google_counter
Total knee replacement with rehabilitation (481718) | University Hospital RWTH Aachen - BookingHealth
{"translation_price":"50","translation_doc_price":"40","child_coefficient":"1.1","transfer_price":"2.00","transfer_price_vip":"5.00","constant_transfer_price_vip":350,"constant_transfer_price":150,"constant_transfer_distanse":60,"type":"treatment","program_full_story":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>physical examination<\/li>\n\t<li>review of medical records<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>indicators of inflammation<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>X-ray \/ MRI&nbsp;examination of the knee<\/li>\n\t<li>preoperative care<\/li>\n\t<li>total knee replacement, cost of the implant is included<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>control examinations<\/li>\n\t<li>the cost of essential medicines and materials<\/li>\n\t<li>orthopedic appliances<\/li>\n\t<li>physiotherapy<\/li>\n\t<li>nursing services<\/li>\n\t<li>full hospital accommodation<\/li>\n\t<li>explanation of future recommendations<br \/>\n\t&nbsp;<\/li>\n<\/ul>\n\n<p><strong>The program includes orthopedic rehabilitation:<\/strong><\/p>\n\n<ul>\n\t<li>Primary presentation in the clinic<\/li>\n\t<li>medical history taking, including family history<\/li>\n\t<li>complex of neurological and orthopedic examinations<\/li>\n\t<li>X-ray examination<\/li>\n\t<li>individual rehabilitation program, which includes:\n\t<ul>\n\t\t<li>Wii Fit training in the use of the balance<\/li>\n\t\t<li>neuropsychological therapy<\/li>\n\t\t<li>functional therapy of the upper extremities (ArmeoSpring)<\/li>\n\t\t<li>kinesiotherapy (physiotherapy)<\/li>\n\t\t<li>biocontrol with feedback<\/li>\n\t\t<li>healing deep muscle massage<\/li>\n\t\t<li>acupuncture of spasticity and pain syndromes<\/li>\n\t\t<li>occupational therapy<\/li>\n\t\t<li>psycho-educational classes<\/li>\n\t\t<li>individual physiotherapy<\/li>\n\t\t<li>microcurrent treatment<\/li>\n\t\t<li>fangotherapy \/ cryotherapy<\/li>\n\t\t<li>antispasmodic drug therapy<\/li>\n\t\t<li>mobilization of limb joints<\/li>\n\t\t<li>hydrotherapy \/ massage therapy \/ reflexology<\/li>\n\t\t<li>training on special trainers<\/li>\n\t\t<li>etc.<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>nurses care<\/li>\n\t<li>stay in the hospital with full board<\/li>\n\t<li>symptomatic and drug therapy<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>Preliminary preparation for surgery<\/strong>: quitting smoking and drinking alcohol 2 weeks before surgery; cancelling non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen); cancelling&nbsp; anticoagulants (warfarin); normalization of body mass, if possible.<\/p>\n\n<p style=\"text-align:justify\"><strong>Preoperative examination<\/strong>, including consultation with an anesthesiologist and necessary related specialists. X-ray examination and MRI of the knee joints are performed. The examination takes 1-2 days.<\/p>\n\n<p style=\"text-align:justify\"><strong>Surgical knee replacement<\/strong>. The operation is performed under general anesthesia and lasts for about 2 hours.<\/p>\n\n<p style=\"text-align:justify\"><strong>Postoperative care<\/strong>. During the first day after the intervention the patient stays in the intensive care unit, under round-the-clock medical supervision. After that, with a smooth course of the postoperative period, the patient is transferred to a regular ward and the drains are removed. The range of motion expands gradually, from light toes movements to walking. Walking with the use of walking aids is allowed in 3-5 days after the operation. Normal walking without the use of walking aids (crutches, cane) will become possible in 6-12 weeks.<\/p>\n\n<p style=\"text-align:justify\">Finally, the attending physician will evaluate the results of <strong>control examinations<\/strong>, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n\n<p style=\"text-align:justify\"><strong>Rehabilitation<\/strong>. The rehabilitation program begins after the transfer of the patient from the intensive care unit to a regular ward. It includes physical activity (from exercises in bed in the early days to exercises in the gym), physiotherapy, massage (including lymphatic drainage). After discharge from the hospital, the patient is transferred to a specialized rehabilitation clinic for 2 weeks, where he undergoes an advanced rehabilitation course.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">X-ray examination, MRI\/CT scan (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>physical examination<\/li>\n\t<li>review of medical records<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>indicators of inflammation<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>X-ray \/ MRI&nbsp;examination of the knee<\/li>\n\t<li>preoperative care<\/li>\n\t<li>total knee replacement, cost of the implant is included<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>control examinations<\/li>\n\t<li>the cost of essential medicines and materials<\/li>\n\t<li>orthopedic appliances<\/li>\n\t<li>physiotherapy<\/li>\n\t<li>nursing services<\/li>\n\t<li>full hospital accommodation<\/li>\n\t<li>explanation of future recommendations<br \/>\n\t&nbsp;<\/li>\n<\/ul>\n\n<p><strong>The program includes orthopedic rehabilitation:<\/strong><\/p>\n\n<ul>\n\t<li>Primary presentation in the clinic<\/li>\n\t<li>medical history taking, including family history<\/li>\n\t<li>complex of neurological and orthopedic examinations<\/li>\n\t<li>X-ray examination<\/li>\n\t<li>individual rehabilitation program, which includes:\n\t<ul>\n\t\t<li>Wii Fit training in the use of the balance<\/li>\n\t\t<li>neuropsychological therapy<\/li>\n\t\t<li>functional therapy of the upper extremities (ArmeoSpring)<\/li>\n\t\t<li>kinesiotherapy (physiotherapy)<\/li>\n\t\t<li>biocontrol with feedback<\/li>\n\t\t<li>healing deep muscle massage<\/li>\n\t\t<li>acupuncture of spasticity and pain syndromes<\/li>\n\t\t<li>occupational therapy<\/li>\n\t\t<li>psycho-educational classes<\/li>\n\t\t<li>individual physiotherapy<\/li>\n\t\t<li>microcurrent treatment<\/li>\n\t\t<li>fangotherapy \/ cryotherapy<\/li>\n\t\t<li>antispasmodic drug therapy<\/li>\n\t\t<li>mobilization of limb joints<\/li>\n\t\t<li>hydrotherapy \/ massage therapy \/ reflexology<\/li>\n\t\t<li>training on special trainers<\/li>\n\t\t<li>etc.<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>nurses care<\/li>\n\t<li>stay in the hospital with full board<\/li>\n\t<li>symptomatic and drug therapy<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>Preliminary preparation for surgery<\/strong>: quitting smoking and drinking alcohol 2 weeks before surgery; cancelling non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen); cancelling&nbsp; anticoagulants (warfarin); normalization of body mass, if possible.<\/p>\n\n<p style=\"text-align:justify\"><strong>Preoperative examination<\/strong>, including consultation with an anesthesiologist and necessary related specialists. X-ray examination and MRI of the knee joints are performed. The examination takes 1-2 days.<\/p>\n\n<p style=\"text-align:justify\"><strong>Surgical knee replacement<\/strong>. The operation is performed under general anesthesia and lasts for about 2 hours.<\/p>\n\n<p style=\"text-align:justify\"><strong>Postoperative care<\/strong>. During the first day after the intervention the patient stays in the intensive care unit, under round-the-clock medical supervision. After that, with a smooth course of the postoperative period, the patient is transferred to a regular ward and the drains are removed. The range of motion expands gradually, from light toes movements to walking. Walking with the use of walking aids is allowed in 3-5 days after the operation. Normal walking without the use of walking aids (crutches, cane) will become possible in 6-12 weeks.<\/p>\n\n<p style=\"text-align:justify\">Finally, the attending physician will evaluate the results of <strong>control examinations<\/strong>, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n\n<p style=\"text-align:justify\"><strong>Rehabilitation<\/strong>. The rehabilitation program begins after the transfer of the patient from the intensive care unit to a regular ward. It includes physical activity (from exercises in bed in the early days to exercises in the gym), physiotherapy, massage (including lymphatic drainage). After discharge from the hospital, the patient is transferred to a specialized rehabilitation clinic for 2 weeks, where he undergoes an advanced rehabilitation course.<\/p>\n<\/div>","is_ambulant":"0","bh_fee":"0","only_for_children":"2","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"2","clinic_icon":"60018dfc3827c.jpg","city":"Aachen","clinic_site":"http:\/\/www.ukaachen.de\/","department_recommend":"1","country":"Germany","country_id":"1","clinic_name":"University Hospital RWTH Aachen","cinic_name":"University Hospital RWTH Aachen","department_id":"463","duration":"20","direction":"Knee Surgery","min_duration":0,"clinic_id":"252","paketPrice":7800,"paket":"<ul>\n <li>Interpreter up to 17 hours<\/li>\n <li>Translation up to 10 pages<\/li>\n <li>Visa support<\/li>\n\n \n<\/ul>","title":"Total knee replacement with rehabilitation","price":{"val":30876.58,"type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[{"id":"need_to_use_head_doctor","title":"Treatment by leading experts","type":"val","val":"5790.53","req":0},{"id":"1_person_room","title":" Single room (whole period)","parent":"duration","type":"count_val","val":"143.00"},{"id":"2_person_room","title":" double room (whole period)","parent":"duration","type":"count_val","val":"70.00"},{"id":"attendant_place","title":"Accommodation for the accompanying person ","parent":"duration","type":"count_val","val":"90.00"}],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"7","distance":"88","airport_title":"Cologne-Bonn"},{"id":"4","distance":"101","airport_title":"Duesseldorf"},{"id":"6","distance":"250","airport_title":"Frankfurt a.M."}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}

Total knee replacement with rehabilitation in University Hospital RWTH Aachen

University Hospital RWTH Aachen

Aachen, Germany
Program id # 481718
Doctor photo
Prof. Dr. med. Markus Tingart
Department of Adult and Pediatric Orthopedics
Specialized in: adult and pediatric orthopedics

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • physical examination
  • review of medical records
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • indicators of inflammation
    • indicators of blood coagulation
  • X-ray / MRI examination of the knee
  • preoperative care
  • total knee replacement, cost of the implant is included
  • symptomatic treatment
  • control examinations
  • the cost of essential medicines and materials
  • orthopedic appliances
  • physiotherapy
  • nursing services
  • full hospital accommodation
  • explanation of future recommendations
     

The program includes orthopedic rehabilitation:

  • Primary presentation in the clinic
  • medical history taking, including family history
  • complex of neurological and orthopedic examinations
  • X-ray examination
  • individual rehabilitation program, which includes:
    • Wii Fit training in the use of the balance
    • neuropsychological therapy
    • functional therapy of the upper extremities (ArmeoSpring)
    • kinesiotherapy (physiotherapy)
    • biocontrol with feedback
    • healing deep muscle massage
    • acupuncture of spasticity and pain syndromes
    • occupational therapy
    • psycho-educational classes
    • individual physiotherapy
    • microcurrent treatment
    • fangotherapy / cryotherapy
    • antispasmodic drug therapy
    • mobilization of limb joints
    • hydrotherapy / massage therapy / reflexology
    • training on special trainers
    • etc.
  • nurses care
  • stay in the hospital with full board
  • symptomatic and drug therapy

How program is carried out

Preliminary preparation for surgery: quitting smoking and drinking alcohol 2 weeks before surgery; cancelling non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen); cancelling  anticoagulants (warfarin); normalization of body mass, if possible.

Preoperative examination, including consultation with an anesthesiologist and necessary related specialists. X-ray examination and MRI of the knee joints are performed. The examination takes 1-2 days.

Surgical knee replacement. The operation is performed under general anesthesia and lasts for about 2 hours.

Postoperative care. During the first day after the intervention the patient stays in the intensive care unit, under round-the-clock medical supervision. After that, with a smooth course of the postoperative period, the patient is transferred to a regular ward and the drains are removed. The range of motion expands gradually, from light toes movements to walking. Walking with the use of walking aids is allowed in 3-5 days after the operation. Normal walking without the use of walking aids (crutches, cane) will become possible in 6-12 weeks.

Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.

Rehabilitation. The rehabilitation program begins after the transfer of the patient from the intensive care unit to a regular ward. It includes physical activity (from exercises in bed in the early days to exercises in the gym), physiotherapy, massage (including lymphatic drainage). After discharge from the hospital, the patient is transferred to a specialized rehabilitation clinic for 2 weeks, where he undergoes an advanced rehabilitation course.

Required documents

  • Medical records
  • X-ray examination, MRI/CT scan (if available)

Service

Price from:
Type of program :
Price for 1 day:
Expected duration of the program:
The minimum duration of the program:
Select

You may also book:

Hospital directly:
Saving:
Guarantee BookingHealth Price from:

About the department

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics University Hospital RWTH Aachen ranks among the top German medical facilities specializing in joint replacement surgery! 

The department offers the full range of diagnostics and treatment for patients with musculoskeletal diseases. The department treats patients of all age groups ranging from young children to elderly people. The department annually treats more than 15,000 patients, and also performs about 1,500 interventions yearly. The department has long traditions, long successful clinical experience, which contributes to its reputable status in the medical arena. The department is headed by Prof. Dr. med. Markus Tingart.

One of the department's key activities is joint surgery and endoprosthetics, including revision interventions. With the support of the German Society for Orthopedics and Orthopedic Surgery, the department received the status of the Maximum Care Center for Endoprosthetics. The knee replacement surgery is carried out using cutting-edge navigation systems, which helps to achieve the optimal placement of the prosthesis shaft towards the acetabulum. Thus, the doctors provide excellent prosthesis functionality and reduce the risk of wear. Also, minimally invasive replacement techniques are widely used in the department, which help to ensure minimal traumatisation and quickest recovery of the patients. The department has all the options for high-precision diagnostics (CT, MRI) for the manufacture of individually designed prostheses.

Another priority focus of the department's work is the treatment of musculoskeletal cancers. The department's specialists have high competence and long experience in the diagnostics and treatment of bone and soft tissue tumors. The entire range of modern conservative and surgical treatment of tumors is available here. The treatment is provided in close cooperation with the Euregional Comprehensive Cancer Center Aachen.

The department also has unique experience in the treatment of orthopedic diseases in children. The doctors mostly have to deal with the treatment of congenital malformations, foot deformities and hip dysplasia. The department also treats congenital clubfoot using Ponseti method and corrects axial deformities of the lower limbs (using minimally invasive techniques). In addition, the spectrum is complemented by the treatment of neuro-orthopedic diseases.

The service range of the department includes:

  • Joint surgery, endoprosthetics, revision interventions
  • Sports orthopedics and arthroscopic surgery
    • Shoulder and shoulder joint diseases 
      • Shoulder impingement syndrome
      • Forearm calcification
      • Shoulder dislocation
    • Knee diseases 
      • Cruciate ligament injuries
      • Meniscus injuries
      • Osteochondritis dissecans
      • Patellar luxation
  • Conservative and surgical treatment of spinal diseases
    • Scoliosis
    • Spondylodiscitis
    • Spinal disc herniation
    • Spinal canal stenosis
  • Pediatric orthopedics
    • Hip dysplasia and hip dislocation
    • Perthes disease
    • Slipped capital femoral epiphysis
    • Scoliosis
    • Axial deformities of the lower limbs and lower limb discrepancy
    • Infantile cerebral paralysis
    • Clubfoot
    • Hallux valgus
    • Flat feet
  • Treatment of osteoporosis and other pathological changes in musculoskeletal system
  • Conservative and surgical treatment of musculoskeletal cancers
  • Foot surgery
    • Hallux valgus
    • Ankle osteochondritis dissecans
    • Achillodynia
    • Heel spur
  • Other medical services

Curriculum vitae

Education

  • 10.1989 - 11.1995 Study of Human Medicine, Rhine-Westphalian Technical Aachen University (Leerss Foundation Scholarship)
  • 07.1995 First Stage of the United States Medical Licensing Examination.
  • 11.1996 Doctoral thesis defense.
  • 03.1996 Second Stage of the United States Medical Licensing Examination.
  • 09.1997 Admission to medical practice.

Professional Сareer

  • 03.1996 - 08.1997 Intern, Department of Orthopedics at the University Hospital Cologne.
  • 09.1997 - 03.2000 Assistant Physician, Department of Surgery II, University of Cologne.
  • 09.1998 Theoretical Basis of the Specialty, Emergency Medical Care.
  • 10.1999 Theoretical Basis of the Specialty, Radiation Protection: Emergency and X-ray Diagnostics of the Entire Skeleton.
  • 04.2000 - 09.2001 Scholarship Program of the German Research Foundation, Harvard Medical School, Department of Orthopedic Surgery, Boston, USA.
  • 12.2001 - 02.2004 Assistant Physician, Department of Orthopedics, University Hospital Regensburg.
  • 02.2004 Board certification in Orthopedics.
  • 11.2004 Additional specialization in Sports Medicine.
  • 12.2004 Habilitation in Orthopedics, Faculty of Medicine, University of Regensburg.
  • 01.2005 Additional specialization in Chiropractic.
  • 02.2005 Board certification in Orthopedics and Traumatology.
  • 04.2005 Venia legendi in Orthopedics, University of Regensburg.
  • 01.2005 - 12.2005 Senior Physician, Department of Orthopedics, University Hospital Regensburg.
  • 11.2005 Additional qualification in Rheumatology.
  • 12.2005 Additional qualification in Physiotherapy.
  • 01.2006 - 09.2010 Senior Physician and Deputy Head of the Department of Orthopedics at the University Hospital Regensburg.
  • 03.2008 Optional training in Orthopedic Surgery.
  • 05.2009 Additional qualification in Physiotherapy and Balneology.
  • Since 10.2010 Head of the Department of Adult and Pediatric Orthopedics University Hospital RWTH Aachen.

Scientific Awards, Scholarships and Honors

  • 07.2000 Clinical Grant, Orthopedic Research Laboratories Alumni Council, University of Pittsburgh, USA.
  • 05.2006 Shoulder Fellowship, Working Group on Arthroscopy.
  • 12.2006 Scientific Prize of the Working Group on Replacement Surgery.
  • 02.2007 Austrian-Swiss-German Scholarship, German Society of Orthopedics and Orthopedic Surgery.
  • 12.2007 Grant for Study Abroad, Working on Group on Joint Replacement Surgery.
  • 06.2008 Albert Hoffa Prize of the North German Orthopedic Association.
  • 03.2009 University Competition, Year of Science 2009, Federal Ministry of Education and Research.
  • 10.2009 Themistokles Gluck Prize.
  • 10.2011 Themistokles Gluck Prize.

Membership in Professional Societies

  • German-speaking Working Group on Arthroscopy (AGA).
  • Orthopedic Research Society (ORS).
  • German Society for Orthopedics and Trauma (DGOOC).
  • German Orthopedic Foot and Ankle Society (DAF).
  • Working Group 16 (AK 16) of the German Society for Orthopedics and Orthopedic Surgery, Navigation Surgery.
  • Working Group on Computerized Surgery of the German Society of Arthroplasty.

Photo of the doctor: (c) Uniklinik RWTH Aachen 


About hospital

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals!

As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the accurate diagnostics, effective therapy and productive research activities within one specialized center.

The hospital has more than 60 departments, institutes and interdisciplinary centers. A competent team of professionals, consisting of more than 7,000 employees (more than 940 doctors, including about 95 professors), takes care of the patients' health. In addition, multidisciplinary teams of nurses, physiotherapists, as well as medical and technical staff are available here. The patients and respectful attitude to their social, cultural and religious affiliations are at the center of all employees' efforts.

The cornerstone of the successful clinical practice is the innovative technical base. The hospital offers the most advanced diagnostic and therapeutic equipment. Thus, the hospital has all the resources in order to provide top-class medical services.

Photo: (с) depositphotos

Accommodation in hospital

Patients rooms

The patients of the University Hospital RWTH Aachen live in comfortable single and double rooms. All patient rooms are designed with large windows, so one can enjoy a beautiful landscape view. Each patient room has an ensuite bathroom. The standard room furnishing includes an automatically adjustable bed, a bedside table, a spacious wardrobe, a TV, a radio and a telephone. Also, there is Wi-Fi access.

Meals and Menus

The patient and his accompanying person have a daily choice of three menus. If for any reason you do not eat all the foods, you will be offered an individual menu. Please inform the medical staff about your dietary preferences prior to the treatment.

Further details

Standard rooms include:

Toilet
Shower
Wi-Fi
TV

Religion

Religious services are available upon request.

Accompanying person

During the inpatient program, an accompanying person may stay with you in a patient room or at the hotel of your choice.

Hotel

During the outpatient program, you can live at a hotel of your choice. Managers will help you to choose the most suitable options.

The hospital offers a full range of laboratory tests (general, hormonal, tests for infections, antibodies, tumor markers, etc.), genetic tests, various modifications of ultrasound scans, CT scans, MRI and PET / CT, angiography, myelography, biopsy and other examinations. Treatment with medications, endoscopic and robotic operations, stereotaxic interventions is carried out here, modern types of radiation therapy are also used. The hospital offers patients all the necessary therapeutic techniques.

  • Embolization of tumors and vascular malformations
  • Aortic surgery, including in children
  • Radiosurgical interventions in the head and body region
  • Cochlear implantation
  • Treatment of all types of sports injuries

These are pathologies of the brain and spinal cord, benign and malignant tumors of various localizations, congenital and acquired heart defects, joint pathologies, stroke, neurodegenerative diseases, eye injuries, inflammatory skin diseases, allergies and other pathologies.

  • Oncology (EU Regional Center for Comprehensive Cancer Care Aachen)
  • Pediatric cardiac surgery
  • General and abdominal surgery
  • Plastic and burn surgery
  • Pediatric and adolescent medicine

Over 940 highly qualified doctors work at the hospital.