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Dr. Miller is an orthopedic surgeon at the University of Virginia in Charlottesville, where he specializes in sports medicine and the treatment of knee injuries, such as complex ligament reconstruction, articular cartilage restoration and repair and meniscal repair and transplantation, as well as shoulder conditions. Its thought this reduces wear and tear, but theres no evidence yet its better than fixed bearing for total replacement. The advantage of partial replacement is that it is a smaller operation which preserves the ligaments, so the chances are it will feel more like a normal knee; with total knee replacement one or both of the main (cruciate) ligaments are sacrificed. His clinical interests and expertise include computer-assisted knee arthroplasty, complex reconstruction of knee instabilities including ACL, PCL and dislocations, treatment of meniscus and cartilage abnormalities. PRIVATE: Nuffield Health Warwickshire Hospital, Fortius Clinic in London, Spire Little Aston Hospital in Birmingham.
Best Orthopedic Doctor in India | Top 10 Orthopedic Surgeons - Vaidam LaingBuisson is the chosen provider of independent sector healthcare market data He is a member of the American Board of Orthopaedic Surgery and the American Academy of Orthopaedic Surgeons. University of . There is no online registration for the intro class Terms of usage & Conditions Referral from January 20, 2017. James E Phillips III, MD. Find a private orthopaedic surgeon specialising in knee surgery near me, including the top consultants in the UK. Linking and Reprinting Policy. 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference, 8th Annual Health IT + Digital Health + RCM Conference, 29th Annual Meeting - The Business & Operations of ASCs, Conference Reviewers: Request for More Information, Beckers Digital Health + Health IT Podcast, Becker's Ambulatory Surgery Centers Podcast, Becker's Cardiology + Heart Surgery Podcast, Current Issue - Becker's Clinical Leadership & Infection Control, Past Issues - Becker's Clinical Leadership & Infection Control, Revenue Cycle Management Companies in Healthcare to Know, Hospitals and Health Systems with Great Neurosurgery and Spine Programs, Hospitals and Health Systems with Great Heart Programs, 50 hospitals and health systems with great orthopedic programs headed into 2023, 100 of the largest hospitals and health systems in America | 2023, 60 hospitals and health systems with great oncology programs headed into 2023, 150 top places to work in healthcare | 2019, Texas hospital set to close, asks University Health to take over, 20+ US hospitals among Newsweek's top 100 global hospitals, Nurse impostor treated patients for 15 years, police say, Some innocent nurses may be caught up in degree scheme, 20 health systems reporting losses in 2022, Biden to GOP: Don't touch healthcare dollars, 8th Annual Becker's Health IT + Digital Health + RCM Annual Meeting. See all responses. I have always strived to provide the best care to the . Mathew Pombo, M.D. Subsequently, I have also completed the highly prestigious arthro Cemented OR uncemented? Becker's is thrilled to feature 65 total knee replacement surgeons to know in 2020. The information in quotes is what we heard about these surgeons. Most specialist knee replacement surgeons will be doing a least 150 a year., Ask your surgeon about his or her revision rate (where a failed implant needs replacing).
best knee surgeons in north east england TAILOR-MADE IMPLANTS: Scans and computer software are now being used to tailor the surgery, implant and even surgical tools to the individual patients anatomy. Dr. Gillogly specializes in cartilage restoration, complex knee disorders, biologic knee reconstruction as well as sports and shoulder injuries and serves as the head team physician and orthopedic surgeon for the Atlanta Thrashers hockey team and the Atlanta Falcons football team. He has been doing high-level knee surgery for over 25 years., Dr. ElAttrache is a sports medicine specialist with the Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California. Dr. ElAttrache is the head team physician for the Los Angeles Dodgers. He also completed a fellowship in sports medicine at University of Western Ontario in London, Ontario, Canada. If you wait too long, the knee gets stiffer and more deformed, says Professor Turner, and results of surgery are worse if knees are really bad to start with. Steroid injections can ease inflammation and pain, while physiotherapy strengthens the thigh muscles that support the joint. WHAT THEY SAY ABOUT HIM: Technically very good and gets good results, says one. He is adept at spotting subtleties.. He completed his residency in orthopedic surgery at the University of Florida College of Medicine in Gainesville, Fla., and a fellowship in sports medicine at the University of Oklahoma Health Sciences Center in Oklahoma City, Okla. GMC/GDC number. He specializes in the treatment of injuries and disorders of the knee, arthroscopic surgery and knee ligament reconstruction. 265 Benton Drive, Suite 104, East Longmeadow MA. He specializes in arthroscopic procedures, knee reconstruction to shoulder instability and rotator cuff surgery. He has presented at multiple national and international meetings on varied complex topics related to knee and shoulder problems in the athletically active. He is a frequent speaker on hip and knee arthroplasty. A lovely chap with a great pair of hands who also does primary [first-time] knee replacement, but he has carved out a niche for himself with challenging revisions.. Dr. Cole is Section Head of the Cartilage Restoration Center at Rush University Medical Center and Chairman of Surgery at Rush Oak Park Hospital. Find the Best Orthopedic Surgeons in East Taunton. He is conducting several trials in this area and his research has the potential to preserve function and prevent osteoarthritis for thousands of patients., Dr. Levy is a professor of Orthopedics at Mayo Clinic in Rochester, Minnesota. He serves as an assistant clinical professor of orthopedic surgery at Northwestern University Medical Center in Chicago.Russell Warren, MD (Hospital for Special Surgery, New York). Dr. Gillogly completed a distinguished military career in the Army Medical Corps with the rank of lieutenant colonel. He graduated magna cum laude and phi beta kappa from the University of Dallas, where he played flanker for the university's rugby football club. He completed a residency in orthopedic surgery at the LAC/University of Southern California Medical Center in Los Angeles. Just another site He did my dads knees and is undoubtedly the most experienced and able knee surgeon in the country, says another. He also specializes in the treatment of neck and back pain. Depending on the extent of damage inside your knee joint, you will be recommended either partial or total knee replacement surgery. Fresh texts reveal Matt Hancock discussed how Covid could 'propel' his career days before virus hit UK and 'Pipsqueak Matt Hancock couldn't stop me': Nigel Farage takes pop after leaked WhatsApps reveal ex-Health Ambulance strikes are called OFF: Unions behind NHS 999 chaos agree to discuss pay with Steve Barclay after 'Piers Morgan is leaving GMB - shall we celebrate?' Deuk Spine Institute, Viera: 7955 Spyglass Hill Rd, Melbourne, FL 32940, Deuk Spine Institute, Titusville: 494 N Washington Ave Titusville, FL 32796 Alabama (287) Alberta (49) Arizona (382) Arkansas (153) . coccidioides titer 1:21:2 He is widely respected for his cartilage work. 5.00. 2060 N Pearl St, North East, PA 16428 1.51 miles. "Dr. Johnson is an experienced physician in the field of sports medicine. Copyright 2023 RRY Publications, LLC. He completed surgical fellowships at the University of Virginia School of Medicine in Charlottesville, Va., and at the University of Lyon (France.) WHAT THEY SAY ABOUT HIM: He is measured, hard-working, considerate and highly skilled in all aspects of knee replacement, one of his peers reveals. He is extremely well versed in the care of professional athletes with knee problems. Reveal phone no. The information in quotes is what we heard about these surgeons. North Carolina (688) Nova Scotia (25) Ohio (743) Oklahoma (214) . All rights reserved. When you see him operate, he makes everything look so easy. He is a member of numerous national societies and serves on the board of the American Academy of Orthopaedic Surgeons and assumes many high level positions on society organizing committees.John D. DiPaola, MD (Occupational Orthopedics, Portland, Ore.).
The best UK Orthopaedic surgeons in 2023 | TopDoctors 01256 Mr.Loughead is a Consultant Orthopaedic Surgeon based in the North East of England. Dr. Fisher is an orthopedic surgeon with OrthoIndy, where he focuses on treating patients who suffer from arthritis, including rheumatoid arthritis, and degenerative diseases of the knee as well as total joint replacement. He is a communicator who is extremely attentive to details. Todd Albert, MD, Hospital for Special Surgery (New York). Dr. Raab's surgical specialties include arthroscopic knee, shoulder and sports medicine surgery, as well as total knee and hip replacement. PRIVATE: The Robert Jones & Agnes Hunt Orthopaedic Hospital (private care), Nuffield Health Shrewsbury Hospital. Mr Kim has performed over 600 robot-assisted hip and knee replacements . Its a little-known fact, but under the NHS Constitution, patients in England have the right to choose where to receive their NHS treatment which means you can ask to have your treatment in any hospital or clinic anywhere in the country, as long as it has the necessary expertise.
Top Orthopedic Surgeons Georgia - Knee Surgery | America Top 10 Marlowe Goble, MD (Salt River Orthopedics, Afton, Wyo.). I wish I had that done not the hamstring.. Harvard University. His previous work included founding several companies, including MedicineLodge, an orthopedic technology development firm; Facet Solutions, a facet arthroplasty device company; and Frontier Biomedical, a leader in comparative medicine. Posted by in the heat of combustion of ethane, ethene and acetylene; employment law conference 2022 . This could be caused by infection or because the knee was done badly some surgeons try to fob patients off because they are worried a number of re-dos will flag a problem with the data they have to submit to the National Joint Registry [which publishes outcomes for every orthopaedic surgeon and hospital unit]. Each year, Boston Magazine publishes the definitive list of the best doctors in Boston, including orthopedic surgeons across the region. WHAT THEY SAY ABOUT HIM: An excellent knee surgeon, explains one. For most people this is going to give you the best results in the hands of an experienced surgeon.. 011 454 5800 & 011 454 6828 .. W & M 44 1 st Ave, Dunvegan, same end of 1 st Ave as Orion Building.
best knee surgeons in north east england His surgical skills have earned the respect of colleagues and patients. Save my name, email, and website in this browser for the next time I comment. The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry.
Orthopaedic surgeon jobs in North East England - Jooble Dr. Purnell is an orthopedic surgeon at Orthomed Center in Modesto, Calif. Arthritis accounts for the majority of the 90,000 knee replacements carried out in England and Wales annually. British Association of Spine Surgeons (BASS), RCSEng, 38-43 Lincoln's Inn Fields, Holborn, London, WC2A 3PE Registered Charity - No.1150365 Company Registration - No.08156883 If you're looking to schedule a video appointment instead of seeing a doctor in person, doctors who meet with patients online will have a "Virtual Visit" button at the top of their WebMD Care profile page. PRIVATE: Mr Beverland does not work privately. All Rights Reserved. He is currently the director of sports medicine training for the Atlanta Medical Center Orthopaedic Residency Program.E. Surname. Search our directory of over 20,000 doctors, Search our directory of over 5,000 hospitals and clinics, Personalised advice from leading specialists, Opinion from GoPrivate.com experts on UK private healthcare, Hundreds of articles from GoPrivate.com doctors and specialists, Get listed and attract more private patients. Frank Kolisek, MD, of OrthoIndy in Indianapolis has practiced out of Indianapolis since 1992 joining OrthoIndy and OrthoIndy Hospital in 1999.
New England Orthopedic Surgeons (NEOS) | Baystate Health Knee replacement surgery ranging from 12,108 to 14,936*. Murdaugh is heckled as he leaves court, Isabel Oakeshott clashes with Nick Robinson over Hancock texts, Ukraine soldiers shoot down enemy drones with drones of their own, Insane moment river of rocks falls onto Malibu Canyon in CA, Fleet-footed cop chases an offender riding a scooter, Two Russian tanks annihilated with bombs by Ukrainian armed forces, Dozens stuck in car park as staff refuses to open gate for woman, Missing hiker buried under snow forces arm out to wave to helicopter. An artificial knee will never be as good as your own most patients rate them about three-quarters as good, according to the charity Arthritis Research UK. See njrsurgeon hospitalprofile.org.uk and njrcentre.org.uk. 0161
UK Knee Surgeon Ranked Among 16 Best in North America WHAT THEY SAY ABOUT HIM: Technically a really excellent surgeon who does both partial and total knee replacements and primary [first] knee replacement and lots of revision surgery [where the implant fails and has to be replaced]. To identify the countrys very best knee replacement surgeons, we canvassed the views of almost 40 leading consultants from around the country. 20 Years Experience. University of Pennsylvania (Perelman) University of California--San Francisco. Dr. Gillogly is founder of the Atlanta Knee and Shoulder Clinic and formed a sub-specialty group of the clinic, the Atlanta Sports Medicine & Orthopaedic Center. Dr. ElAttrache is chairman of the Board of the Kerlan-Jobe Orthopaedic Foundation and program director for the Kerlan-Jobe Fellowship. He is honest and thorough and discusses the risks and benefits of surgery with his patients., Andrew has made it his lifes work to eradicate every painful knee in the country, adds another. He is not suggesting that we should be more robust about pain, rather that he fears the fallout from people swapping their own rickety knee for a replacement too soon, as some of these people will live well into their 90s and that knee is likely to need replacing a couple more times [these will be] increasingly challenging procedures with more risks and potential complications. Dr. Explore feedback from real patients, what awards they've won, and much more to help you choose. I.P.S.Oberoi is one of the top Orthopedic and Joint Replacement Surgeons in India and specializes in knee replacement, hip replacement, and arthroscopy. FIXED VS MOBILE: Normally, the plastic spacer in an implant is fixed to the metal plate on the end of the shin (a fixed-bearing joint) but, with a mobile-bearing joint, the spacer can rotate within a certain range on the plate, so it can find its own position of comfort, says Howard Ware, a knee surgeon at Chase Farm Hospital in London. If you are interested in a particular orthopaedic procedure and would like to discuss your treatment options with a consultant in Newcastle, you will need to book an initial consultation by calling 0191 281 6131. How Helen Whately and Matt Hancock joked about toasting My accent ran-offski! In addition, look for the Patient's Perspective boxes and callouts that tell you what other patients liked about the doctor. Pavement where disabled woman gestured at cyclist before fatal crash, Wheel of Fortune contestant answers food puzzle wrong, Incredible footage of Ukrainian soldiers fighting Russians in Bakhmut, Pro-Ukrainian drone lands on Russian spy planes exposing location, 'Buster is next!' He specializes in solving complex adult reconstructive problems. condos for sale far west side madison wi Menu. Unfortunately, he re-injured the repaired ACL in December of 2021. He is a tireless worker who balances a very busy clinical practice with his duties as Head Team Physician for Arizona State University. Average Cost for Hip: $33,483* . The location you tried did not return a result. The list was developed through nominations and internal research. You can also check The National Joint Registry, which has information on over two million joint replacement operations in England, Wales and Northern Ireland since 2002. The best are high-volume surgeons, who do a large number of operations, and are expert in both partial and total replacements, so you get the full range of options. Patients can check their prospective surgeons profile on the National Joint Registry website to see how their surgeons caseload measures up against the average (see right). Hes also very nice, straight-talking chap with particular expertise in partial knees for younger patients with a history of dislocation., Patients shouldnt be afraid of asking their surgeon about the number of knee replacements they carry out, says Professor Phil Turner, a knee surgeon at the NHS Stepping Hill Hospital in Stockport and vice-president of the British Orthopaedic Association. "Zarins is the best orthopedic surgeon in the world, as far as I'm concerned." more. Dr. Darren Johnson, chairman of UK Orthopaedic Surgery & Sports Medicine has been ranked as one of the "16 Standout North American Sports Knee Surgeons" by the publication Orthopedics This Week, the most widely read publication in the Orthopedics industry. Hip replacement , Knee arthroscopy , Knee surgery , Knee replacement, Hip fracture , Osteoarthritis. In alphabetical order, then, here are 16 of the finest sports knee surgeons in North America. There are options to try before surgery, ask your surgeon if you are suitable. In his articles for Total Health, Sam explains, "A good outcome is where the patient's quality of life is significantly improved after their joint replacement". Dr. Noyes received his medical degree from George Washington University School of Medicine in Washington, D.C. More people are having knee replacements - each year in England and Wales 80,000 patients, with an average age of 69, undergo knee replacement surgery. Dr. McKeon is an orthopedic surgeon with Boston Sports & Shoulder Center, where he focuses on the treatment of sports-related injuries, particularly of the knee and ACLs. Your GP can arrange a referral to the specialist you would like to see.
best knee surgeons in north east england - ronde.me Dr. Leslie is an orthopedic surgeon who specializes in total joint replacement and sports medicine at his practice, Leslie Ortho, in Camdenton, Mo.
Orthopaedic surgery in Newcastle upon Tyne | Nuffield Health In addition, he is the Gibson Chair of Orthopaedic Surgery and chief research and innovation officer of the Pan Am Clinic. Dr. McKeon also serves as an assistant clinical professor of orthopedics at Tufts University School of Medicine.Dr. Whilst most hospitals will have several consultant orthopaedic surgeons, certain hospitals are dedicated orthopaedic centres, such as the Nuffield Orthopaedic Centre in Oxford and the Royal Orthopaedic Hospital in Birmingham. Some knee implants retain the posterior cruciate ligament (PCL) which runs from the back of the shin to the bottom of the thigh; others involve removing it (as the implant is differently shaped) to give the knee the equivalent stability. He is a fellow of the American Academy of Orthopaedic Surgeons. Those against argue that treating the arthritis in the main part of the knee is enough to treat the pain, and resurfacing the kneecap can cause problems of its own. Opinion on UK private healthcare from GoPrivate.com experts plus hundreds of healthcare articles from doctors and specialists. Dr. Macaulay is the director of the Center for Hip & Knee Replacement and a physician with Columbia Orthopaedics in New York City. June 29, 2022 Posted in kawasaki monster energy jersey. He is the current medical director for Oregon Health Systems and Montana Health Systems. Explore 662.000+ new and current Job vacancies. Consult multiple doctors. All Rights Reserved. He performs . 1. He is an internationally recognized authority on the diagnosis and treatment of complex knee problems. New England Orthopedic Surgeons is made up of 18 Physicians, 23 highly trained Physician Assistants and Advance Practice Registered Nurses, and 180 . This service is based in the Darlington and Stockton on Tees, covering a large area of North Yorkshire and North-East England. According to a recent survey (2017-2023), musculoskeletal disorders affect around 1.71 billion people worldwide, causing 22.3 million orthopedic surgeries .
Knee Surgeon Springfield | Knee Replacement Chicopee, East Longmeadow, MA Think of this as a pre-emptive strike, says Professor Andrew Toms, an orthopaedic surgeon at the hospital. I suggest you phone Williams and Meyer physiotherapists because they must have the phone number (s) you want. He is also a member of the American Medical Association, the American Osteopathic Association, the American Osteopathic Academy of Orthopedics and the Midwest Osteopathic Orthopedic Society.William Macaulay, MD (Center for Hip & Knee Replacement, New York). Reveal phone no. Dr. Goble has had several other notable achievements including serving as a lead surgeon for Zimmer on the prosthetic ACL development and as Utah State University team physician.Christopher Harner (University of Pittsburgh Medical Center, Pittsburgh). If arthritis affects only one side of the knee, it may be possible to have a partial knee replacement, where only the damaged bone is scraped out and replaced (stock image). U.S .
10 Best Neck Surgeons For Patients with Neck Pain in 2022 He is well known for meniscal transplants, and is an extremely innovative and research oriented surgeon., Dr. Cooper is a sports medicine specialist with the Carrell Clinic in Dallas, Texas. We are no longer accepting comments on this article. 2023 NFL Draft prospect rankings: 64 best available players Who needs to step up for Lakers in wake of LeBron James' injury College football spring storylines: New coaches, QB battles, more to watch Dr. Fu is the David Silver Professor of Orthopaedic Surgery and chairman of the department of orthopedic surgery at the University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, where he was previously the department's executive vice chairman. Your email address will not be published. Find Orthopaedics services. Obesity is partly blamed for the boost in demand from younger patients; a joint overloaded with excess weight will wear out faster. Dr. Fisher performs around 500 total joint replacements annually and several arthroscopic procedures. He received his medical degree from Columbia University and completed his orthopedic surgery residency at the Musculoskeletal Institute at the University of Pittsburgh Medical Center. He is an outstanding clinician-scientist and a technically proficient surgeon. He serves as the chief medical officer and head team physician for the Boston Celtics and has performed surgery on many high-profile athletes. He was brought in to clear the waiting lists in orthopaedics in Northern Ireland and has made it his lifes work, but unfortunately this has faltered in recent years due to further demand and no additional funding to pay for it, comments one. Dr. Raab is a senior partner and one of the founding members of Illinois Bone and Joint Institute, one of the country's largest orthopedic and musculoskeletal practices. 0207 WHAT THEY SAY ABOUT HIM: Excellent dedicated knee surgeon who is a specialist in partial knee replacements., WHAT THEY SAY ABOUT HIM: One of his peers describes him as an excellent surgeon, recognised as an expert in early interventions such as osteotomy. This is where either the top of the shinbone or the bottom of the thighbone are cut and shaped to realign the knee and ease pain. But theres no research to show gender specific implants last any longer or provide better function most off-the-shelf artificial joints come in a range of sizes anyway. These techniques are available on the NHS as well as privately but are rarely used (less than 1 per cent of knee replacements) in the NHS because theyre more expensive, time-consuming and havent been shown to provide significantly better results, says Howard Ware, a knee surgeon both in Chase Farm Hospital and The Wellington Hospital. Don't be afraid to ask questions. PRIVATE: Rivers Hospital in Hertfordshire, The Chelmsford Hospital. Dr. Jinsil Kim Sung, MD . McKeon participates in many clinical trials and funded research studies related to articular cartilage. Yet armed with this MRI, the patient will almost certainly find a surgeon prepared to operate.. Listen. He performs surgery at Northern Westchester Hospital and at the Ambulatory Surgery Center of Westchester. Published by at 30, 2022. Choose from the 10 best orthopaedic surgery specialists for hip replacement. He is well known for multi-ligament reconstruction of dislocated knees. WHAT THEY SAY ABOUT HIM: A lovely man and excellent technically, very good with patients, he is very thorough and pays great attention to detail, says one. He has amazing expertise in managing a range of high level athletes and recreational athletes.
Find your Surgeon or Specialist Royal College of Surgeons Best Orthopedic Surgeons Near Me | Zocdoc See reviews, times, & insurances accepted.
He is an excellent speaker, a superb and innovative surgeon., Dr. Lowe is chairman of the Department of Orthopedic Surgery at The University of Texas Medical School at Houston and medical director of the Memorial Hermann IRONMAN Sports Medicine Institute. He has made significant contributions to knee, shoulder and elbow injury prevention and treatment. He is one of the best knee surgeons in the NFL and has written extensively on anterior cruciate ligament problems in these athletes; he is also good with posterior crucial ligament problems.
The 16 Standout North American Sports Knee Surgeons Comprehensive directory, reviews and ratings of orthopedic surgeons across the United States and Canada.
Top 15 Orthopedics Surgeons in the World- Updated 2023 The future, he says, is still conventional implants using standard instruments. 2 verified reviews. He served his orthopedic residency at the Metropolitan Medical Centers in St. Louis.
Find Top Orthopedic Surgeons by State - WebMD Uncemented knees are more expensive, but the surgery is quicker, and some say it fits to the bone better. Hes not interested in fads. I am willing to travel so there are no geographic restrictions. This information was obtained via a telephone survey of thought leaders in the field. Reveal phone no. Dr. Johnny T. Nelson is a Raleigh native and a second-generation orthopedic surgeon. Find the best private knee surgeons and specialists near me - Compare, learn more or get on the Fast Track from GoPrivate.com: Get options fast. A total knee replacement may also involve replacing the under-surface of your kneecap with a smooth plastic dome. WHAT THEY SAY ABOUT HIM: Very empathetic, level-headed and what we in medicine refer to as a good pair of hands. Mr Rajiv Limaye works as Lead Foot/Ankle surgeon at University hospital of North Tees and Hartlepool since April 2014. He performs ankle and elbow surgery and has been highly trained in joint . To help you make informed decisions about your care, weve also talked to experts about the latest thinking on treatment. Dr. Macaulay is familiar with the latest minimally invasive, bone preserving and recuperation enhancing trends in knee replacement surgery and is conservative in his approach to the patient and uses surgery as the last resort. Dr. DiPaola regularly speaks about injured workers' care at regional and national meetings.Jack Farr, MD (Cartilage Restoration Center of Indiana, Indianapolis). Dr. Robb is an orthopedic surgeon with the Illinois Bone and Joint Institute and specializes in treatment of the knee, including computer-assisted knee surgery and minimally-invasive knee surgery.
The best surgeons to pick for your knee op | Daily Mail Online Weve canvassed the views of more than 260 consultants across seven specialties from around the country, and asked them this very simple, but key, question: If your own nearest and dearest were to need treatment in your field, to whom would you refer them and why?