When comparing them to others in their field, I would say they are by far the worst I have ever seen. My wife was referred to Dr. Murphy due to a hearing problem after taking antibiotics for an ear infection that had not cleared up. He perscibed nasal spray. After a month of 'spraying' the problem was still there. On the next visit, his comment on why the nasal spray had not helped was 'bad luck' and then next advise was 2 sprays each day. After more spraying and feeling uncomfortable with the diagnosis, she went to another ENT who quickly diagnosed a cancerous tumor in her nasal passage. We both wish that we had visited this ENT first to save a few months of tumor growth.