It's ridiculous how BAMC wants to normalize that it's ok to wait 3 plus hours in the ER waiting room before being seen, this isn't ok. This should reflect on poor management and leadership. This isn't how you treat people. You can hear staff joking about patient complaints which are valid. Mean while watching people just get up and leave because no one wants to keep anyone informed. This place is obviously run by one of the finest medical Officers the Army must employ. Meanwhile down the road offers 10 min ER wait times which are surprisingly are true.

Delivered my daughter here last week & I can say the care was absolutely terrible. After delivery while still in L&D no one came to change my undressing as often as they should’ve. I sat in soiled dressing for hours. A few of the nurses were attentive, but others were there just to be there. Once moved to postpartum care things took a turn. My IV fell out after not being taped for two days when asked. No one explained my ability to move about in postpartum care. Was there extra time for medical reasons which I understood, but there came a point where some of the doctors were too scared to make the decision to release me & pawned me off to the next shift. I was told by one nurse “this ain’t a prison it’s not like we’re holding you hostage” which was very unprofessional (Nurse Jule). So I began to pack my belongings to walk out. I hadn’t even seen an OB doctor that day either. Once finally discharged it was done very quickly. It was literally done in the rushed manner of ok you wanted to leave get your sh!t and go. I was not wheeled down to the car and no one bothered to help me with my belongings. I do not recommend care here at all.

Absolutely nothing done for our son tht has had two weeks coughing his lungs out. The staff didn’t even do chest x-rays nothing, wasted my time basically to tell me the same. Honey was recommended, which is what I’ve given him for the last two weeks, it obviously didn’t work. Save your time, go somewhere else where they actually do something for you and your family.

I would like to say thank to all Doctors and Nurses healthcare workers, in Brooke Army Urgent & Emergency Care -Medical Center. You are noticed and you are so appreciated. Thank you so much for your bravery, your sacrifices, and your unflagging compassion. Health care workers are heroes, and we wouldn't be able to get through this time without you. You are my inspiration. Sending you all my love. With the deepest sincerity, I want to thank you all for risking your lives for us day in and day out. Frontline workers like you deserve our respect, encouragement, and praise for doing what you do. Thank you​ BAM❗

DO NOT TRUST THESE DOCTORS!!!!!! My husband received the worst medical care at this facility in the ER from Doctors that just sat behind a computer and didnt know how to diagnose a life threatening problem from someone blood work. My husband was in this ER, 3 times from the week of November 7th to November 10th 2022 in severe abdominal pain, weak, could hardly walk or speak anymore and dehydrated but these doctors couldn't find anything wrong with him and would just send him home with Tylenol. During our 6hr vistis, I would continually ask the nurses if they could put him on IV since he had been weak and dehydrated but they would just reply,"we have to wait for the blood work to come back or waiting for x-ray, or CT scan but no fluids to help him feel better only Tylenol. (2nd visit) Again I asked a doctor if they could put him on IV and her answer was, "oh they haven't started him on it" while they all circled around a dog they where petting with no concern about the IV. For 3 different visits my husband left there disappointed and in lots of pain. Day 4 of his anguish we decided to get a second opinion at UMC and we weren't there but 2hrs when they drew blood and realized he was severely dehydrated, so they put him on 3 bags of IV and diagnosed him with Diabetic Ketoacedosis, they had to admit him because by this time his blood was to acidic. If he would have waited a day or two longer to go back to the ER, my husband could have died all because the doctors at Ft. Sam Houston didn't take the time to draw the blood work needed to figure out he was DKA. Thank God for UMC, I do not recommend BAMC hospital ER and I know they dont care for their patients either. They should all get fired and hire Doctors who really care for our military veterans. I will continue to make necessary complaints on this experience because no one should have to experience this service.

Absolutely incredible staff. I took my toddler to the emergency room on a Friday night and every single person we encountered throughout multiple departments was just fantastic. I’ve never been in a medical facility where every single staff member was kind and friendly and also good at what they did. I got home and immediately submitted compliments through ICE and the patient advocates because I was so impressed with the attention and care my child received. I could not recommend this hospital enough!

Went to the ER when I was newly pregnant for cough, vomiting, trouble breathing, chest congestion, fever, so on. Waited for a couple hours, was called back along with 3-4 other patients by a nurse who was clearly overwhelmed. She stuck us each in a room and came back about an hour later explaining that her shift had just started and she was trying to clear out the waiting room. She was nice but she then stayed “you’re here for cold symptoms” at which point I corrected her that it was much more than cold symptoms. Some time later a dr came in and recommended an X-ray for pneumonia which I agreed with because I felt that was the proper diagnosis. The X-ray techs were quick and friendly. The dr came back in later discussing the results but then got paged in the middle of our conversation and immediately walked out. Another dr came In later and we started the whole conversation over. I was told I had bronchitis and sent home with medication. The whole experience took about 6/7 hours. Two weeks later I was still sick and went to a different dr. Turns out I had pneumonia the whole time. The drs and nurses, as kind as they may have been to me, are extremely over worked. They are missing important details which terrifies me. I’m supposed to give birth at this hospital, but I’m exploring other options because all the departments I’ve been to in this hospital seem to be unable to focus on providing proper care. I gave 2 stars because it is clean and for the most part in my experience everyone at least tries to be nice.

Is it me or has the care at this hospital decline? My daughter has been sick the past 2+weeks. They sent her home with instructions of warm tea with honey. 2 days later she still wasnt feeling well, went to an urgent care in Schertz and she HAS PNEUMONIA!! This is not the the first time they misdiagnosed one of my kids. Im so livid, the first time was with my baby. She has been tramatized ever since her er visit. I cant trust this hospital anymore. If you go here, you make sure they listen to you and request specific tests to be done. If they brush you off, go get a second opinion. You cant trust the doctors or the PA's they have here. Also, surveys get sent home after visits, but are they even being reviewed?

Path E and path C -Awesome caring staff for my Aunt Paula Cordero and Son Robert Cordero. Robert was very well taken care of here, he mentioned how nice every one was and the Doctors and nurses and how patient the staff were and also gave great information in medical needs for him and his mom. The Chaplain Man that came in and prayed for my aunt and Cousin, Thursday night August 03-2023 Thank you 🙏 so much , from the family. Thanks for bringing us coffee and snacks it was very warming to all of us. Thanks 🙏 Coffee was so delicious. Please tell the Man, thanks for the blessings. The hospital is clean. The cafeteria had delicious food and great price. The gift shop lady on August 04-2023 around noon was so helpful, as I bought a man planner book. Thanks to you all. Great Hospital 👍

I was a patient at BAMC for my chemo , surgery and radiation . I spent a year in and out of BAMC . My doctors were absolutely the best in the world . Dr Krell my surgeon is a miracle worker. All my doctors were great . The staff was professional and top of the line at all times . I had the best care I have ever had at any medical facility. Unfortunately the pharmacy leaves a lot to be desired. With the "GENISUS " program activated the entire system is in a free fall . Absolutely the worst situation you can imagine , cant talk to a human being . No one is in charge or staff cant give supervisors number out to resolve problems . Absolute nightmare now .It took me 2 1/2 hours to get a problem resolved with my refill on prx. But BAMC IS THE BEST HOSPITAL IN THE WORLD AND I HAVE BEEN ALL OVER THE WORLD. DEPT OF DEFENCE SENDS OUT QUESTIONAIRES ON PATIENT OPINIONS . That is how you run a hospital .

The system is broken for spouses and dependents. My spouse has spent a lot of time calling numbers simply to get the contact information of my child’s doctor to connect them to her school system. BAMC operators telling her they don’t know instead of finding her solutions is unacceptable. Since tricare wants direct communication to be top secret with a multitude of complex systems, simple simple communication and tasks are made frustrating and impossible. I am always infuriated dealing with them and hope someday we drop Tricare and improve Soldier Health Care.

My husband was recently taken there by Care Flight after an inhalation incident with bleach. The concern was chemical burns in his lungs. He was admitted and treated promptly and at 1:15am the next morning I got the call from the doctor that his lungs were basically OK except for one small spot. The whole team was very efficient and caring, but Nurse Randy in unit 4T of the burn unit was an exceptionally caring and helpful person. BAMC is lucky to have him. I thank the entire system for taking excellent care of my husband. Words will never be enough.

This review is for the OB/GYN clinic. I had a procedure scheduled with them. I've had awful ob/gyn experiences elsewhere in the past so I came to this office ahead of time to inquire about options for mitigating discomfort during my procedure. The receptionist came back and said someone else said "oh yeah no problem, just ask for toradol right when you get in for your appointment. It works instantly." So my appointment rolls around, and as soon as the NP walked in, I told her I wanted the pain relief I was told to ask for. Aside from being apparently completely cold and unconcerned that I wanted to experience as little discomfort as possible, she just told me that she's not authorized to do that and doesn't routinely do anything for pain mitigation in patients. "It's not that bad." So yet another example of the medical system expecting women to just put up with reproductive procedure pain and invalidating their experience. Nice. Well after speaking with Ramona, the Nurse in charge of the clinic (who is also the only saving grace of this place and was very sympathetic and apologetic) and explaining the misinformation I was given, I rescheduled with a provider who can. That provider prescribed me a medication ahead of time. Except he didn't input the prescription right, so when I went to pick it up I was told he'd need to resubmit it because it was invalid. I was also told it was invalid because my address was missing. The same address I've given the clinic like 3 times by this point, mind you. So now I've wasted a bunch of time, will have to waste more again because BAMC pharmacy takes forever, had to take another day of leave for the rescheduled procedure, had multiple people be completely unsympathetic to the fact that I've had traumatic reproductive procedures in the past, and people not do their job right which in turn makes their mistakes problems I now have to deal with. Thank goodness I don't want kids because this clinic ain't it. Beware of misinformation and frustrating staff.

This place is outstanding, if you were a Wounded Warrior back in 2007-2011. We had the best Healthcare and medical experiences in the entire USA, at the time. Now it seems like policy rules over treatment. For almost 3yrs durning this crisis, I stood away because I know I cannot wear a face covering and didn't want any trouble. I was recently admitted to the hospital for chest pain resluting in a heart condition I wasn't aware of that needs immediate treatment. I also learned I'm possibly a candidate for a blood cancer that I'll know from a bone marrow biopsy I have scheduled for this Friday. Let's see if I'm allowed to have this done? Even then when I was in hospital, they treated me like I had a contagious disease because I refused a covid test. My wife and kids were not allowed to visit me neither within those 5 days. They won't allow me to recieve care because of a paper face covering. It doesn't matter that I'm medically exempt they will remove you from the building unless you have a note. Still my provider won't provide. I'm being left to hang with my condition. I'm just one more combat wounded Veteran, paying for services, not being given the right to fair medical practices. Where are my rights? Don't get me wrong because it trickles down from the top. There's hundreds of good people working here and some docs who really care for their patients. It's when mixing politics into it that makes it almost crimminal. God bless our troops? Yeah not when they're retired. Shame.

I went to FT Sam Houston for a military training event, got injured and the POC (Mr. Roberto G. Perez) I was given to assist with providing me proper documentation of injuries was a nightmare to communicate with. On several occasions I spoke with him and he was cold, dismissive and for some reason obstructive since I had to reach out several times to get an actual hard copy of my documents (took years). From what I gathered he screened my complete medical records, he started asking questions in order to dismiss my current injuries. He was trying to act like a representative from VA asking probing questions as to why I am asking for a Copy of MY documents? And what was I planning to do with them? Also telling me it's pointless to get documents I would be receiving from him since I would not be able to use with VA. He asked me if I would be contacting VA also. 1. I NEVER asked for his opinion/guidance on anything. 2. His JOB was to simply provide me MY documentation. 3. Trying to BLOCK a soldier from obtaining their records is discriminatory in so many ways. What an unprofessional individual. I contacted Patient Liaison to provide feedback on what was occurring and he was fast to dismiss me also and get a nasty attitude after I gave him the name of the Representative. Seems they were buddies. If you are a Soldier do not get discouraged by this Mr. Perez. YOUR documentation is your RIGHT to have. Keep pushing, you will come across many mean spirited individuals who want to sabotage what you are trying to achieve. Did not have a bad experience with the medical center itself just the Individuals mentioned.

Absolutely horrible mismanagers of time, will take 12 + hrs of waiting in ER to only take an X-ray. Pharmacy worse when the same people working there can literally go ahead of you twice in the line before they even get your meds ready. Any other hospital in SA would be a shorter, more efficient wait time than here.

I have never, ever experienced a hospital as excellent as BAMC. My grandfather was admitted after experiencing a fall. The staff from the emergency department and everyone else we worked with were extremely kind, attentive, and we were NEVER left with unanswered questions. My grandfather was treated with the utmost respect and dignity during his stay. It’s nice that he had the same nurses and doctors throughout the duration of his time at the hospital. I can’t express the gratitude I have for the staff at BAMC. My family was beyond impressed with this hospital. Also, hospital is immaculate, and I mean immaculate, and there are several amenities for guests and visitors.

Walked in to get a quick Covid test. Never been there for Covid testing, so I was unsure of process. Followed the signs and came upon a table with stacks of forms. No sign saying fill out, place in bin and wait. No clipboards, no pens, no clean and dirty separators. Two men at desk laughing and talking to themselves. When I asked them what to do, they acted like I bothered them. The proper answer would be to focus on job, ask customer who is standing next to table looking confused if you can assist them. The attitude was ridiculous. Common courtesy goes a long way. As a Retired Lt Col of the USAF and a Veteran a little courtesy would be nice. In addition, another older couple who was also unsure of process was equally disrespected.

We've been using this facility for about 6 months. It's clean, modern, and so far we've been tested very well. As with any military medical service, there can be waiting, but I've seen much longer waits in the past. So far we're very pleased and grateful.

This should not be listed on google maps with the big “H” as a hospital. IT IS NOT OPEN TO THE PUBLIC. It is a military hospital only for active military and veterans. I hope someone that doesn’t live here or know better doesn’t bring a sick or injured person here, you will not be let in and will waste valuable time in an emergency. Google - DO BETTER

Big thank you to the team at Brooke Army Medical Center. They helped us through a very rough time after a catastrophic head injury that took the life of our loved one. They were responsive, attentive, kind, respectful and kept our love one comfortable until they transitioned to the next life. Special thanks to Chaplin Hughes. You are truly called to this work!

Don't know how this has almost a 4 star. Every wait is almost 2 hours. Even if its for my daughter (11months) when she was having fever of 101.9, high heart rate, couldn't hold anything down, etc. You get called back, rooms are empty, people standing around talking & laughing. Takes another 45 mins to see one dr and explain everything again . Once waited 7 hours for "emergency surgery". They were the ones who told me it was an emergency and i need it right then and there. Smh

I really try to avoid coming to the ER unless I absolutely need to, the wait is typically long much like norm Ops for an ER however, every time I come her the care I get is beyond my expectations. The staff I’ve always encountered are friendly and seem to really listen to the patients. I really have no complaints about the ER, the wait is always worth the care you’re about to receive.

The emergency department itself was very professional and quick. The pharmacy is a real stinker! Today the wait time was over an hour and a half. The people back there are just ignoring the patients waiting. I’m sure they’re busy, BUT a little attention to us I’m sure would be appreciated by all!!

First off, if I could give this hospital 20,000 stars I would 🙏🏼 from 3W to STICU where my father spent his final moments there are no words to express the Respect and Gratitude me and my family have! From the moment I walked into the hospital to be with my father, everyone from the information desk to the cleaning crew to the Dr’s & Nurses it was the upmost respect and care that we received that deserves this review and much more! You all did an outstanding job and we thank you all very much! The Zygmont-Ramirez Family

I am meal card holder. Today the cashier told me that you can not take the salad ( i had tomato, cucumber ,lettuce and olive ) together pizza ( i had 1 slice pizza +1 salad +1 fountain drink ) . But look at the pictures which one they made a poster at the entrance

I spent an hour on the phone trying to get a prescription refilled, first on their automated line, which by the way doesn't work right, with broken links, then 40 minutes waiting for someone in the pharmacy to pick up, and she said she's a pharmacist tech and cannot contact my doctor to request a refill, but I should call the communications room to have them look up my doctor, who by the way no one has ever heard of. I already spoke to someone in the communications room. They can't help me because I spent 1500-1600 on hold and now everything is closed. This is about to become an ICE complaint and then we'll see about getting a refill, but I can't do anything until tomorrow. When I first moved here I spent 6 months trying to get my antidepressants refilled and they said I couldn't do so without getting ahold of someone in the Annapolis pharmacy. Could this be any more frustrating??

Nice staff, good doctors. I've never attended the way the staff in the ER and when I checked in toy room. I feel like I was in great hands. Very efficient. Top notch. But it's absurd to make an emergency room patient who was checked in for chest pains, stay in the hospital for 3 Three THREE FULL DAYS and possibly have to leave without getting seen for a freaking MRI. Totally unacceptable. There's a possibility that I'll leave with an OUT patient appointment (possibly 6-8 weeks later, I'm told)because they still won't have seen me 3 days later because I'm not a priority. The doctor needed the MRI to determine if I needed blood thinners. I can't get what I need until I get an MRI. I hope nothing happens to me between now and my appointment. IF it doesn't happen today. Also, patients have to advocate for themselves if they're not currently in a medical emergency. Some of the RNs and docs were very helpful. I don't know for sure, but I suspect my priority level gets knocked down a spot or 2 after the 12-hour shifts. I got no updates about where I was in line for MRI the last 2 nights. It felt like one call was made early in the night shift, and that was it. I heard doctors and RNs say it's super hard to get the MRI section, and they had to call multiple times just get an answer for just one patient. God forbid both sections are busy. That's a problem that needs to be raised and addressed with higher and/or operations. "That's just how things are" shouldn't be acceptable for staff,IMO. Lastly, I highly suggest using your own toiletries if you have to stay a few days. I'm clearly typing this at the height of my frustration, but what I'm saying is fair. I'm an operations/HR guy, so I believe policy/procedures should always be reviewed and updated periodically if necessary, and staff needs to speak up when issues arise. Off soapbox**

On 25 May around 2150 it was brief to me that visiting hours end at 2100. This information was not brief to my sister and I. Also the visiting hours are not listed on their website. My sister is my caregiver. She has taken this role since the beginning of my condition. I have been diagnosed with a tumor over a year ago. After I stated that I wanted to be discharged Dr. Min Phwin said that he has not discharged anyone and doesn’t know how. It was also stated to me by Lt Mee that the reason my sister needed to go is because of COVID. I was told by a nurse that they are not doing testing via email. There is not anyone else in room 330. At 2330 the Nurse Almaraz came in to put leg massager. She stated that it was a concern due to my heart rate but my heart rate was 128 earlier in the night shift. They did mentioned if decline medical care that Tricare would not cover the cost. Tricare doesn’t stated that declining treatment would be out of pocket. It was also stated that since I’m active duty I can’t get discharge. Currently I’m under patient status I’m not working or attached to any squadron but I am assigned to AMTU at Lackland. My decision to stay at BAMC overnight was on a voluntary basis. Dr. Duncan is my doctor that conducted the procedure. Dr. Duncan said that I could go home due to procedure going so well. Since being inpatient the nurses have only come in to give my medication. No other treatment was conducted. The plan of care is observation and pain management. I haven’t had any issues due to my procedure since being admitted. The justifications that were presented to me were not consistent. Since my condition my sister has provided me with emotional support. Telling me the visitor hours abruptly like this put my anxiety on a higher level with cause my heart rate to be even higher. None of my concerns were taken in consideration.

Had an appointment at 0800. Doctor called said we need to meet at 0900 because of a meeting. I was there at 0900 and was told I missed my appointment. Finally at 1030 the doctor comes out and starts apologizing about a lack of communication On top of that the individual working the desk misplaced my ID. Gastroenterology, be aware

Avoid if you can. Which you are military, typically can’t if you’re going here. Some staff are obviously nice but overall care to anything is below bad. Long wait times, staff that doesn’t care, zero communication. I could go on for a long time.

Worst customer service I’ve experienced in my 25 years of active service at the pediatric clinic front desk. Policies are inconsistent across the clinics! If you have private insurance through your spouse I highly suggest going to a more reputable clinic or hospital. Military medicine has gone down the toilet ever since being absorbed under the DHA.

Never seen medical staff this rude. When the wait seemed long I decided to leave. A man named Ken stopped me from leaving and said “It is our policy that uniformed service members are not allowed to leave. If you leave I will call the police and call your CO.” I sat petrified for hours thinking I was about to be detained. Eventually a nurse come up to me and informed me that Ken had been mistaken. Worst healthcare experience of my life, if you can even call it healthcare. More like hostility and threats.

Worst customer service: Pediatric specialty; rude lady at front desk whom is very disrespectful and treats people bad over the phone and in person. Should not be working there. Gave a 3 star because the pediatric cardiologist doctor is good otherwise it would be a 1 star.

Feel down and broke both my ankles, one more severe than the other. Everyone there was extremely helpful, caring, and loving. John especially in ER would give me advanced notice of what type of pain or relief I would feel. Thanks everyone from the EMS drivers to the entire staff for getting me home as soon as possible. Gonna name all those who remember sorry to those i forgot. Megan, Roland, Mary, and luietanant Moore.

My daughter was shot and was sent here From the moment she came unto discharge she was treated very well Dr's were great They explained everything to me and did everything they could to save her hand.

I was there for surgery twice and each time the surgical team was excellent , i was on East wing the first time the second time the west wing both did an excellent job in caring for peoples. The best place you will get treatments from.

I have had pretty good experiences at BAMC. The only thing that made me knock it down to three stars is CAMO. I don’t know the inner workings of the system, so I rely on agents to tell me the correct information. I called a month ago to schedule an appointment to see the allergist at BAMC who I’ve seen many times before. I didn’t know that I’m not allowed to see the allergist any longer because I’m not PRIME.. Since I am able to go to the emergency room, I thought I could go see the doctors there since I have TRICARE select. When I called Tricare they told me that I can go anywhere that Tricare is accepted, and if I don’t go where it’s accepted, that’s the only time I need a referral. The lady I spoke to today explained that to me but in a very curt tone and then she hung up on me. That is not okay. She can be mad at Tricare for giving wrong information, believe me I am too, but she should not take it out on me. Now I’m glad I don’t have to deal with them anymore.

Hands down best ER I've ever been to. The ER had to do some short notice blood work on me to make sure I oath in, the person in charge saw to it even though it got close. My one regret is not getting the name of the Marine that calmly addressed me and answered my questions about the Corps. while my blood was drawn. I am forever thankful to that Marine, the docs, nurses, and other staff that did work on me. I ship to boot camp on 6/26/22 thanks to you guys. Yes; I'm the kid that needed the glucose test hahaha.

Captain Barkley from the ER and Dr. LaFour from Orthopedic were amazing to my Son tonight, May 29, 2022. Captain Barkley truly went out of her way to ensure that me and my son were both comfortable and asked if we needed anything she was very informative checking on us providing updates. Dr. LaFour was very kind and super fast she casted my sons arm so careful and kind my son was very comfortable with both of them. We were definitely in GREAT hands. She was so kind and understanding about his cast getting wet accidentally vs him feeling like he was going to receive a reprimand. THANK YOU BOTH.

Delivered my baby here and I had a very positive experience. Each nurse and doctor that I saw took the time to explain what was going on and walked me through the options without pushing me in any direction. When I was ready to push, I had several nurses and doctors coach me and they were very encouraging and reassuring. The postpartum care was amazing too and I have to say, the nurse Rose was a godsend to me and my husband, offering us encouragement and words of advice. We loved her! Lactation consultation could have been better is my only feedback.

Went to BAMC for a medical emergency, we were there for a total of 9 hours. The staff and nurses were good to us, but medically nothing was really done to help the problem. All my grandma was given were some pain and anti nausea meds, she was taken for a CT scan we never got results for, and they discharged her with meds to take at home after being told multiple times she can’t keep any food or water down. Honestly disappointed in how they took care of her.

My dearest relative was transported to BAMC from out of town with a brain injury. Wonderful doctors explained information and answered all questions that we appreciated. Now nurses, not the same professionalism. When blood pressure dropped we learned from doctors that taking blood pressure from forearm never acceptable. Then nurses asked questions to check cognitive function. First question was who is the president she answered and replied with a snarky comment. She was able to respond correctly right after she realized it was a mistake. Then they preceded to make political statements. Regarding taxes too high. Of course, I commented because some Congress members refused to vote to do away with tax cut for the wealthy So they proceeded to complain about old people in office, feminism is a problem and constitution say’s lawyers should not be in office. I did engage hoping civil discourse would end commentary. However both continued complaining about our current government and based on comments it was easy to determine their political affiliation which is none of our business I have never ever experienced such bedside manner. Especially from military personnel who’s boss is the Commander in Chief-The current president. Is this what the military has become? Is this becoming behavior of military personnel? Considering the political climate in this nation the last place I would expect to see this is a military hospital. These were the same nurses that took blood pressure on forearm which is we learned is unacceptable.