Arthroscopic shoulder remplissage procedure in 775 Orthopedic surgery clinics worldwide

I don't know where to start from,I had a fall on Oct 7 2023 and ambulance took me to ED,I was attended fast and though I was high with green whistle but I can still say all the staff who attended me was very supportive. Mind it I never been to hospital in my full life. After I came out of theatre, I moved to orthopedic ward,some ward5 ..sorry don't exactly remember, but the Nursing staff there was so helpful and supportive they really tried there best,they talk positive they listen you ,understand you and took care of your dignity and privacy,after a week I moved to.plastic OMG the Nursing staff there was like an angles sorry I can't name anyone as they all were the best including an Asian uni student.what a great level of skills and patience the staff have.thank you very much all doctors and nursing staff to fix me up and taking a great care of me.will surely visit in person to pay my gratitude and to say thanks to all once am completely recovered. Wish you all a very merry x mas and a happy new year. Regards

You've been fantastic! Your positive attitude and kindness reassured my family that I was being looked after, and throughout my stay I felt I was in good hands. I am now feeling stronger, and I am feeling much more hopeful about my recovery. Kind regards, Saba

We were ask to attend for an elective planned surgery. This is a second procedure follow on from the first. The 1st admission process was smooth with minor hiccups that we overlooked because we were happy with the surgical outcome. The second procedure we were aware that we might be the 3rd listed for surgery. We were advised to attend for pre-admission procedure at 6.30 am. We did as we were told. The nurse advised us that we might be called in at 1130hrs to get ready to be taken to theatre. We waited, waited and waited and no call for theatre or a decency of an update on the delay. We attend RMH at the surgeon request which we know is best with the expert in the field here. We attended as private patient in a public system. We don't have any problem with that arrangement either. But someone who is highly anxious with heighten anxiety and a delay such as this is entirely unacceptable. It further exacerbated with such appalling poor communication. Providing the best health care does not stop at surgical outcome alone, but how the patient and the family made to feel the entire experience will be what constitutes best health care. I don't know this is a result of poor training where empathy is out of the window or complete complacency of the public system. If one were to admit to ED, with no bed within 4 hours will be a red flag. Not until we approached the reception staff we received an update. What has been a good encounter is tarnish by such lack of attention to basic courtesy of good communication. Very disappointing today.

I hade a spine surgery 2 days ago. Thank you Dr Barnes a fantastic job. and Dr Graham .thanks all hard working nurses, they are very friendly, and always look after me. It was absolutely 5 stars

Excellent service and very satisfactory! I had an open heart surgery here and I feel like home . Everyone who works there take good care of me and always there when needed. Thank you for your service ❤️

Had hip replacement surgery and Mercy made it an absolutely top experience. Thanks so much to the nurses, surgery team, physio, caterers, cleaners. Everyone made the procedure as painless as possible.

Got seen very fast for a simple broken ankle. All the staff were super nice and professional. Couldn't have gone better. Other than the broken bone part.

Absolutely amazing staff. Every single one of them. The nurses are wonderful especially Sheridan or Sheri as we called her. She is one of the best nurses I dealt with. Sharon is also a wonderful nurse. The surgeon Dr Segar is the best around and the anaesthetist as well. The best hospital I've stayed in. Big rooms, great food and lovely staff.

I went To this facility. For A asthma attack that was Induced by A infection The wait time was very long though. This is understandable as they were Short-staffed. The nurses were lovely. And took good care of us. The issue I came across. Was the doctor? At this point I had been Coughing to the point of not being able to breathe and almost throwing up for 2, maybe 3. Hours The nurses moved me to a room by myself so I wouldn't disturb. Other patients? But when the doctor finally arrived. She looked at me with a raised eyebrow. And accuse me of faking it. I was In shock Not 5 minutes into talking to the doctor. She says "Your coughing has picked up a lot since I came here." She called it convenient. She sat there looking at me not giving me Instructions But she did give me a asthma inhaler. Something a nurse had already done. She proceeded to interrogate me. And ask me what I was trying to skip out on. This was because I had asked for a medical notice To give to my strict school. This blatant disrespect completely ruined The experience I was already exhausted from a being late. And having coughing fits every 5 seconds. And then I had to deal with that. To be honest, it seems like a decent facility. I think I just got unlucky with either a too tired or too unprofessional doctor.

ER is terrible! Unprofessional doctor with zero ethics.

Actually I don’t l know what to say because honestly we still can not believe what happened, my mom had an eye surgery 6 months ago more or less ( ophthalmology department) and she went more that once to follow up with her ophthalmologist on her case and the feedback was her surgery went good and she was ok and no need any more to follow up, meanwhile she was very sick nowadays and she went for a checkup on her eye and suddenly doctor saying that stitches still inside the eyes and the new doctor in the same ophthalmology department in the same international medical center removed 2 from the stitches and said that was the previous doctor mistake because he didn’t follow up correctly on his case and didn’t remover the stitches and after all mom is very very sick and she needs laser sessions to feel better. She very old and is feeling sick for what happened and we don’t know how to report or how to escalate honestly.

Radiotherapy section is clean. Very polite, friendly and responsive staff. Scheduled time for the session is accurate you come as per your schedule you start the radiotherapy session right away. Very clean dressing rooms to dress in the medical gown. You pay EGP 10 at the car entrance gates. Parking is available. Very clean bathrooms.

A bad nurses behavior even not a smile, not organized at all and in several departments which i deal with, as for the out patients clinics, internal admissions process- their policies are not clear- tr wrong directions as a patient you do not know your responsibilities , or your right they do not gave any medical expectations or procedural- by the way i did a surgery and this is another story to told- for nursing which is a disaster- as a one day surgery- the nurse came holding in her hand all of medications and stuff for doing blood analysis without a tray or gloves - for the operation procedure normally in any respecting hospitals- they always gave scrub - the nurse came at my room which had the number 124 - through the scrub ( in a package which a least something good) on the trash can and told to wear this ?! My way to the operation room is another comic story of none nursing medical procedure behavior- very bad experience- not recommend

Saudi German hospital is like a Chinese car which looks good on the outside and hollow on the inside. Orthopedic doctors are seemingly one of the worse departments in Cairo hospitals, very low standards, although the mighty tone, over confidence, ignorance is spread like soft butter on a toast. Not recommended unless you wanna stay in a hotel like hospital but with butchers as your medics.

I lost my grandpa who was the closest person to me in the ER, doctors are oblivious and ignorant, online it says to admit people with aneurysms to an OR asap yet my grandpa was in the ER for three hours and died there, i saw the doctors walking around fast having phone calls,what looked like they were freaking out because there is no surgeon or an available OR. Its so bad to lose someone like this. I am not mad at the hospital only but at this country. We paid 12k after with insurance covering 40%, so it’s about 20k. They spent one hour doing blood tests and another trying to measure his blood pressure because they didn’t trust their equipment, basically i can say if you have any serious emergency don’t go there, unless you don’t care about coming out. A side note google maps shouldn’t be where we post hospital reviews. But what can we do anyway in this country. It’s a lost cause.

As an Amerivan medical professional, I was in need of Emergency services. I had visited this hospital in the past so I chose to come here. Ultimately, I was admitted for surgery, which was scary being in foreign facility. But let me tell you something, the staff are AMAZING here. They ensured all my needs were met at all times, and even took the time to answer all my questions. Most do speak English.. The building is clean and the rooms are nice. A complete surprise was the food, it was high quality traditional Egyptian meals. I will recommend this facility to any family or friends who come to visit. I want to thank all the staff who cared for me, you truly are amazing people. May God bless your lives abundantly.

Excellent hospital service and quality

No time respect at all

I would like to recognize Dr. Shahenda Ahmed from outpatient Pharmacy team as she is a very supportive person and putting the patient satisfaction as her first priority! She also made sure to educate me very well about the medicines and answered all of my uncountable queries with patience🥰

Eng mahmoud zahran I want to thank all the staff nursing and housekeeping administration Doctor's as well for caring and medication Dr walid kamal icu in charge and thanks for al Salam hospital

My name is Carmen Felicita Figueroa and I was in the  hospital from  August 10, 2023 through August 13, 2023.  The nurse Esraa Adel make me feel like her family in my stayed at hospital. Her care for patients are outstanding and her blessings hands can’t feel the needles at all.  Her charismatic is beyond excellence. I recommend her for any hospital in the globe.

Thank you for taking care of me for about 2 months due to knee surgery. I waited about a year and a half for the surgery to be performed by Dr. K. Fuji, an excellent doctor. Ever since he was broadcast on TV Tokyo's Cambria Palace, he has become a famous doctor among knee patients and is known for his very careful surgeries. I am very satisfied with the results. This hospital also seems to be famous for its rehabilitation department, and I received encouragement both physically and mentally. In particular, Mr. Yada, who works in the rehabilitation room of a general hospital, is very good at the treatment, and there were complimentary comments on Ameblo.

In mid-May of last year, I was admitted to the hospital for a complete removal of breast cancer by a breast surgeon, and I received great care. Although I live in the prefecture, I initially planned to have the surgery performed at a nearby university hospital. but… I couldn't find the doctor in charge, and while I was researching various surgical methods, I realized that the breast surgery at Kameda Hospital was an endoscopic surgery, and most of all, when I asked for a second opinion, the cancer consultation center I decided to have the surgery at this hospital because of the personality of Dr. Fukuma, the nurse in charge of breast surgery and the chief breast surgeon. I am very grateful to Dr. Fukuma and other outpatient nurses at Kamogawa for their help. I had to see Dr. Fukuma several times because the surgery was far away, but even though he was tired from seeing dozens of patients a day from the beginning, he continued to talk to me late into the night in detail about the condition of the disease and the surgical procedure. Even when I was hospitalized, he came to my room until late at night. Thank you for treating me in such a friendly and calm manner when I was really anxious and scared. Even though I didn't know much about cancer, she taught me a lot of things, and even though I wasted a lot of time, the detailed explanations made me feel at ease. I made an unreasonable request to have the first surgery done early in the morning, but I was able to have the surgery done before the doctor's appointment, so I am truly grateful to the doctor. Unfortunately, I was not able to see the doctor perform the surgery because I was under general anesthesia. (lol) The reason I chose Kameda Hospital was not only because of the endoscopic surgery, but also because there were many different doctors there, and I was able to call and talk to the nurses several times before the surgery, which made me feel at ease. It was my first time being hospitalized after getting sick, but the food was delicious, and I was able to enjoy the view of the Pacific Ocean, swallows, and surfers, which made me feel better after the surgery. In particular, there is a beauty salon in the women's ward, and I felt comfortable in the private rooms that required reservations. I would like to thank Dr. Fukuma, nurse Kawana-san, and Yoshida-san from the consultation center for their help. Cancer requires long treatment even after surgery, and for those who are considering treatment, there are Kameda Hospital in Kamogawa, Makuhari, and Kyobashi in Tokyo, so if you can commute, you may want to consider it...Also, before surgery In addition to MRI, there are excellent tests such as PET-CT. I am really glad that I had the surgery at this hospital. It seems that no one person has the same symptoms of breast cancer, so the surgical method and post-operative treatment will vary depending on the person, and the treatment will last several years, so please choose the hospital that suits you without regrets. I am currently undergoing post-surgical treatment and am indebted to Dr. Nashimoto, who also performed the same surgery on me. Dr. Nashimoto gave me a detailed explanation of the surgery and reconstruction before the surgery, which made me feel at ease. Thank you very much for your kind explanation even though you were tired until late at night. One year has passed safely, so I would like to write this to express my gratitude.

Very nice hospital with top surgeons and friendly nurses. The rooms are nice and some have a swell view of the ocean. There are busses that run from the hospital to various places in Chiba and Tokyo.

I use it regularly for obstetric examinations. Personally, I am satisfied with the male doctor's treatment and explanations. I get the feeling that the female doctor is irritated because she's in pain and doesn't seem to have any time to spare. Many of the midwives are overbearing, and the nurses are unfriendly and cold, so I hate every visit. Even if there's something you don't understand, you don't feel like you can ask for advice. Even if I could do the job, I don't think I'd be a good person.

I was admitted to the hospital to undergo surgery at an otorhinolaryngology department, but I felt uneasy about the quality of the nursing care (cooperation, response, and skill), so I canceled the surgery and was discharged the next day after admission. I have been hospitalized and had surgeries at other hospitals several times, but this is the first time in my life that I have felt so anxious at a hospital. As a result, I was only hospitalized for one day, but I had to pay a hospitalization fee of just under 60,000 yen. When I got home and looked at the bill, I was surprised to find that the bill included several ear medications that I was not prescribed to take after the surgery. It ended up being a waste of time and money as it didn't cure my illness. However, I have no choice but to undergo surgery at a hospital like this and entrust myself to a nurse who is difficult to trust. There were some things I was worried about before the surgery, so I asked her about it over and over again, but she always said, "It's okay." I had no idea what was okay. Finally, he said, "Do you care?" I ask because I care and I'm worried. I understand that you are busy, but I think you should give a thorough explanation and take appropriate measures as soon as possible, even if it is a hassle. I would like to ask you to remove any peeling nail polish before you start work. I seriously doubt its reputation as the ``best hospital in Chugoku and Shikoku.'' I can't help but wonder if that was a long time ago and things are different now. As for ward nursing, I once again thought that a large national or prefectural hospital would be better. *The photo was taken the day after I was discharged from the hospital.

A 5-month-old baby fell off a chair and had a swollen head and went to the emergency department at night. I was asked to fill out a medical questionnaire and when I went to hand it over, I was told to wait until they would call, so I was unable to receive it. However, when I told her that my baby had hit her head and was crying and that I wanted to speak to a nurse as soon as possible, the person at the reception desk said there were a lot of people around, as I saw around her. One point tension. There is a triage room, but it takes an hour and a half until you are called there. What is triage? Isn't it for determining priorities? I ended up waiting two and a half hours to see the doctor. I don't want to go there again.

A beautiful hospital in a beautiful city Padova

I was in Italy for vacation and had an accident which was not dangerous but would have ruined my holiday. The emergency room at Padua university hospital treated me anyways and the waiting period was absolutely okay. Thanks!

This place basically saved my life 🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼👌👌👌👌👌👌👌 I saw hell but I had my Guardian Angels watching over me so I made it back. I heartily thank each and everyone and specially my surgeons. You are miracle makers and no god or goddess can replace that for me. Thanks a million 🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼🙏🏼

Once again in this awful building. 2 people almost dead, and the 3 of us are waiting for 3+ hours. You should be ashamed of yourselves honestly. How dare you calling yourselves emergency???

Thank you so much for the professional help on my situation. I went there for emergency, very friendly-approach from all the staff & doctor. Thumbs up for your kind & professional help.

This place is a nightmare. I always come here complaining because you always stay here at least 4 ou 5 hours to get a simple antibiotic for flu. It's ridiculous the disorganization. It's not clear where the waiting room is, not clear what is the next step, you see a lot of people passing by and not doing anything. It's a disaster. Only come here in case of serious problem. It's very bad here.

Best people, very professional, best healthcare, very good food catering.

Nurses were really nice when I had the medical examination (invasive). I was nervous and bit scared but they put me at ease. Doctor also gave me all the answers even when I was half way pass out.

Good hospital and skilled Staff. The only downside is waiting time.

Great experience with the trauma department on November 29, 2023. Empathy meeting professionalism! Thank you very much to the whole team!. True heroes !

Saturday 11 of November 2023 , I had severe pain in my legs and repeated chest pain plus confusion as result of 4 days non sleep ! After 16 hours in the Ambulance the doctor she sent me to psychology KH nord ! She said all OK just !!! W+÷×+=% ,Big Thanks to KH Nord they discovered thrombosis in my lower body and i am still under treatment as result of wrong and late diagnosis . Guys I just got confused again what to say to this Dr ? Any one please feel free to recommend what to say and what to do ? I just got shocked.

I had a emergency where I had to get surgery straight away to repair my broken jaw,Unfortunately my insurance didn't go through so i dont know who I'm angry with. I was waiting two days in one of the bedrooms until some bald guy in a white coat entered my room asking me for €3400 in card or cash, I thought it was a nightmare but I didn't wake up. He explained to me that I was not covered by insurance and that I should start making payments, I went down to the office and they confirmed he was in my room asking for money, The result was me getting up in the worst state to go sort out my insurance so that I could get my emergency operation done a little later and be covered by my insurance so that Inkasso won't chase me for like €30.000 Note that nobody at this point told me to stay in hospital get your jaw fixed first and sort your insurance out later because they can back track everything, instead I was set into confusion when they asked that I pay them cash or card. I was there for two days in the worst pain and didn't receive surgery but a bill for £3400 which was not covered by my insurance I left the hospital and sent all the rest of my documents to AMS and OGK and sorted my insurance. Later I arrived at hospital to find out that they checked me out automatically and wouldn't treat me straight away. I was sent home and a swelling started to occur on my face where I realised that I was sent home with a medical emergency so I went back to the hospital as soon as I could and eventually they accepted me back. I spent from 29.10.2023 to 15.11.2023 waiting for my jaw treatment, after the swelling went away they decided to give me the operation and they told me the waiting time is because there where other patients in need more then me and I had a swelling. Now I'm recovering from my surgery but I'm not sure if my surgery went one hundred percent correctly, the results are yet to come. The point is if your not Covered by insurance stay in hospital regardless if they start asking for cash or card and sort your insurance out later because if you leave the hospital you might not get the treatment you really require being a Austrian citizen won't help you get the free medical treatment you really need if you don't have insurance. However they must treat you if you have a medical emergency and you can get it sorted out later. Also Google maps didn't let me post this information so I wrote it in English let's if they block this info this time it's not right people shouldn't of gone through what I went through at the beginning when I had a medical emergency. My wobbly jaw was waiting to get repaired but I was plagued by the though of no insurance and having a struggle of my lifetime as a result. I was promised an operation from day 1 but ended up having it on like day 16 Long waiting times for operations beware make use you have insurance but if not stay in hospital and get your insurance sorted out later if I'm wrong let me know Anyway it's like day 20 after my injury and spent like 18 days in hospital, regardless of how my hospital stay started I come to a realization that I was treated very well at this hospital and I'm thankful for my surgery and all the hospital stuff for taking care of my issues I had a bad start because my insurance was not going through but however the operation did go well, after my wound heels I'll have to go to a specialist to see if they can straighten out my jaw so that I can have a better smile.

I went to emergency at 9 pm. I got bleeding from my uterus and very painful Stomachache, I am bleeding non-stop like 3 days continuing and the doctor asked me "Why are you here?" Asked me two times and I explained my symptoms and she told me to take pain killers without checking my bleeding things. PS. I am not on My period right now and I am still bleeding until now! What a Unprofessional Doctor! No any patients would like to go to Emergency if they really do not need help!

We were in an emergency situation where we were informed to reach the BDU department. Unfortunately it was the wrong department for the treatment which was needed but the BDU department saw to it that they won't even touch the patient who is in excruciating pain. They didn't even try to give the patient some kind of pain medication. After an hour we reached the right department and they were in horror to see the patient and surprised why the BDU department didn't do anything. Thanks to the urology department, we got the right treatment on time but the negligence of the BDU department and how they shrug their shoulders off is something I had to write here. I hope no one else goes through this..

Thanks a lot to all team of Palliative department for care support and warmth to my father!!!

Our two children were born in this hospital in 2019 and 2023. We can only report positive things about our time here. You felt very cared for and the entire team is extremely competent, motivated, courteous and friendly. It is important to me to mention this and thank you for all your efforts. Thank you very much for your support. All the very best.

I had the most horrible experience in the gynecology department here, my house doctor told me to go to the emergency room and when I got in for my consultation the doctor told me my problem is not an emergency and that there are people who actually need help. It was my first time seeing a gynecologist and she asked me if I have been before and I said no because I was not financially able to ever before and she almost laughed at me and said „no doctors in your country?“ she was clearly bothered by the fact that I asked her if we can speak in English. After she consulted me she said she can’t give me a diagnostic and than gave me a prescription without a diagnostic. She made me feel very uncomfortable, she made fun of me and where I come from, made me feel like I am not worth helping even tho my house doctor did. That woman should not be a doctor of any kind she was horrible!

We were in the children's hospital last night with our 10-week-old daughter and were really excited. Of course it was to wait but that's the way it is now. The doctors and the nurse were super nice and took really good care of our mouse. Our mouse obviously felt good, despite being in a really bad mood. During the examination she made the whole team and us smile and laugh. We felt very well cared for. Thanks!

of the best clinics in Bogotá.

Design and sophistication for the Health of Colombians!!!

apparently, this poor guy took the high speed rail all the way from 台中 to see the doctor only to find out that the doctor in question took the day off or something and the hospital didn’t even notify him that there was a substitute doctor instead. given that it was the same doctor i was scheduled to see, i can confirm that it was indeed a different doctor, but she was perfectly fine for my needs. it is, however, really scummy that the hospital didn’t notify its patients of this swap, and i would have expected far better of a private hospital.

Went to 家醫科 Number 19 . The doctor was superrrrrrrrrrrrr bad . he talked to me with high notes and said "do you understand chinese, you understand or no!" like for hundred times i just asked one part that i rly didn't understand what he meant. and this his job to tell me the detail. why he got angry to me lmao. hate that doctor. gonna remember in my life and won't ever comeback to this place again.Never

Referred over by a small clinic that had already provided photos of the issue - I waited an entire six hours in a wheelchair unsure if I was still hemorrhaging internally while they lackadaisically ran a few tests and at the end I wasn’t even sure if which nurse/doctor was in charge of my case and just sent home with meds. I give a one star because I’m still alive but to wait six hours in an EMERGENCY room is ridiculous.

I went to see an OBGYN at NTU because I had been having pelvic pain for about 2 weeks at that point. I'd felt similar discomfort before when I'd had an infection, so that was my best guess. The OBGYN did a very perfunctory pelvic exam and declared it couldn't possibly be an infection or related to the gynecological area because it didn't hurt when he pressed externally on the pelvic area, so I left with no treatment. That night, I had to go to the ER for stabbing pelvic pain and bleeding and was diagnosed with a bad pelvic infection. In summary, would very much recommend Taiwan Adventist Hospital's OBGYNs (called specially to the ER - so thorough, caring, and efficient) over NTU (for gynecology anyway).

I was at the start of a month long vacation and needed an emergency spinal epidural. I met with the neurologist, Dr Chang, who was able to perform the procedure the next day. This was probably the best medical treatment that I have ever had. And the cost was $172 USD. Here in the US, the same thing cost over $2k. I highly recommend this hospital.

Excellent doctors, nurses, and staff. Surely they can find a better way to organize their elevators? They have treated my elders in thoughtful and humane ways. We are grateful.

I just want to say that Dr. Parkes is extremely attentive and professional. He knows English is not my native language, so he made a conscious effort to slow down his speech to ensure I understood what he was saying. Throughout the process, all the nurses and staff at the front desk were also very attentive and friendly. This has been an amazing experience for me, probably the best I've ever had in a hospital.

Awful service, took over 45 mins for a blood test as the staff were just chatting behind the counter. The place wasn't even busy. Staff were incredibly rude too. Better off using the NHS. Avoid at all costs.

I would like to thank all the staff at The London Independent Hospital who were involved in my treatment. I was informed regularly of any updates to my surgery. Dr Jones was amazing and I am so great full to have finally been listened to after years and years of pain. Dr Jones understood this was not normal investigated and treated me. Thank you all for making me feel welcome, at ease and felt like i was in the best care.

The attention I received from reception to the consultant was first class. Timing was excellent and the whole experience was efficient and comfortable. This was reassuring as I was a little concerned about my investigations. I cannot praise the hospital highly enough on this occasion.

A big thank you to everyone involved in my care at the London Bridge Hospital. Cannot recommend the hospital enough! Mr. Ember and Tessa are always easy to talk to. Despite his busy schedule, I never felt that Mr. Ember was rushing in our appointments. So very patient in explaining every thing which made me feel 100% confident in him. The nurses were brilliant! RGN Bambhi (Abhi) Q. went above and beyond to make sure I was comfortable during my admission. She has already finished her night shift when I arrived but she still went to my room, answered all my questions and made feel comfortable. She also made sure to check on me after discharge. RGN CJ looked after me, her bright personality is truly refreshing but stayed professional the whole time. She made sure I was well looked after before during and after my procedure. Additionally, RGNs Dana and Gladys, were also exceptionally kind and knowledgeable. The food was impressive! Catering staff were always so polite. Was kinda bummed that coffee was instant coffee(not a big deal tho). Overall, I am extremely grateful to the whole London Bridge team!

I was a day patient for a knee surgery. The hospital staff is absolutely fantastic and friendly, they are always there to help you and to answer questions. The food was good beside I was not able to eat it all (i had anesthetic side effects) and the facilities were immaculate! Thanks for making it such as smooth process.