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Dr. M Whitney Parnell, MD

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Specializes in: General Surgery

Creighton University School of Medicine (1995)

Professional interests include: breast biopsy, lumpectomy, mastectomy (breast removal surgery), and more.

315 East Elm Street Suite 350
Caldwell, ID 83605

(208) 459-0028

Dr. M Whitney Parnell, MD is a general surgeon in Caldwell, ID specializing in general surgery. She graduated from Creighton University School of Medicine in 1995 and has 31 years of experience. Dr. M Whitney Parnell, MD is affiliated with West Valley Hospital.

Office Locations

West Valley Hospital

315 East Elm Street Suite 350
Caldwell, ID 83605

(208) 459-0028

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Some issues Dr. M Whitney Parnell, MD can help you with:

Breast Biopsy

Breast biopsy is a procedure where a small sample of tissue is collected from the breast for testing. A physician may prescribe a breast biopsy for a variety of reasons, but they are most frequently prescribed for a lump found in the breast. Biopsy samples extracted are examined by pathologists in a laboratory setting and are tested to determine if they are cancerous or benign, or indicative of some other condition. Depending on the lab results, physicians may prescribe additional treatment. Other circumstances which may prompt a breast biopsy include:

Mammograms that detect other unusual features in the chest, such as a cyst or calcium deposit
Breast scans or ultrasounds that display abnormalities
Nipple changes, such as scaling, crusting, or bloody discharge

Breast biopsies are collected through several different procedures and the specific type of biopsy that a patient receives depends on the size, location, and features of a breast lump or irregularity. The three main methods of collecting a breast biopsy include:

Fine needle aspiration (FNA biopsy), where a thin needle is directed into a breast lump or abnormality, extracting a small sample of tissue or liquid
Core needle biopsy (CNB biopsy), where a hollow needle is directed into a breast lump or abnormality, extracting cylinders of tissue called "cores"
Open (surgical) biopsy, where a breast lump is removed through an incision in the breast

Fine needle aspiration (FNA) and core needle biopsy (CNB) are sometimes image-guided, where a mammogram, ultrasound, or MRI helps direct the physician performing the needle extraction.

Fine needle aspiration, the most common biopsy method, generally requires few patient preparations. It is recommended patients avoid using lotion, deodorant, and perfume prior to their biopsy procedure. FNA biopsy is performed with local anesthesia (topical numbing cream) and typically has a quick recovery, but patients may experience soreness for a few days. Core needle biopsy extracts slightly more tissue than an FNA biopsy.

Open (surgical) biopsy is more invasive and requires general anesthesia, where patients are put to sleep during the procedure. Patients must fast prior to the surgery. After the biopsy is performed, patients are monitored in a recovery room for a time before being discharged, when they will need someone else to provide transportation.

Although some may consider breast biopsy to be a simple procedure, it can catch critical issues - particularly breast cancer - that impact wellness. If a breast biopsy reveals an underlying condition like life-threatening cancer, patients can receive the diagnosis and medical treatment that is necessary for their long-term health.

Gallbladder Removal Surgery (Cholecystectomy)

The gallbladder is a small, pear-shaped organ on the right side of the upper abdomen, underneath the liver. Its purpose is to store bile, which is used to digest fat. Occasionally, the gallbladder can develop mineral stones, called gallstones. If they are large enough, gallstones can block the ducts in the gallbladder and cause swelling and infection. Gallstones can be treated with lifestyle changes and medication, but sometimes this is not enough. In these cases, it is best to remove the gallbladder before it can cause more serious problems. The surgical removal of the gallbladder is called a cholecystectomy.

Today, most gallbladder surgeries are done laparoscopically. Four tiny incisions are made in the abdomen, and small tools are inserted through these tiny incisions to perform the surgery. Because the incisions are much smaller, recovery time is much faster with this type of surgery. Patients are usually discharged from the hospital the same day. Sometimes, open surgery is used to remove a gallbladder. In this type of surgery, a cut about six inches long is made in the upper right abdomen. After the gallbladder is removed, it is sutured or stapled closed. With open surgery, patients usually stay in the hospital for two to three days to recover before they are discharged.

Gallbladder removal, like any surgery, carries some risks, such as bleeding, infection, or the development of blood clots. Doctors will tell patients how to minimize their risk for complications. After surgery, patients are advised to avoid strenuous activity for several days. They should not soak in a bath until their sutures or staples have been removed. Patients should wash hands before touching the area around the incision. It will take a couple of days until patients feel like themselves again and a few weeks until their scar has healed and faded.

Mastectomy (Breast Removal Surgery)

Mastectomy is the surgical removal of all or part of the breasts, most frequently associated with breast cancer treatment (for both male and female breast cancer patients). Breast cancer patients who receive a mastectomy typically have undergone other treatments, such as chemotherapy, radiation, and less invasive breast-conserving surgery (lumpectomy). If these treatments are unsuccessful, oncologists may eventually prescribe a mastectomy. Other conditions that may prompt a mastectomy include:

Two or more cancerous regions in the same breast
Inability to receive chemotherapy or radiation therapy
High likelihood of recurring breast cancer
Large tumor that is bigger than two inches across
Pregnancy that prohibits radiation therapy
Preexisting conditions like lupus or scleroderma

Notably, some patients may elect to undergo mastectomy without a breast cancer diagnosis. Preventative (prophylactic) mastectomy is performed on those with a high risk of breast cancer, such as having a family history of the disease or carrying the breast cancer BRCA1 or BRCA2 gene. Preventative mastectomy substantially reduces one's chances of developing breast cancer in the future, but it cannot wholly prevent it.

Surgical oncologists perform several types of mastectomies, depending upon the severity of the breast cancer (including factors such as its location and spread), as well as the patients' own aesthetic and personal choices. The six main types of mastectomy include:

Total mastectomy, where the surgical oncologist removes an entire breast, including parts like the pectoral chest muscle, skin, and nipple.
Radical mastectomy, where the surgical oncologist removes the entire breast, underarm lymph nodes, pectoral chest muscles, and outer skin and nipple. One of the most invasive forms of mastectomy, radical mastectomy is infrequently performed.
Modified radical mastectomy, where the surgical oncologist completes a total mastectomy and also removes the underarm lymph nodes. This procedure is slightly less invasive than radical mastectomy.
Skin-sparing mastectomy, where the surgical oncologist removes cancerous breast tissue and nipple, but leaves most of breast skin. This method is used in conjunction with breast reconstruction, as implants can be added below the skin. Skin-sparing mastectomy often requires a treatment team with a surgical oncologist and a plastic surgeon experienced in breast procedures.
Nipple-sparing mastectomy, where the surgical oncologist removes cancerous breast tissue and leaves the nipple and most of the breast skin. This method is only available to patients in the early stages of breast cancer. Similar to skin-sparing mastectomy, this procedure is frequently performed with breast reconstruction.

Any of these procedures can be done on both breasts, in which case the procedure would be known as a double mastectomy. For example, a surgical oncologist might perform a total or nipple-sparing mastectomy on both breasts. Double mastectomies are often used as a preventive surgery for those who are at risk of developing breast cancer later on in life.

Patients have one or two days of hospital stay before returning home from their mastectomy procedures. Full recovery can take several months, but some patients find they are able to resume normal activity within one month of their mastectomy. Patients are advised to limit arm and chest movements whenever possible.

After surgery, patients must also adjust to changes in their appearance. While some patients choose to receive breast reconstruction, other patients may decide to wear prosthetic breasts or will simply embrace their new chest.

Mastectomies permit patients to conquer cancer and lead healthy, thriving lives as breast cancer survivors.

Noteworthy Medicare Patient Procedures Performed by Dr. M Whitney Parnell, MD in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 25%

By Affordability:

hospital care

inpatient care

inpatient hospital care

In 2012, Dr. M Whitney Parnell, MD had a list price for hospital care, inpatient care, and inpatient hospital care (for patient admitted to hospital) that was lower than the list prices billed to Medicare by 75% of providers in related specialties within Idaho. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2012 were hospital care, inpatient care, open surgery and diagnostic procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

breast procedures	52
diagnostic procedures	71
doctor visit	291
excision	71
hospital care	93
image guided procedures	32
inpatient care	93
lymph node procedures	19
minimally invasive procedures	32
minor procedures	32
open surgery	71

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2013 were excision, lymph node procedures, hospital care and inpatient care.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

breast procedures	28
cancer surgery	13
diagnostic procedures	34
doctor visit	327
excision	47
hospital care	39
image guided procedures	15
inpatient care	39
lymph node procedures	40
minimally invasive procedures	15
minor procedures	15
open surgery	34

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	48
Female	173

**Ethnicity**
Non-Hispanic White	204
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	118
From 75 to 84	52
85 and over	23
Less than 65	28

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2013

Hypertension	71
High Cholesterol	68
Stroke	5
Ischemic Heart Disease	24
Depression	20
Chronic Kidney Disease	16
Asthma	9
Osteoperosis	9
Atrial Fibrilation	9
Heart Failure	14
Chronic Obstructive Pulmonary Disease	12
Diabetes	34
Dementia	6
Cancer	39

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2014 were breast procedures, diagnostic procedures, lymph node procedures and excision.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

breast procedures	73
cancer surgery	23
diagnostic procedures	71
doctor visit	451
excision	56
image guided procedures	38
lymph node procedures	64
minimally invasive procedures	38
minor procedures	38
open surgery	33
ultrasound (sonogram)	12
women's imaging	12

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	37
Female	186

**Ethnicity**
Non-Hispanic White	205
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	135
From 75 to 84	47
85 and over	20
Less than 65	21

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2014

Hypertension	70
High Cholesterol	75
Stroke	0
Ischemic Heart Disease	28
Depression	22
Chronic Kidney Disease	17
Asthma	0
Osteoperosis	13
Atrial Fibrilation	9
Heart Failure	13
Chronic Obstructive Pulmonary Disease	12
Diabetes	28
Dementia	0
Cancer	48

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2015 were diagnostic procedures, breast procedures, lymph node procedures and minor procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

breast procedures	60
cancer surgery	17
catheterization	12
diagnostic procedures	68
doctor visit	483
excision	42
image guided procedures	43
lymph node procedures	46
minimally invasive procedures	43
minor procedures	43
open surgery	25

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	60
Female	454

**Ethnicity**
Non-Hispanic White	470
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	308
From 75 to 84	112
85 and over	30
Less than 65	64

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2015

Hypertension	71
High Cholesterol	69
Stroke	0
Ischemic Heart Disease	26
Depression	21
Chronic Kidney Disease	21
Asthma	10
Osteoperosis	16
Atrial Fibrilation	7
Heart Failure	9
Chronic Obstructive Pulmonary Disease	11
Diabetes	28
Dementia	0
Cancer	49

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2016 were diagnostic procedures, lymph node procedures, excision and breast procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

arthrodesis (bone fusion surgery)	12
breast procedures	39
cancer surgery	19
catheterization	11
diagnostic procedures	43
doctor visit	520
excision	42
image guided procedures	20
lymph node procedures	43
minimally invasive procedures	32
minor procedures	20
open surgery	23
spinal procedures	12

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	44
Female	284

**Ethnicity**
Non-Hispanic White	298
Black	19
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	206
From 75 to 84	70
85 and over	28
Less than 65	24

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2016

Hypertension	69
High Cholesterol	69
Stroke	4
Ischemic Heart Disease	28
Depression	20
Chronic Kidney Disease	17
Asthma	15
Osteoperosis	20
Atrial Fibrilation	7
Heart Failure	12
Chronic Obstructive Pulmonary Disease	14
Diabetes	25
Dementia	5
Cancer	53

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2017 were breast procedures, excision, diagnostic procedures and lymph node procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

arthrodesis (bone fusion surgery)	19
blood draw	17
breast procedures	67
cancer surgery	30
diagnostic imaging	11
diagnostic procedures	53
doctor visit	625
excision	57
image guided procedures	26
lymph node procedures	53
minimally invasive procedures	45
minor procedures	26
open surgery	27
spinal procedures	19
women's imaging	11
X-rays	11

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	65
Female	331

**Ethnicity**
Non-Hispanic White	365
Black	16
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	226
From 75 to 84	105
85 and over	29
Less than 65	36

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2017

Hypertension	68
High Cholesterol	63
Stroke	4
Ischemic Heart Disease	24
Depression	24
Chronic Kidney Disease	16
Asthma	8
Osteoperosis	16
Atrial Fibrilation	9
Heart Failure	9
Chronic Obstructive Pulmonary Disease	12
Diabetes	28
Dementia	6
Cancer	48

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2018 were minimally invasive procedures, diagnostic procedures, hospital care and inpatient care.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

arthrodesis (bone fusion surgery)	12
breast procedures	13
diagnostic procedures	25
doctor visit	285
excision	12
hospital care	24
image guided procedures	13
inpatient care	24
lymph node procedures	23
minimally invasive procedures	25
minor procedures	13
open surgery	12
spinal procedures	12

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	49
Female	206

**Ethnicity**
Non-Hispanic White	234
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	142
From 75 to 84	65
85 and over	23
Less than 65	25

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2018

Hypertension	66
High Cholesterol	71
Stroke	0
Ischemic Heart Disease	22
Depression	20
Chronic Kidney Disease	22
Asthma	6
Osteoperosis	13
Atrial Fibrilation	7
Heart Failure	13
Chronic Obstructive Pulmonary Disease	13
Diabetes	24
Dementia	6
Cancer	48

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2019 were hospital care, inpatient care, minimally invasive procedures and spinal procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

arthrodesis (bone fusion surgery)	19
doctor visit	68
hospital care	59
inpatient care	59
minimally invasive procedures	19
spinal procedures	19

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	51
Female	60

**Ethnicity**
Non-Hispanic White	89
Black	0
Hispanic	11
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	35
From 75 to 84	30
85 and over	11
Less than 65	35

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2019

Hypertension	72
High Cholesterol	52
Stroke	0
Ischemic Heart Disease	26
Depression	32
Chronic Kidney Disease	33
Asthma	0
Osteoperosis	0
Atrial Fibrilation	10
Heart Failure	12
Chronic Obstructive Pulmonary Disease	17
Diabetes	32
Dementia	13
Cancer	12

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2020 were hospital care and inpatient care.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

hospital care	49
inpatient care	49

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	26
Female	33

**Age**
From 65 to 74	22
From 75 to 84	19
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2020

Hypertension	75
High Cholesterol	59
Stroke	0
Ischemic Heart Disease	34
Depression	27
Chronic Kidney Disease	44
Asthma	0
Osteoperosis	0
Atrial Fibrilation	0
Heart Failure	19
Chronic Obstructive Pulmonary Disease	0
Diabetes	25
Dementia	0
Cancer	24

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID during 2021 were hospital care, inpatient care, excision and lymph node procedures.

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

breast procedures	23
cancer surgery	23
diagnostic procedures	19
doctor visit	73
excision	42
hospital care	98
inpatient care	98
lymph node procedures	36
open surgery	19

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	53
Female	93

**Ethnicity**
Non-Hispanic White	132
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	56
From 75 to 84	44
85 and over	29
Less than 65	17

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2021

Hypertension	71
High Cholesterol	51
Stroke	0
Ischemic Heart Disease	33
Depression	34
Chronic Kidney Disease	48
Asthma	15
Osteoperosis	12
Atrial Fibrilation	13
Heart Failure	21
Chronic Obstructive Pulmonary Disease	22
Diabetes	27
Dementia	12
Cancer	37

Medicare Procedure and Patient Information

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Age**
From 65 to 74	0
From 75 to 84	12
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD in 2022

Hypertension	75
High Cholesterol	64
Stroke	0
Ischemic Heart Disease	0
Depression	0
Chronic Kidney Disease	0
Asthma	0
Osteoperosis	0
Atrial Fibrilation	0
Heart Failure	0
Chronic Obstructive Pulmonary Disease	0
Diabetes	0
Dementia	0
Cancer	52

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2022

Volume of procedures performed by Dr. M Whitney Parnell, MD for Medicare patients.

The highest averages for the top procedures that Dr. M Whitney Parnell, MD treated as a general surgeon in Caldwell, ID were inpatient care, hospital care, diagnostic procedures and excision.

arthrodesis (bone fusion surgery)	15
blood draw	17
breast procedures	44
cancer surgery	20
catheterization	11
diagnostic imaging	11
diagnostic procedures	48
doctor visit	347
excision	46
hospital care	60
image guided procedures	26
inpatient care	60
lymph node procedures	40
minimally invasive procedures	31
minor procedures	26
open surgery	30
spinal procedures	15
ultrasound (sonogram)	12
women's imaging	11
X-rays	11

Average Medicare Patient Data From 2012 - 2022

Information about Medicare patients treated by Dr. M Whitney Parnell, MD.

**Gender**
Male	39
Female	165

**Ethnicity**
Black / African American	3
Asian / Pacific Islander	0
Non-Hispanic White	181
Native American / Alaskan Native	0
Hispanic	1
Other	0

**Age**
75 to 84	50
85 and over	17
Less than 65	22
65 to 74	113

Average of Total of Conditions of Medicare patients treated by Dr. M Whitney Parnell, MD From 2012 - 2022

The highest averages of the most common conditions of Medicare patients that Dr. M Whitney Parnell, MD treated were hypertension, high cholesterol, cancer and diabetes.

Hypertension	64
High Cholesterol	58
Stroke	1
Ischemic Heart Disease	22
Depression	20
Chronic Kidney Disease	21
Asthma	5
Osteoporosis	9
Heart Failure	11
Chronic Obstructive Pulmonary Disease	10
Diabetes	22
Atrial Fibrillation	6
Dementia	4
Cancer	37

Education & Training

Dr. M Whitney Parnell, MD graduated from Creighton University School of Medicine in 1995. She completed residency at Phoenix Integrated Surgical Residency. She has a state license in Idaho.

Medical School: Creighton University School of Medicine (1995)

Residency: Phoenix Integrated Surgical Residency (2000)

Licensed In: Idaho

Affiliations & Hospitals

Dr. M Whitney Parnell, MD is associated with these hospitals and organizations:

West Valley Hospital

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General Payments

These charts describe general payments received by Dr. M Whitney Parnell, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Novadaq Technologies Inc.	$2,022 DERMACELL $2,022
Intuitive Surgical, Inc.	$1,431 Da Vinci Surgical System $1,431
Medtronic Xomed, Inc.	$1,063 Advanced Energy Cutting Device $1,063
Stryker Corporation	$682 SPY-PHI SYSTEM $645	SPY Technology $22	None $15
Medtronic USA, Inc.	$194 ELEVATE $149	PIVOX Oblique Lateral Spinal System $25	CAPSTONE $20
Other	$1,100 SAVI $174	BioZorb $136	EDWARDS INTUITY Elite valve system $92	OVATION $69	OviTex Reinforced Bioscaffold With Permanent Polymer (OviTex) $55	Other $575

**Types of Payments**
Travel and Lodging	$3,958
Food and Beverage	$2,535

Biography

Dr. M. Whitney Parnell is a physician who specializes in general surgery. She is a graduate of Creighton University School of Medicine. She trained at Phoenix Integrated Surgical Residency for her residency. Dr. Parnell's areas of expertise include hernia surgery, hernia, and colorectal cancer. Dr. Parnell is professionally affiliated with West Valley Hospital.