Paranasal sinus cancer surgery in 238 Oncology clinics worldwide

Two weeks ago I got a fixed appointment to see a specialist. When I showed up on time for the appointment, we were told that no doctor would be there today and the appointment would not take place! I was kept there for 4 hours with unsuitable staff and in the end I was just given a piece of paper with a different phone number so that I can try to arrange a next appointment. I was present with my mother in a wheelchair, who is chronically ill and in severe pain. The emergency room didn't help us either! Thank you, I hope you stay healthy!!

I had vomited 4 times, was in sever pain and fever. I went to the emergency for some assistance at 6am in the morning, the doctor and the receptionist refused to take me in and instead said you won’t die if you dont eat for another 2 days. Extremely rude and racist behavior. Never EVER anybody with a person of color should go there. Don’t deserve even 1 star.

Extremely rude attitude even at the reception. Then we visited the eye clinic and there the "head" of the department was arrogant, rude, mean and disturbingly angry. I would not recommend EVER! We were waiting for an examination of a child, but it never happened.

Extremely inflexible and unhelpful.

👌🏽👌🏽👌🏽

If I could give a no star I would. The worst experience me and my family had in this hospital. My dad was put into the ICU-intensive care unit. U would think each patient is in good hands Once handed over to any hospital but I wouldn’t say in this case. We waited for hours and hours until someone finally came back to tell us even what was going on..it was a mess and a poor communication even for a German citizenship like me. Unclear what he even had after so many hours waiting in the waiting area. Once my dad was “stabilized” we were able to enter. 2 nurses were attending him laughing and joking about some ridiculous joke they were talking to each other. (Keep in mind my dad was on the machine with pipes unconscious) and we as a family stood there in shock! A doctor in charge came along fiddling with the oxygen machine since it kept making noises. He just casually went oh get another cable from the Keller or any fake Chinese one will do. Well it hadn’t to do with any cables in the end. IT WAS BECAUSE IT WASN'T EVEN CONNECTED TO ANYTHING!! Starting with this and throughout the night readers can guess how it ended up with my dad! To the lady nurse who was a visitor that day from the neighboring hospital we thank you for giving us the time you gave us explaining us that dad had good chances of survival and giving us hope that our dad will come home again.

I want to give Zero star. There is not a single thing good in this hospital. I broke my foot (multiple hairline fractures) on 17 July. I went to the emergency department (Notfall) and waited almost 6-7 hours (there were hardly 5-6 patients). The doctor did only the XRAY and said no bone is broken. Please take Ibuprofen and sent me back home with an appointment to see me again after 5 days. On Monday i went again, the pain was unbearable. I told the doctor and they did CT scan (waiting time was again 4-5 hours). She told me later that my bones are broken and they put Gips on my foot. After every two weeks, i came for a basic check-up with an appointment but still had to wait 4-6 hours. Today, 04 Sept, i had an appointment at 11:00. I came on-time and still waiting (it’s been more than 4Hrs+). Is this how a developed country’s hospital should be? Why they are unable to manage a small amount of patients? There are hardly 20 patients. I’m really irritated, disappointed and angry on the public health care system of Germany. Better to get treated from a developing nation, where doctors are more competent and you get better service and treatment.

The worker here are so lovely and caring…despite I don’t understand German but I was loved

I made an appointment on Friday at 11:15 . I come to the appointment and they say they don't have it. They send me to the emergency room instead, where i wait for 3 hours. You sit there, without any clarity, afraid to going to the toilet so not to miss your precious turn, getting hungry and anxious, watching all your day plans crashing apart. Story #2: I've made an appointment, at "Notaufnahme", the doc told me "make it early", so I scheduled for 8:30. I spend 130eur on taxi to reach the Klinik from Clausthal (the only way to reach at this time). They have a complete haos (bad weather, understandable). Aftet 6h of waiting, it turned out that THEY LOST MY FILE. (and I asked about my file at the 6h of waiting and received then a rude "you have to wait", instead of them checking if my file was present). In total, my waiting time: 8;30-20:30, that is 12 (TWELVE) hours. From the nurses/admin I received no apologies nor kind words nor anything of this kind. The doctor was the only person who got into situation, and applied good "comm skills", kudos to him. So it happened twice: first, they lost my appointment and told me they didn't have it. (story #1). Second, they lost my documents (story #2). Story#3: that is a normal interaction: had an apntmt at Notaufnahme at 8:45, waited 1h, got invited, then doc said "surgeon is busy wait for more 30min, go have a tee if you want", came back after 30min, got "serviced". Thanks to the doc for clarity ("go have tee for 30min"). That is a positive interaction: only 1h30min waiting in total, everything was clear. Added one ⭐ (now one, prev 0zero). On the negative side: turned out my Monday visit with 12h waiting was absolutely useless. Story#4: so they gave me a receipt for physiotherapy, but put the WRONG name on it. I ve an appointments with the physio, waited for three weeks, attended 3 sessions, and the physio now cancelled all the other appointments bcs of the wrong name on that receipt that they gave me. Now I need to get another physio prescription from UniKlinik, then wait another three weeks (?) for new appointments with physio. And all this while doctors are urging me "you really need therapy, or you have big troubles with your joint". Lesson: always check the documents they give you, they make mistakes.

I spent 6 days in the urology ward. Both the doctors and all the nursing staff were always very friendly, helpful and made a competent impression. They took their time with the patients and always had an open ear. I have nothing negative to report. 👍

Absolutely .... No problem, nobody likes going to the hospital, but the people here are very friendly and helpful. It doesn't matter whether you're registering or on the ward. Medical ? I can't allow myself any judgement. I, for me (blood cancer) am very very satisfied. I feel looked after and cared for by professionals all around me. The nursing staff also has a professional knowledge that inspires. A very big thank you to the Department of Internal Affairs ab and cd. And to the kitchen ;-) I thought the food was ok. PS: very tasty roast beef. Thanks to

Worst experience.. I waited almost an hour. They simply sent me back because it’s not emergency. As a doctor., their minimum responsibilities to treat the patient. I have been suffering from itching from past 2months. Same thing I told them as I’m not getting Termin with Dermatologist. She simply said we can’t treat you. What kind of hospital is this , the god knows.

Reception and communication is terrible, I had to wait for an emergency for more than 2.5 hours because the reception clerk forgot to register me, TWO TIMES.

Ok!

Wxcellent Hoslital, one of the best in Romania, as well as from Bucharest. Very clean, tidy, professional doctors and nurses.

Ok

This review is well overdue. I came to this private clinic a few times and I had a great experience each time. I lived overseas for some time and I am used to high end medical services. Before I met Dr.Deutsch, I sworn I will never see a gynecologist in Romania ever again after a bad experience in a private clinic in Bucharest. I wanted to take this time to give a shout-out to Dr.Deutsch Horatiu! Needless to say I was pleasantly surprised after my first appointment and will be a returning patient. He is not only very kind and compassionate, he is also very patient and understanding. I no longer live in Sibiu buy will also come back for my anual here. Keep up the good work and thank you for your help and guidance.

Bunica mea o venit de 2 ori pentru nimic. Rdv a fost fixat și Dr. nu era prezent. Bunica de 80 de ani! My grandmother came twice, for nothing!!! She had an appointment but the doctor "wasn't there". Nobody called her to cancel. It's a shame!! My grandmother is 80 years old, they have no consideration. Boycott it!

Kindly sir give me whatsup number, i want to come luxembourg for PG from Pakistan How i will do apply this hospital for PG job. kindly sir please give me information about the pg general surgery in this hospital so I'm waiting for your response???

Waited three hours for them to do nothing, they prescribed me a medicine that is not suitable for my disease, with a large list of side effects, which must be taken with another medicine ( they didn’t tell me this). They did not cure me, but made me worse.

It’s not bad, but the service is also not something to write home back about. Paperwork took quite a while, but I have to note it was my first time there. Personnel was nice to me, even though I don’t speak a word French. Also notified me of an approximate bill for the all procedures. Maybe it depends on a type of your emergency, a doctor who’s treating you or they just improved, but for me it was not so bad at all!

All employees in all departments are so cooperative, kind, and respectful, and systemizing between all departments is amazing.. but the rooms need some simple renews.. thanks a lot😉

Ended call in my face after transferring my call twice during an emergency call as didn’t care to speak English. Very shameful hospital

Mohammad Qandeel frm the the Endoscopy department was fantastic, he’s super friendly and he has a great attitude, he’s definitely a great asset for this hospital.

I had very very bad experience at king Hussein Hospital.After flying ten hours from London Heathrow to King Hussein Hospital to attend a doctor's appointment. My sister received a breast cancer diagnosis in Iraq while I was residing in London. Based on numerous online recommendations regarding its cancer treatment success, I decided to have my sister travel from London to Jordan as a private patient. Regrettably, I can’t in good conscience recommend this hospital for a multitude of reasons: Lack of Compassion: As a healthcare professional myself, I was deeply disheartened by their patient care. When dealing with cancer patients, it is vital to consider their mental well-being: a. Prior to receiving the results of an axillary biopsy to confirm the extent of her breast cancer, one of the doctors made a premature, unconfirmed statement that "it looks like it's probably positive." Such a diagnosis should never be made without proper medical confirmation, as it can significantly impact the patient's prognosis. This is unacceptable and unprofessional. b. My sister chemotherapy treatment discussion was rushed, with a doctor listing all possible side effects in just three minutes. While it might be a formality for healthcare professionals, for the patient, this information is life-altering. A more sensitive and considerate approach would be more appropriate. Lack of Organization: c. The results of biopsies brought from Iraq took an astonishing 10 days to be released, despite such tests typically having a turnaround time of three days. d. Communication regarding result availability was lacking; we only received information after persistently inquiring about it. e. The critical result of the axillary biopsy, determining whether the cancer had spread to the lymph nodes or remained localised in the breast, was not provided by the doctors. Instead, we had to request all results from the international relations assistant, and by sheer chance, we discovered this particular result. Imagine having to uncover your own results through administrative channels? f. During an ultrasound appointment scheduled for 12:30, we were not called until 2:30, and this was only after numerous complaints. Even then, my sister was left waiting alone for an additional hour. It appeared that the call was made at that time to forestall further complaints from us. Cancer treatment requires a patient-centered approach that emphasises comfort and well-being. Unfortunately, at The King Hussein Cancer Center, my sister never felt at ease. Consequently, we decided to relocate her to another hospital due to the substandard treatment received.I don’t recommend this Hospital at all.

A place of science, healing and hope 🌱

There’s a problem on air condition and that’s make me feel like a chicken on the fryer

Excellent place to give treatment and care for patients ,had distinguish staff and I'm proud to be one of the specialty hospital staff 🤍

The staff is very good and take care of all details , the room is clean and always there is a follow up all over the day . Catering staff is very nice and provide on time and well -prepared meals that fulfill patient expectations.

A thoroughly professional and pleasant service during my 3-day stay at The Specialty. The staff in Level 1 wards were exceptional and the hygiene and care brilliant. Lovely cafe, too. Prices better than most.

Had my appendix removed about two months ago only complains I have are in the emergency department I was told by one of the doctors I was getting surgery, he was then pulled out of the room by a nurse and never returned. When asked do I know what’s happening for my surgery later that night I hadn’t a clue cause the doctor never came back and told me what it was for or when. The nurses on the ward when I went up where amazing looked after me so well really reassured me not to worry. The nurse that took over their shift after was out of surgery was completely different I had gotten sick after coming out of surgery she left the sick bag on my table the entire night along with the blanket I had gotten sick on, I was too unwell to even realise I had been sleeping in my sick the whole night. The next nurse to take over her shift had not been too impressed with me for not throwing the sick bad out or the sheets even though my iv was attached to the bed so I couldn’t physically move from the bed to do anything. It was only these two nurses that made my experience bad at the beacon as I’ve been before for a separate issue and it was absolutely amazing. I would recommend their hospital and I wouldn’t let them two nurses stop me from going to them again, but I would say it really did make me feel worse especially spending so much money to stay and be in their care.

As an American who has always been treated at the top clinic of Mayo Clinic my entire life I was scared to death to experience healthcare anywhere else. After breaking my foot I’ve been pleasantly surprised by how great the staff is here. The nurses, registration, consultants..everyone. I feel a lot of comfort after being seen here now multiple times and having surgery. It’s a different process than I’m used to but that’s a learning curve on my part. Thank you to all the staff for putting my anxiety to the way side.

Just back from taking my elderly mum for a CT in the Beacon Hospital. Lauren in radiology reception was fantastic with her. She was clear, helpful, friendly and very patient with with mum. CT staff were fantastic and efficient, meaning we were in and out in no more than 30min.

Incredible experience from start to finish. Appointment time 230. In doctor's office at 235, out on the road home by 345. Staff extremely friendly. Could not have asked for better. Also exquisitely clean. 10/10

Overall, not a great experience and wouldn't use them again. I went in for a heart ultrasound, stress test and a plaque test. The stress test was a nightmare. I was put on a running machine with a face mask. I kid you not. I was forced to undergo a stress test on a running machine where I could barely breathe. It was an horrendous experience. I really thought I was going to have a heart attack there and then on the machine as they increased the stress on my heart. How they could expect to get accurate results based on that is beyond me. I paid on the day and shortly afterwards got an additional bill....then another bill. I still don't know what the additional costs were for were for. I couldn't work out the statement that accompanied the bill as it was overly complicated. I went to my doctors a few months later about another minor matter and though it might be a good time to discuss my tests. He didn't know what I was talking about. He'd received nothing. I tried ringing radiology several times and it always went to voice mail. The receptionist told me to send an email which I did. I wrote an email and I did receive a reply saying they would send out one of the test results to my doctor but wanted his address. This was odd as my details and those of my doctor were on my initial induction form. I explained in a replying email that there were several tests...not just one and could they forward them onto him as well....nothing. No reply. I've never heard anything back and at this stage have given up trying to get my results posted out. I really would not recommend them based on my experience.

Had an unfortunate accident which brought me to the ED. The receptionists were very efficient and very pleasant to deal with. I was so fortunate to have had Dr David Foley looking after my case, he was extremely empathetic to my predicament and made me feel at ease at such a stressful/painful time. He referred me to Dr Stefan Byrne in Orthopedics who dealt with me very promptly, he was very professional. I left confident in his care and thankful for the kindness of his receptionist. Overall for such a traumatic time I was so grateful to everyone for making it that bit easier.....except for the pay for parking machine which refused to give a receipt one day and also refused to give my ticket back another day after paying

Fabulous GP service!! Especially Nadia on the front desk. She always does her best to help/accommodate you.

I dont know where to start, my problem is with the reception 1- I did blood tests for pregnancy , and no body notified me and when the results appeared I booked an online call with a doctor who completely ignored me and did not call. 2 - I registered for maternity care with them and after I delivered my baby they told they lost the application and I had to come over and refill it again or I will need to pay for the 2 and 6 weeks visit which should be free. 3- 5 out of 10 times I call them to book appointments they dont answer. 4- one time I went for a gp visit and I paid and when I left the reception lady called and and asked me to pay again she told me she cant see my payment.I had to send her the invoice and bank statement to convince her!

Great service with very caring staff - We joined about 6 months ago as we had a newborn. Great service and always take time to listen to what you need and will always do their best to fit you in for an appointment. Highly recommend!

We had the misfortune of Dad being referred to the care of plastic surgeon Catriona Lawlor at St. Vincent's Private for stage 2a Skin Melanoma. She was medically negligent to my father in that she didn't carry out any regular post care checks after the primary treatment. I asked her why and she came up with lies regarding covid, despite the National Screening Service telling me that there were no restrictions on cancer checks at the times she claims she didn't check my father for his own safety. She is a liar. My father again had the misfortune of coming under Prof. John Crown (or Professor Clown as we came to know him due his ridiculous and aggressive outbursts) once cancer progressed. He delayed my father's cancer treatment by 2 months because he wanted to conduct tests to identify the correct type of immunotherapy, despite these results already being available from 18 months prior. He put my father under 3 unnecessary and risky biopsies, one of which was a liver wedge section performed by a liver transplant surgeon. There were also 4 MRIs indicating stroke in this time, we're told most likely due to the spread of cancer. It took 4 MRIs and 7 weeks from 1st MRI in the care of St. Vincent's Private before my father was referred to a neurologist for tests and appropriate medication. At one point my father's nutritional supplements were withdrawn without discussion with my father, nor us. He was put into a private room and Professor Clown told me to expect the worst within the next two weeks. I immediately requested nutritional intervention and this was given. My father survived for over a year after that. Prof. Clown then tried to discharge my heavily dependent father onto my mother to which I refused to do without additional help outside of basic HSE home package. Prof. Clown's only option then was to leave the medical team, for which, he called my mother and sister into a meeting and accused them of being abusive because at that meeting they queried his treatment of my father and why no regular checks were done on my father. Prof. Clown claimed no checks were needed earlier but then said he never stated such at this meeting. He went on to send an email from the ward email address claiming we were abusive and threatening. For original treatment under Catriona Lawlor my parents were sent incorrect bills for which the finance department said they would fix. They never corrected their mistakes and a bill for €30 was sent to the debt collector for arrears. After my father left St. Vincent's Private there was a shortfall of €13,000 because VHI didn't cover the private room for my father in which he was placed to die prematurely. To this day no bill has been sent despite my queries to Paula Ryan and Dr. David Fennelly (took over from Prof. Clown, another member of the circus). We all know that this is due to their medical negligence. Be extremely careful if your loved one is under the care of this hospital. Private healthcare is completely unregulated in Ireland. Should any doctor in this hospital mess up you are on your own. The doctors are contractors and legally independent of the hospital itself. The hospital will not investigate and neither will the Ombudsman, HSE, Dept. of Health, etc. VHI covered 6 months of care in a private hospital for my father. I appealed to the management for extended care and treatment due their medical negligence. This was refused and Dr. David Fennelly put pressure on my father to choose the hospice for further care. I had to email Fennelly to take pressure off my father and give him space to decide. He was cut from the same ilk as Prof. Clown. My father survived 9 months in the hospice without any follow up with scans or care of an oncologist nor neurologist despite our requests to Dr. Fennelly for a plan of care to be ongoing. This hospital is unsafe and completely disorganised. Should any of the above be untrue I look forward to their legal letter for defamation but I know that won't happen because my defence would be the truth which they know themselves.

I am writing to express my deepest gratitude for the exceptional care and expertise provided by Dr. Anthony Stafford during a critical period in my life. Dr. Stafford's remarkable skills as a surgeon not only saved my life, but also transformed a terrifying situation into a remarkable journey of healing and recovery. Facing a life-altering medical issue was undoubtedly one of the most challenging experiences I've ever encountered. However, Dr. Stafford's accurate diagnosis and prompt action gave me the hope and strength to overcome the ordeal. He demonstrated an unparalleled level of professionalism and dedication, reminiscent of a guardian angel who emerged in my life precisely when I needed him the most. What truly sets Dr. Stafford apart is his unwavering commitment to not only address the medical concern at hand, but also considering the broader implications for my overall well-being. His expertise ensured that the surgical intervention was tailored to minimize impact on my body, allowing me to embark on a path towards a healthy life. As a woman, the significance of his approach in prioritizing my health and recovery cannot be overstated. In essence, Dr. Stafford's impact extends far beyond the realm of medical expertise. He restored my health, instilled hope, and empowered me to embrace life with renewed vigor. Every step of the way, he exuded compassion and professionalism, creating an environment where I felt both cared for and confident in the journey ahead. I owe my gratitude and a debt of profound appreciation to Dr. Anthony Stafford for being the beacon of light that guided me through the darkness. His contributions to my well-being have left an indelible mark on my life, and I am forever thankful for his presence during my time of need. Regards, Isha

My sincere appreciation for the diagnosis, and treatment. I’m looking forward to getting back out there and living my life. The feeling of gratitude is so difficult for me to put into words. I’d just like to let all those working here know what a good job they’ve done. You’re a great team, thank you. John

Well I loved how I was cared for and treated by the staff, doctors and nurses but who actually loves being admitted to hospital. Both my grandparents passed away in St James after battling chronic illnesses. The hospital did a tremendous job whilst caring and helping my grandparents and myself.

After 10 hours waiting for be attended in the Ermegency Dep. the doctor kick me out saying it wasn’t an emergency and without a prescription. Next day I went to a private GP and they gived me a prescription and look after me very well. It’s the worst hospital I’ve ever visited and I had one of the worst experiences of my life. (Also I paid 100€ for it, thieves)

My mom just returned from the A+E, as a qualified nurse myself, I'm appalled at the treatment and medical negligence of the Doctor on duty working A+E. Not only did you mix up her name and confuse her for another patient who had the same first name, you failed to do your safety checks to ensure you got the right patient and confused my mom with CHEST PAIN for someone who was DRUNK, You then dismissed her anxiety and told her to just calm down!? You gave her no advice, no comfort, if the job is that hard for you and is causing you to treat your patients like this, you need to find another job. I'll be taking this further and making a formal complaint.

We had a very pleasant encounter with this hospital this summer. My father in law was hospitalized here for over a week and the staff and the hospital crew its absolutely amazing.You get answers at every single question you ask. Compare with other " so called emergency room" this one is a life saver. Yes its quite expensive but you get what you pay for. There is no attitude when you ask something and you get to be treated like a human, plus you get the treatment that you indeed need, not just random medications so they make sales. Thank you medpark.

My recent visit to Medpark Hospital left me thoroughly impressed. The entire team was amazing. Recomand

I really liked how professional are Dr. Cusnir Valeriu (Ophthalmologist) and Dr. Andronic Ana (Internal medicine). My experience with them was very pleasant. They answered all my questions and gave advices for treatment and health overall. P.S. Emergency Department Reception has the best personnel

Facilities are very clean, the staff is professional, and respectful! Best in the country. Also the food in the cafeteria is very good.

It is a expensive hospital, but it is worthy. My 1 year old baby was diagnosed with testiculo tumor, he needed to be operated ASAP. Now he is 100% out of danger. Thanks God and the doctors. Never felt more comfortable in a hospital.

I have been a patient at Vivian Pellas for over 9 years in that time I have had 4 surgeries and my wife had her hip replacement done there. My past experiences have been good up until a little over a year ago. Went in for what I thought was hemorrhoid surgery. According to all my papper work which I still have but instead I received a sphincterotomy and no hemorrhoid present at the time. Be carefull there! Still having ongoing problems as a result

Special thanks Arjun Rajeev❤️ Wonderful experience with Badr Al Samaa Hospital ruwi. Dr Rakesh was a wonderful surgeon, and the staff was always helpful and kind. They ensured I had a smooth prep, surgery,and follow up. I am so glad I choose Badr Al Samaa Hospital,ruwi and would highly recommend to anyone.

Dr. Thashli Thankachan has been our family doctor for the past 12 years, and I can't say enough about his exceptional care. His joyful and caring demeanor has made each visit a positive experience. From the moment you walk into his office, you can sense the warmth and compassion he brings to his practice. One of Dr. Thashli's standout qualities is his ability to explain medical conditions and treatments in remarkable detail. He takes the time to ensure that his patients fully comprehend their health concerns and the options available to them. His explanations are clear and delivered with patience, making complex medical concepts accessible to everyone. What truly sets doctor apart is his profound understanding of our health problems. he listens attentively, asks the right questions, and conducts thorough examinations. His diagnostic accuracy is impressive, and we've always felt like we're in capable hands. The trust we've placed in him is the result of his unwavering commitment to his patients. he has consistently demonstrated his dedication to our well-being, going above and beyond to provide the best care. His guidance has been invaluable in managing our family's health. Having Dr. Thashli as our family doctor has brought us peace of mind and confidence in our healthcare. His trustworthiness and dedication to his patients have created a lasting bond that we cherish. We're grateful for the care and support he has provided over the years, and we look forward to many more years with him as our trusted healthcare partner. Dr.Thashli truly exemplifies what it means to be an exceptional and compassionate healthcare provider.

Very rude behavior from receptionist. Two times i face like these.. That is the only reason iam sending now.Atleast keep some peoples they are talking politely. On 23/10/23 Mrng 8.30 am one lady call back for appmt booking that time.i ask just token number.. She is shouting wait... Wait.. Wait... Atleast she can tell i wl tell u sir.. Like that.. Is there any option for 0 rating i wll give that.. For the receptionist not for the hospital..

Had met the gynecologist. Very good experience. Overall facility is good. They have started the valet services. Which is very convenient.

Had come to meet the general practitioner with fever. Came to reception , they gave me suggestion whom to meet. Went to the vitals area. They greeted me with a smile. Then went to doctor. He is a gem. Told what to be done. Very good overall experience. Thank you nmc

It's a very rubbish hospital. A group of children are waiting to see a doctor. Only one doctor sees a child for 20-30 minutes, and he is said to be an expert. If you don’t have good medical skills, you have to make up your time. It takes at least 3 hours from registration to seeing the doctor. I think it's funny. The attitude of the two Indian nurses was particularly bad. They were very impatient when asking her questions. I think this hospital needs to be managed well.