t operated or treated. I hope I’m not dying but still don’t have any diagnosis or confirmation of anything.Now thinking I need to go to another country for help ? Wouldn’t recommend to nobody?? They won’t do anything about these reviews and even give the same answer to each person.

Avoid this hospital! I had to visit the hospital because of a sinus infection, but was rushed into several entirely useless procedures just to hike up the bill. The whole experience was horrible with unfriendly and rude staff. However, the worst part was that a nurse stole 340 euros from my purse in my handbag that I left in the examination room with the nurse when I was pushed into a toilet for another useless test. The hospital operations reeks of scamming people in every possible way. Despicable behaviour preying on people in a vulnerable situation.

Avoid this hospital My husband was admitted to this hospital in 2021, 2022 and 2 days ago. In 2021 I visited him on a Sunday, and he was on the floor (with a broken leg) trying to get onto the sofa, to get out of the window as he was hallucinating. He was on the second floor! The window was then closed and locked but no-one had noticed my husband on the floor, which is a worry. I then had to push for a brain scan, which, according to Xanit showed nothing abnormal. He has now been diagnosed with dementia at Guadalhorce hospital, so I chose to go private again to make things happen faster. We saw a neurologist at Xanit who said he should be hospitalised. When we arrived at the hospital it took over 20 minutes to park as the car park was full, then when we got to reception there were almost 35 people in front of us. We were over an hour late to get to our appointment and then the computers went down!!! We had to go down to Urgencias to be admitted. They told me he had to go to a hospital in Malaga. I then had to go back to the neurologist, as Urgencias refused to call him, and he told them to admit my husband. There was an amazing lack of communication, and the girl who was in triage was basically rude. We were then subjected to a 2/3 hour wait, then taken to a surgical ward where the nurses all moaned about the fact he was being taken into this hospital. I speak and understand Spanish so was very aware of the things being said and I am absolutely horrified at how we were treated. He was hospitalised on Wednesday, and we were told he would get an MRI and CT scan. My husband was aggressive, and I was told I had to stay with him 24/7. This is not why I’m paying private health insurance. I was told there are insufficient nurses to deal with all the patients they have, so I had to stay. The MRI and CT scan didn’t happen as the machine had broken down!!! My husband was very agitated, and the neurologist and I agreed he would be better at home. Therefore, we had to make an appointment for the MRI and CT scan (29th November) I waited over an hour to make this appointment, while my husband was in his hospital room. There were 6 people in front of me, and one person in reception, who decided to deal with people who jumped the queue and one friend (I think Fran was his name). Reception staff are awful and provide terrible customer service. They wander away on their phones when they feel like it and don’t appreciate that people visiting the hospital may be dealing with life and death situations. They are abysmal and need training. I see from these reviews this has been going on for over a year, so I’m not sure if my comments will make any difference at all. Absolutely shocking service. On a brighter note, when you actually get to see a specialist, they are amazing.

We went to Teknon for the birth of my son. I can't say good enough things. The reception was friendly and helpful, the doctors, midwives, and nurses were all so nice and helping. All the doctors and midwives and some of the nurses spoke very good English with us. Even the ones who couldn't, tried their best to communicate effectively. The hospitality was very good, we received nice accommodation and great food. After birth, our son needed to be admitted to the ICU, and they took very good care of him there. When being discharged, they helped us by providing all kinds of useful information and even offered us their phone number to ask our questions later. They also gave us gift boxes and many extra diapers, baby milk, etc.

Performance, quality, professional care and human treatment. In Dep. 121-122 Traumatologia there are the best Doctors you can imagine. Behalf myself I have the best!! expirience with Dr. Casañas and Dr. Pedrero who did a real, real great job giving me a new artificial knee a few dayus ago. Thank you very, very much! greetings from Herbert

I've tried to book an appointment for a general medical check-up, in multiple occasions, both using the form on the website and calling to the phone on the website. On the phone, I provided all my contact information again, and the company told me that they were an intermediary and that the Teknon Medical Center will call me back. They never called me back nor sent me an email. What do you do with the information that you collect if you don't contact the people, at least to tell them that you can't offer them an appointment?

The best hospital in Madrid! I recently had a complex surgery and everything was impecable!

The immunology team made up of Dr. Sánchez Ramon and Dr. Navarro is great. They took good care of me throughout my pregnancy and thanks to them I was able to have my baby a year ago. They have always treated me very well, even by email at times when I was worried about the results of the analysis. I have nothing but words of gratitude for them. They are the best without a doubt.

Great quality care.

Covid PCR test for 98€. Booked the appointment online. However, my foreign credit cards didn't work (had to ask a Spanish friend). Furthermore, I had to set the browser language to Spanish, as else the date picker didn't work. I suggest you just go to the clinic directly and make the appointment there. Getting the test was super easy, fast and punctual. Just sit in the lobby until your name gets called at your scheduled time.

I would recommend to avoid this hospital by any chance. I had very unpleasant experience when I booked my PCR test and then tried to cancel it within 24 hours. The receptionist said that it is possible to cancel, but the Finance department refused to reimburse my EUR 98 despite I was cancelling within 24 hours. As a customer I have a right to change my mind within 24 hours and to be reimbursed. However the Finance Department has ignored this and do not reply on my emails where I ask contacts of the Manager to discuss this issue. This is very unprofessional attitude and I'm very dissapointed. Hospital Quironsalud, I'm still waiting for the compensation - EUR 98. Regards,

Personnel unhelpful, rude and specially not patient with kids (in the pediatrician area). I asked questions as a worried mum, and they gave me rude answers, they treated my 2 yo son with zero patience whilst he was having 3 tests done. They didn't explain anything, and did things in a rush and completely uninterested. - will not recommend this place

Very good hospital with excellent services

Everything takes a lot of time. But overall this hospital is amazing. 1 kidney stone takes 4 months to remove. The employees, cleanliness, equipments are really good.

Terrible experience! I have been waiting with my friend, who we suspect had a stroke, for more than 3 and a half hours and all the doctors and nurses have been rude and useless. They have done the same test 3 times, and still not come back with the results from the blood test or urine test they did 3 hours ago. I am not a doctors but I am pretty sure she should have had a scan by now, and if this was a pre stroke we are essentially just waiting for the real one. Doctors are meant to help people not stress them out and watch Netflix while someone thinks they might be dying. PS. We only got a bottle of water after 2 hours even though we already asked in the ambulance.

Every time we went there, it was fantastic. The only problem is that no one can speak English there. Especially in the reception section. I think for a hospital with a lot of international patients, it's necessary to have at least one person in each reception who knows English

Excellent service!

Dr Victor Villalobos (Obstetricia y Ginecologia) has been wonderful at our first meeting. He has been kind and patient in answering our questions and we felt very relieved to know that he would be looking after the delivery of my baby. We look forward to seeing him again in my next appointment and we are thankful to have such a professional care provider!

My husband underwent surgery at this hospital. Superb vascular surgeon of world renown, hence going to Spain. Excellent surgery/surgical results and immediate post op care (first few hours) but thereafter care was appalling, too few nurses, alarm calls very slow to answer, food absolutely disgusting (almost inedible), private room not cleaned daily, towels/sheets not changed. Had to beg for sheets to be changed due to blood leakage from a drain and then had to wait and wait. Wanted more soap for the bathroom and was told the hospital had no soap! Administration is very sloppy and disorganised and manager ineffective despite complaining about the poor service. Only interested in taking the money asap. For self funding private patients I would never recommend this hospital (not even worthy of the one star I had to give). Bar the successful surgery and a very fine surgeon, it was dreadful and I would not want any patient to be treated as my husband (who is a retired UK consultant surgeon) was; it was a disgrace and way below the standard of UK private hospitals.

If I could give it a zero star I would. The client service is beyond bad, there is horrible management and is incredibly disorganised. I spend 2 hours in the building being bounced from floor to floor, department to department. All this to no avail. Furthermore, they scheduled a vaccine appointment for me to the 8th of August. When I arrived, I spent yet another hour in the building being bounced from floor to floor. Only to the be told the department that does vaccines is closed today. SO THEN WHY DID YOU SCHEDULE ME AN APPOINTMENT FOR TODAY. No one takes accountability, everyone shifts blame and no one ever has answers.

As someone who's Spanish is a bit limited, huge thanks to the two lovely receptionist's. They were able to give invaluable help, especially sorting out issues I had with DKV.

It's unfortunate, this already seems like social security and even worse!!! I've been here in the emergency room for THREE hours and I'm still waiting....with my back hooked and with horrible pain as they tell me that this is in order of severity...what a mess...well for me it is mine is urgent of course and painful!!! The lack of health personnel and the delays that make patients suffer is a shame!!!! Why do we pay private insurance???? To receive this terrible medical care!!!! It really is sad!!!

Private hospital where you arrive at the emergency room and wait 3 hours to be treated because they only have 3 doctors! And to have an ultrasound it took them more than a month to make an appointment and since they had to change it until January they don't have time... It's a shame to pay private insurance for this. Disaster of organization and way of managing this hospital. The people who work there are charming and professional, it's a shame that they have to work for such a poorly run center.

Unpunctuality and poor patient care. I give one star, not because of the doctor's treatment, but because of the lack of professionalism of those who manage the appointments. It seems to me that, in addition to underestimating the time of those of us who have to suffer the delay of consultations, they try to make us look like fools, making whoever they want go first. The least they could do is give a ticket upon entering to assign a shift, as in other services at the same center. I don't understand how they don't know how to report how long they estimate the wait will be, or at least how many patients are ahead.

Cardiology sent me to ER for a heart issue (atrial flutter). Dr. Garabetyan totally ignored that, and ended up fabricating a non-existent pneumonia. She then IV’ed a fluoroquinolone (floxed me) w/o my knowledge or consent. I now have permanent disability (FQAD), which includes peripheral and small fiber neuropathy, tendinopathy, vitreous detachment (floater) and myriad other disorders and symptoms. Nobody cares, they gaslight you. Be careful.

I visited emergency room in this hospital. Had an acute abdominal pain. I do not speak Spanish well and was afraid of misunderstanding but all hospital staff, physicians and nurses, were very polite and tried to speak with me in English. Also all analysis, CT and medicines were done in a timely manner. Finally, I went home with required treatment. Thank you All!

Thank you very much for safe my life, ZABALETA CARVAJAL, IVAN ANDRES🙏🧚🏻‍♂️and hospital very nice clean comfortable convenient

The new rooms in the new area of the hospital are nice, clean and modern, but the old rooms in the old part of the hospital need to be refurbished, they do not live up to the hospital standards. The food was very basic, not much flavor and for the price of a day stay in the hospital the food should be better quality, taste better and have options on what you would like to have. They also need to improve the wifi/phone signal because nor the wifi nor the internet from my mobile phone provider worked in my room. The television only had Spanish channels and for a high quality hospital one should have international channels in English and other languages. The personal attention was great, the nurses and doctor where amazing. They took excellent care of me.

Had a surgery here and it went very well, staff were working with upmost care and respect. Compared to most hospitals in the US where I'm from, this one deserves 5 stars for the quality and value.

Terrible hospital. The staff are very unfriendly, and if you struggle to speak Spanish they will not put any effort in to try help you in English. I have been there twice in the past 4 weeks for the same issue and the doctor always just prescribes ibeprufon when it’s clear my situation has gotten worse. They also don’t have any equipment, he used his iPhone as a torch and put a pencil in a latex glove and used that to push my tongue down to examine my throat. Completely pathetic the service one gets from this “private” hospital.

I booked an appointment via their online platform with the Diagnostica d’imatge department, because I needed to take a MRI exam for my leg. In the online platform I uploaded my traumatology doctor’s referral where it says I should have two MRI exams taken, one in a rested state and another one after running for 20 minutes to see the difference in my muscle. I even sent the referral via email to the Diagnostica d’imatge department in order to make sure they knew about the fact that I need to make two exams and not only one. They didn’t answer to that email even though I asked for confirmation of receipt. I had no luck reaching the right department via telephone because I don’t speak Spanish or Catalan so well so I gave up on trying to get a confirmation that way. Anway, when I arrived on the day of my appointment, the secretary in the Diagnostica d'imatge department told me that I should have booked two appointments instead of one and it was a problem, but she will try her best to find a solution. I was afraid because I came to Barcelona only for this appointment (I live 3 hours away from the city). After waiting for around 20 minutes the secretary (her name was Andrea, I think) called me and confirmed that I can take the two exams one after the other right away! Eventually everything turned out well and the staff was super friendly, even when I only spoke English. Big thank you again Andrea you saved my day!! :)

Excellent service . Professional doctores and they take care of their patients in a very human way

Im calling all day to cancel an appointment with traumatology, no answer all day, it's been always like that i have to keep calling for hours maybe they pick up the phone, but today no one pick up the phone.

I had to attend the oftalmología urgencias department and the four staff present treated me fantastically. This was on Saturday October 7, and they were busy all day. I had lots of tests and was given an appointment to return on Monday to the main department for a revision. Spain really has the best public care in the world, I'm sure of it. Muchas gracias.

The urgent care facility is dirty, poorly organized. The staff engages in unsanitary practices: trash receptacles-including those that take hazardous waste are left uncovered, and you often see trash littering the floor around the trash cans. Also, multiple patients are asked to sit and lie on the same paper covering on the examining tables. I saw this in multiple examining rooms. The doctor who cared for me, Manuel Luis Gomez Blanco, was rude, impatient and haughty. He tried to dismiss me after treating me for only one of the ailments I came for. It was a very unpleasant experience, but I was able to get the treatment I sought. I just should not have had to deal with such an unprofessional environment and uncaring treatment by staff. I am fortunate my ailments were not life threatening.

I didn’t even want to give you a star. First this La Paz hospital is not friendly to English speaking patients. For international tourists or expats! You will die here . I brought my daughter to their ER. She was having shortness of breath..due to her asthma exacerbation. they made us wait for 3 hours but no treatment given nor tests done. Horrible private hospital. I went to see the doctor to tell her that my daughter needs to be nebulized. Instead of talking to me properly. They sent me out because none of them speaks English and they said wait to be called ! For 3 hours of waiting nobody gave my child management nor diagnostic procedure ! They didn’t care as to what I was pleading for . i will complain to Adeslas my health insurance and will make a report on this . I’m a dermatologist and a medical journalist from the philippines. I know the management to asthma very well. Their doctors/ nurses are all rude and with no empathy to patients. They should have. English speaking representative for the tourists coming to Spain. It’s pathetic that they have no treatment .-

I am shocked at how mediocre and overrated this nationally famous clinic is. Even as an international, self-paying client my appointments in late 2022 were continually mixed up and, worse still, the 3 weeks of extensive diagnoses were inconclusive and they recommended cortisone for the pains throughout my body, claiming there was no alternative to this treatment. My pains steadily increased and at one stage I could no longer get out of bed without help. I finally visited a microbiologist in Hamburg who correctly diagnosed the cause, and with a simple change of diet I was pain-free within a week!. I am now completely off cortisone.

The worst childbirth that you could imagine! Unfortunately, we chose this clinic for childbirth. At the 39th week Dra. Laura Muñoz Saá said me, that labor induction was needed. Although we did not agree with this, but we trusted her words that everything will be fine and that it is better for me and child. The doctor assured only about the advantages of induction of labor. However, there was not a word about complications and possible consequences. Although everything was written in the informed consent. After the start of induction, irregular labor began (opening from 2 cm to 10 cm per hour). I screamed from pain and begged for pain relief due to excruciating pain. Everyone just said that I should breathe, and I will never forget the words of the anesthesiologist who came to install epidural anesthesia. He said "all women give birth, what do you mean you can't sit down for 2 minutes?" In those moments, I prayed that it would end soon and barely sat through those 2 minutes of hellish pain. After the examination, the doctor on shift told that the cervix was already fully dilated and the child was in distress. I was told that a caesarean section should be performed immediately. To go through hellish pain so that it ends with an operation is not the worst. The worst thing is when they start making an incision, and you say that you feel pain, just pain, and not the feeling that something is being done. In response from the anesthesiologist, I heard "don't make it up, you can't feel pain." No one but me will understand the torments that I went through and that left a mark on my heart forever. The most beautiful day of my life became one of the worst for me due to excruciating pain and a feeling of helplessness. When you beg for pain relief, which they still think about giving you or not, because they don't believe that you can feel such unbearable pain. The only thing that was at the highest level was the help of the nurses and the matrons with the child. Thank you very much for your work and help!

My parents have been getting treatment at this place since 2018 and since it's doors first openend then, the customer service and quality has gone down by a lot. They are taking on too many people and they are loosing sight of what matters most: the patient and their family. I lost my father recently and I am sure that his doctors at the CUN could have looked after their patient more in detail rather than making us wait for hours sometimes and the most difficult part was for my dad or me to get a hold of his doctors. The ER room service is also basically non existent. I will never use that Clinic again. Great doctors, latest Tecno but not attention to detail and bad administration.