Sraddha Basnyat's 'In our doctors we trust' (#167) was informative on medical referral trends in Nepal. However, it is unfair and misleading to hint that Bumrungrad's size has obstructed its number one priority: individualised and personalised care is given to each and every patient it serves. Bumrungrad Hospital thrives on its individuialised services. Despite the physical and operational size of the hospital, and patient pool that stretches all over the world, Bumrungrad is able to personalise and attend to even the smallest needs of its patients. Individualised patient care is the perfect complement to cutting edge medical technology and very qualified manpower at the hospital. Bumrungrad's level of services, technology and human qualities, has received mention and coverage from reputed international media.

Amod Pyakuryal,
Bumrungrad Hospital

. After reading 'In our doctors we trust' one gets the impression that the health care sector has improved in Nepal, especially in cardiology and ophthalmology. Some areas of specialisation are no doubt doing well, yet in other cases it is business as usual. We have often read stories in newspapers, of complicated surgeries being successfully conducted by renowned doctors of Nepal. However, such stories are never followed up to find out what happens after the patient goes home. While we are talking about such tertiary level care, which may be limited to the affluent class of the Nepali society, we forget that in terms of primary health care our country lags behind. Plagued by weak health infrastructure, lack of skilled human resource, lack of resources for basic supplies and very poorly managed facilities even at district level, most patients are deprived of medical care. The medical profession is fast turning into a money making business with expensive nursing homes offering good care for a price. But is it really the quality we pay for? From the doctor's perspective, quality may mean providing the correct diagnosis, but from a patient's perspective quality means much more. It means a clean environment, prompt service and most importantly, compassionate care and respectful behaviour.

Sangita Khatri,
Kathmandu