Photo of Dr. Kanwar Partap S. Gill, MD

Dr. Kanwar Partap Gill is an urgent care specialist in Fresno, CA. He specializes in minor illnesses and injuries requiring immediate medical attention.

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Dr. Kanwar Partap Singh Gill discussing Health Care issues.  

Interview with Dr. Kanwar Partap S. Gill MD and discussion the current healthcare system. See for more info.

English ()0:09welcome to weaponize news0:11with your host store web in stamp cheney0:14fighting the international bankers one-world government scientific0:18dictatorship0:19break for my control be the change you want to see in the world0:23and now here's our whole stiller and fam0:27welcome to weaponize news0:30I'm your host your weblog may cause Sam cheney a0:34we are broadcasting here in 1680 a.m. in Fresno0:37please visit weaponized news dot com we just launched a couple weeks ago0:41and we are now broadcasting as weapon is news we love it we love our new site to0:46check it out0:47will be posting everyday news stories what's going on0:50so please check out the site and will be looking for advertisers as well0:54here for the first hour broadcast we have a special guest0:58doctor I would seek Kanwar1:01Gill IMD he will be discussing1:04the some things he dislikes about %ah the where health care industry is going1:09though what he has to deal with and what is patients have to deal with so1:12thank you for joining us thanks for having me so1:16what exactly why is our health care system1:19a in you then I United States1:22giving so many fewer problems what is what is it is it the bureaucracies that1:26Obamacare1:27what are you struggling with the most in 20 patients struggling with them up most1:31I think you know the health care system the way it is in the way that direction1:34it's heading1:35from is giving us trouble because two most important1:40people in the entire system are being totally sideline and that is the1:44position1:45and the patient it's all about doctor-patient relationship1:48and unfortunately on that that that1:52that Batticaloa relationship is been disregarded and everybody else is trying1:56to help1:57without listening to the two individuals were involved in here2:00yes the most important people you know every it it's just unbelievable that2:05now the government is the third party that I guess has the most say in between2:09a you know someone has2:11cancer and you're trying to treat them and the San discuss what the white right2:14direction they need to go to a source treatment goes2:18the government has a saint2:19in the end the can keep that person from my from NN yourself from2:24from possibly operating on that person because all other regulation2:27and the new law that was implemented correct yes and that2:32that has you know that the they're trying to call it accountability2:35um and it does promote accountability and so did we but2:38not at the cost of the harm being done to the patient's2:42so we have two foes recognize that whatever initiated2:45we take one of the things is not do any harm and then do good of course2:50and essentially what has happened in the wait is transforming is2:53arm a harm inadvertently are or something2:58in in general is being done to the patient care which bothers us and at the3:02reason I'm taking my time on a busy evening3:05is it bothers me as a position this was not the thing3:08I went to school for in this is something that our bodies me3:11would be one of the Dom disappointments3:15when my kids considered to pursue a career in medicine3:18and unfortunately I would not recommend anyone to the3:22to my children to go into medicine because of the way the system is heading3:26in the direction it's heading to3:27yeah well I mean I wouldn't get into3:31going I would try to become a doctor right now because you have to deal with3:34the government and the government is directly involved in your life3:37constantly3:38and at and and also your just like you said3:41you first you wanna make sure that you don't do anything wrong but also you3:44then you wanna make sure you do good but now3:46they're affecting both at those options too much right i mean they're affected3:50out now you want to operate but now you can't because there's so much regulation3:54track3:55the regulation and deregulation is not very constructive deregulation3:59is based on one you know they they all know that there is a cost attached to4:03on the care to patient care and a lot of the sick people fall in the age group of4:0865 in about4:09which are funded through programs in medicare and medicaid4:13and most of those payments are coming are from4:17the government on the Treasury as we would say4:20on unfortunately the private insurance market is4:24on limited to younger age group which is fairly healthy which is4:27with the risk and exposure to the insurance companies is lot less4:31arm and essentially we do understand government is4:35my putting in a lot of money in here what what we do not understand is that4:40that direction which government has as well as spending is concerned4:44you know you coming up with pilot program the CEO being one of them4:48right now Affordable Care participation is voluntary propositions4:52but I'm sure you know they'll come over data in five to 10 years from now4:56come over the numbers that would not make most sense to4:59educated people but would be presented in a manner that5:02a we were able to achieve this many billions of dollars in saving5:06because if there's at a cost of somebody who died5:10court waiting for a surgery yeah are because I could not see the patient5:14yesterday5:14because I would not be good insurance yeah so does though5:18so it's going to be like a ration care then and now5:21they're gonna twist that data around inform statistics that5:26they're gonna sell its in mainstream media has been successful winner5:30somebody years working in the field like yourself knows that that is not the case5:34and yes and that is truly the case and that that is being done on a more5:38national level in the organization5:40which which claim to represent positions but only a handful of the executive5:44position5:45who are not in the trenches we don't practice medicine we don't see patients5:48on a daily basis into those positions do not have5:51any idea what we go through in terms of making things happen for operations5:56be be really struggled sometime who even5:59a get a consular guess to get an MRI done and that's so unfortunate it was6:04not the case when I discuss my cousins6:06who graduated in late eighties from residency programs they said things were6:10a lot lot better6:11even up to late 90's and I'll beginning of 20006:15things headed in a direction but they were not bad up until about6:18last two or three years and Nabi weaves the started to feel every one of us have6:23started to feel patients being the worst sufferers are what is going on6:26on I personally have a belief that6:29if patients do not take care6:32of dedicated at right now things would6:36not improve it all they have to be engaged they have to be empowered6:40they need to know they need to be educated now is not the time6:43to sit back on the back seat and let somebody else drive the car6:46yeah is so are medical care used to be.6:50tests probably the best in the world at some point a couple that decades ago6:53right6:54it was it's totally you know it depends on what indicators you look at for6:58into their some persons would call it it's the leading cutting-edge technology7:02how7:03you minutes no ration care adds that as a matter we have the technology but we7:07don't but now it's just deciding the government gets to decide who gets the7:10operations in7:11you you can accept certain adjourns plans because7:15all the regulation him the truth the regulation you know the wreck it should7:19be a free market economy7:20young people like me they should be able to come to me you should have a choice7:24to come to me7:25right now the choice with the law to my patients7:28the choices they don't really have a choice to see me they like me7:31but they just have don't have a choice to see because they don't have the7:35correct insurance plan right they don't have that you know that there was a time7:38when7:39I had to put on as my voice you know the initial I am7:42welcome message on my phone system that I do not take covered California and I7:46do not take7:47Obama now so you know if that is the first thing you hear from a doctor's7:51office7:51because I used a lot of the patients that you could potentially see it help7:55and you can people be even tired of getting calls when we would not be human7:58being compensated accordingly8:00so we decided you know instead of wasting our office time telling that we8:04don't take this8:05why not just go head and arm just have it as a message8:09that we don't take it if you still want to talk to us will be with you shortly8:12yes some people still wanna go if they really want good care they're just gonna8:16say no I'm gonna pay it8:17they are a lot of my patients have chosen that bad yeah and it either way8:21it should be at this point8:23be a dick it shouldn't be these are those men and women who worked for this8:26country8:27the they had invested their time we heard a number of years to be eligible8:31for Medicare8:32and now when when our time when really would want them to get the care they8:38need8:38yet the ABN creating too much of administrative hurdles8:42out for them to even get the task accomplished yet so having insurance is8:45pointless at this point you're paying out of pocket if you want to get stuck8:48actual work done right yes you know if you have a deductible as high as 5,0008:52and 10,000 you're just a 32-year-old8:54yeah you would not be able to meet the deductible because you won't get that8:58sick8:59that he would spend five thousand dollars in a year on your own app9:02unionism9:02yeah just go to a doctor like once or twice a year yeah9:05and you know that is something that should have been envisioned in these9:09programs9:10if they were trying to make health care health insurance Odin9:13make a high deductible plan and make things cheaper let doctors9:17exactly do I enter into the free market I would have come up with my plan like9:21forty nine dollars a month yet here we go9:24so you know we don't unfortunately the way they were all insurance9:27and us restructured we cannot be in small positions cannot really9:32are come up into the open market and compete with these insurance carrier9:36yeah because of the regulation that is forced upon us9:40through legislative process yen in the AM9:43and it's through your license RAM you could get your license taken away if you9:47do something wrong right9:48while dad that and of course that is what can happen9:51and a novel I'll little bit later I'll just come9:54all licensing is a state on California State9:58arm um authority10:01and hauled the regulation is being structured that federal government can10:06literally control the way we practice medicine it is that is a big change10:10it's a slow change but that's the direction it's leading up to10:14yeah and you know it's just pisses me off is that10:17you know you're you're a licensed physician your doctor and an10:21you should be able to operate in the free market now we not we're not a free10:24market anymore though10:25government controls command-and-control met a joke on me a 16 the economy is10:30health care10:30and so I so you can operate so if there is no incentive now for10:34for young kids that wanna go learn how to be doctors amid what's the incentive10:38they might not even have it i mean they may not be making the money that they10:41they should be making10:42or the they're going to have such a headache with all the regulation then I10:46can be able to set up their own practice without10:48but you know get going bankrupt at this point right I made well they intended10:51of the regulation is to peak private practice10:54out of10:55a party bosses over position they want to read they want the 2011 construed and10:59wants control of our health and11:01yes that was the kind that's where it is heading to I'm11:05yeah Dec do you want to get into the whole the data sharing11:08issue that while um it was you know the the11:12the data sharing that has been it hasn't it is happening at multiple levels and11:16multiple organizations have been channeled into11:19who quote-unquote help government does this government11:22into a bigger initiate evolve mining I don't call it sharing11:25II iconic mining or digging yeah because essentially that's what we're not11:30sharing sharing is consent consent required here they're forcing the right11:33through the regulation11:35with through certain processes that have been in place one of them was being11:39board certification11:40or doctors try to be board-certified it's an Edward is meant to make11:44nothing really changes after you take this then exam after two or three days11:48I've been studying11:49are you don't have to do in pass you didn't have to take it for more at least11:5210 years11:53number now the government has incentivize we get .5 percent extra12:00everybody's baited so in the payments so12:03but but the participation requires that we shared12:07heart patients treatment plans leave they add the only thing missing is their12:12name12:12its it and not be ideal in their number attached that data12:15there is a number attached to the dot I but um12:19that number isn't bad right now it's it's very mmm12:22very limited the number right now but I have a feeling12:26we government-funded electronic health record beginning 201012:30nineteen billion dollar those invested to12:33give doctors and a financial incentive to start electronic health care records12:38which is basically because they were not able to begin to our people charged and12:42now they have a12:42they have a certified technology to dig into the charge12:46my my concern I don't have a problem with somebody looking12:49at my practice I don't have I die I wish12:53I would learn AutoCAD what I have a problem is12:56with two things I don't have a patient consent when that happens I'll13:01I I definitely have a problem in when the trust and privacy is violated13:06I have a problem because its POS Malaysia13:09no business you know like that's a direct violation of the government's own13:12law here for13:13I mean yeah their constraining if the other thing is the thing is it13:17is it is while Asian it days while Asian offer hit by Matt stricter sense13:22but there is the legislation which we images being which has been13:26promoted by a lobby right now that legislation say's that13:30if that kind for data is shared for research purposes13:34it would be excluded from here below regulation13:38oh wow it's just as likely that your address and actually13:42um on some the key people have actually supported that then I i'm13:47I'm who I'm won't go into the details of those but essentially there is a plan to13:51make it more of a law13:52to excluded data for research purposes13:56and consent is not needed we usually have business eg business associate13:59agreements with the Medical Board when14:01you know you see that box on the body bottomed before you submit to check the14:05box yeah14:06I agree to the terms and condition you're not the doctors have that kind of14:09a time when they take a test14:10they just checked the box and summitted and one ordered one of the business14:14associate14:15agreement some conditions is that we will be sharing their data14:20without your consent I wish I had known it14:23I didn't know about it but when I found out they've started asking14:26in fact I got a call from the see all chief operating officer for American14:31Board of Family Medicine14:32he he threaten me over the phone that big inning generally first 201514:37my board certification would be revoked and we've developed past14:41novels to January but it started to look the extended14:45I told them I'm not going to share data period wow okay so you still you stood14:49up to them14:50yeah I stood up to them and I'm they extended it and I don't know how long14:54will has14:55because they know you're in the right and they are in the wrong day or just14:58being a moral person and say I'm not doing this violates15:01my morals and have a credit growth see seed15:05thing is that I was told 56,000 physicians15:08one on the bandwagon that they agreed to sharing the data and position do not15:12have that kind of a time15:13to stand up and um dad I mean basically15:17fight with someone15:19AL well have put be politically active its heart you guys are busy trying to15:23help save lives immediately don't we just what every time we get we try to15:26spend it with my family and we'd be really don't have that kind of a time15:30the second thing is which is also are starting to happen is15:34these these medical boards although the nonprofit15:38the call them some will not be $375 million dollar15:42annual business yeah their financial lobby15:45the the be our boards which is the trade association15:49and they have a foundation and the way the money flows between the two15:52is a closely guarded secret but it's all about money15:56yeah um American Board of Internal Medicine have upwards of $20 million16:00income they're very notorious a filing their returns were delayed16:04the tax-exempt right their tax-exempt but you can always get those returns16:08online and last time I was looking at it16:10I was personally shocked and most of that income was coming from my wallet16:14and physicians like me16:15what they're doing is they're trying to give hospitals glance16:19to do those little tiny small studies and they're trying to make board16:24certification as part of privileges the app so16:26what what the world is gonna happen is that if I'm for example I'm in Fresno if16:30I were to get privileges and community arts build on down16:33I have to be board-certified community also really were runs16:37a group called sin be positions and food to be published on their panel you have16:42to be board-certified16:43although this is the well-known preprocess board certification16:46is quote unquote 1923 but you look on a daily day-to-day business16:51we cannot really just be without it yet16:54this is it just seems like the American Medical Association that is what you i16:58mean you have to be certified through them corral be17:01we don't have to be let me rephrase Ilya it's a voluntary process we take it17:06because we just want to be me just take it and just17:10get rid of it yeah essentially makes a and made a standard right it's not a17:14standard mix look good on the17:16ma non are visiting Qatar business got board-certified is a trademark17:20American Board of Medical Specialties and whenever something is a trademark17:24that his daughter Kylie money link behind17:27so how who can who has the power to revoke your license17:30license nor do you accept the Medical Board of California17:33and there are strict rules governing it federal government has no authority17:38yeah on my license but unfortunately it doesn't have authority on licensing me17:43but there is an unusual arm17:47pressure being put on me through various regulations17:51to control the way I practice so you on one hand a state has given me a license17:56to practice17:56on other hand you would buy my and literally behind my back when is not18:00active thing18:01talking to practice like that yeah have you thought about18:05a filing lawsuits are how do you know other physicians that have filed18:09lawsuits18:09see there is a jaded there is a large sued actually file in Chicago18:14arm on and view its it too it turned into a class action18:18and this is positioned actually going against the ABMS or American Board of18:22Medical Specialties18:23arm that the process is that they have devised18:27are braced they do not promote excellence18:30the kinda promote stagnation yeah you know that they would ask a question me18:34question from 2009 in that exam that taking in 2015 exactly eyes changes18:39daily you have you heard18:40so I have knowledge I have to think like what could have been the right question18:44in two parts line 32 other night because a line change that by the time change on18:49has changed so you have to fix you I mean why would you take an exam18:52with said she was 67 years behind the the cutting edge technology18:57yeah no sir it literally is just19:00a their stifling innovation their stifling be19:03their seven just care that's waiting to be given through regulation I mean if19:07you want to eat so you operate19:09you're just have a private practice right now right her and just to operate19:13a private practice how much of a headache is it i mean are you how much19:17longer you gonna continue19:18if this continues to escalate more and more regulation19:22I i mean are your I know you're fed up by your you paint patients19:26obviously come to you for a reason cuz you're good at what you do19:29but I mean are they getting fed up with what's going on don't know I died this19:32is what I approach you know and the patients are the19:34are the basic support pillar so far19:37I tell them I'm fed up and they tell me no you don't get fed up19:40we are behind you in Albany will supply with you so it is because of my patients19:44that19:45BB we have eased this I won't say a water but19:48arm on some sort of a determination that we have now19:52is because of the active support and engagement to my patients19:55and the other ones who really are helping us through this tough time I19:59would call19:59this changes change that is happening is affecting us financially20:04is affecting us our psyche it's affecting the way we make decisions20:08we shouldn't make decisions I that we have to20:12evaluate from arm apps standpoint of20:16on Hall be would do it20:19if we were not tied with a regulation you know hall would be would do it20:23if it's the best forget about money forget about everything20:26way to do what is the best thing for this patient20:29yeah if the answer is the second best I think then of course we are not the best20:33health care system20:34the answer should be best thing for the patient yeah that's just the way it20:37should be in a free market20:39so but you know what your what you're doing right now is gonna benefit you in20:43the future and it's already better for you now because20:45people once they realize and I know my for20:48I have a friend who's pregnant right now I'm she's change doctors multiple times20:52and it just it's terrible what she's going through20:54I've had friends that had health care at the same health care plan for like nine20:58years and then20:59no doctor will see them now and they pay more21:02also and so but what you're doing is21:05you're standing up to the system and like you said your patients are behind21:08you there's going to be more patients that are kinda want to see a doctor21:12and they're gonna be willing to pay even if it's a little bit you know either way21:15we're all paying for it anyway21:17it rather you get the care not work it would we have to pay Obamacare makes you21:20pay21:21makes you pee F yes so I'd rather go to someone I know I can trust that is21:26against what's going on the just wants21:27to do what they what they think is best for the patient what they've decided21:31I'd rather go to someone like that and operate in the free market even if it21:35costs a little bit more to start but it's just like21:37eating organically I'm in the market will change people are gonna need21:40healthcare21:40I'm I don't really need it right now but because I'm healthy21:44but I the only reason I don't go to doctors cuz I don't wanna go see a21:46doctor that says21:47well you know it's a subject21:49every time I go it's a big bureaucratic to like okay you gotta get your flu flu21:53shot I mean in every way i right just cite yeah21:56in and I don't want them known any my somebody but doctors like you21:59people need that and they're gonna be looking for that because22:03how much longer you think Obamacare I mean will be able to be implemented22:06and and actually function and people are you having so much trouble right now22:10let's let's step back and see two years ago when Obamacare was22:13are and implemented you know what became up was that22:16medi-cal are state Medicaid as we called we call it in my head I'm at a22:21california here in California magic built22:24covered californian medi-cal does our those are the black covered californians22:27are the plan that has subsidized22:29to some degree by the government based on your income these these22:33there are plans for a call medi-cal which most people who are22:36are you know bill also deny income have it so22:40what government said was that we will support equal payments to Medicare which22:45is substantially high for California22:47for 2013-14 come december22:5031st 2014 a lot of those patients who got insurance22:55couldn't find a doctor I was so I i kno hard it was and is generally first for23:01me23:02when a lot of doctors stop taking the medical patients because23:05all of a sudden in one night a clock was reset to two years behind23:10and payments dropped from maybe seventy to eighty dollars to sixteen dollars23:15would see a patient for a sixteen dollars nobody would average23:19reimbursement is 1623:20and for that but Alex told the truth was that was gonna increase access to care23:24when actually it decreased access to care because physicians can even23:28afford operating expenses for their practices to keep the doors open to keep23:32to accept this23:34the the government healthcare this actually decrease the axis appear23:38now if you look at it the enrollment increased23:41are many fold and when enrollment in keys you would expect more doctors23:46and all of a sudden the doctors have stopped seeing these patients23:49and you we have more people insured now23:52then we hired when we start in January of 201323:56but we have a lot less doctors who are willing to continue what they've been23:59doing for the last two years24:01so where it where it is the good thing where is24:04their word was that there are missed us now where is the promise God that it24:08when a free care24:09well the promise doctors all be gone in Pisa payment the prom and patience24:14you'll have access to the doctor24:15the thing is this is not this we have to step back and see that24:20this is the problem you're trying to solve not for ourselves24:23but also for arcades what is the best way let's listen to the stakeholders24:28stakeholder is essentially24:29patient and physician listen to them the government says though the stakeholders24:34in our lives I guess so basically what happen is that they've24:37they've turned to the health care system over in control of the government has24:41controlled the health care system24:42and now doctors like you won't accept24:45there the insurance plan that we all die in a rosary hey you never know we are24:49ready for it24:50Affordable Care you can't afford a portable care so what's gonna happen is24:53it just gonna be24:54but where are we gonna have to pay I mean I mean is gonna have to be24:59just lines have people to see only certain doctors that what are25:03are paid a certain wage a through got a25:06government brand hospitals are ya that what we're gonna be25:10there that is exactly what is gonna be we have be could be called them25:13federally qualified health centers those are the ones you without the lineup like25:18the Veterans Hospitals25:19no veterans is for the veterans okay these are special clinics like Lanikai25:23said %uh Vista25:24these are funded through federal government programs and25:27you know you this is just real bit I would say it would head25:32I the may not have the best doctors25:35but they certainly would have their doors open with a be25:39time a thirty to sixty days I mean if you call them and you tell them you have25:43this insurance sometimes25:44they won't say that you don't own they don't take it but they will say you know25:48come back in about ninety five yeah if you have any a banker and let me know25:52that a broken leg I'll 9a five days is not where you25:55and most of these people would end up in the ER and seek yam25:59bed will be the cost-saving would and wouldn't it be a better that I see a26:03patient in my urgent care26:04stabilize and send them home yeah audible you pay ten times more26:08in any art for the same patient where is the common sense here why not have more26:13doctors26:14who could attend to so we can weekend kinda fun clog oder systems26:18so yes is where it is you know we need to focus26:21on individuals we need to focus we need to bring26:25medicine to the people right now there is a lot of distance between26:29help and health care absolutely26:32and folks this is what happens when you centralize thinks26:36k the centralization of power the centralization of health care26:40men less options we gotta go to a quick break but where26:43with our guest come word doctor come well Kanwar Gill26:47will be back on the celebrate in Iraq26:54I'm26:59welcome back to weaponize news with your host your web27:02and Sam cheney and now back to the cell27:05now back to you guys welcome back we're here with our guest doctor27:11Kanwar Gill he is talking to us about the health care system is private27:15practice27:16and ease discussing why he does not like27:19what's going on with the health care industry I'm your host your web along27:23with my clothes Sam cheney this has weaponized news on 1680 a.m. if27:27you just joined us well let's get back to the interview so27:31that folks when you centralize27:35when you centralized things you have less options are right now27:39a were talking to doctor gil here he can accept a lotta plants because their27:45government there27:46their government plans cracked yes and so or would you say you can't you can27:50see someone for sixteen dollars a27:52keep the lights are well hi I have to lie I don't see medi-cal27:56be have a my huge percentage of this company's medical and I don't see it in28:00my office I have nothing against the patient28:03yes not financially by cannot even stay in practice if you have 50 to be start28:07seeing those patients I'm working28:09I'm working a deal with health net which is can be by you know which is28:13a company that manages some of these plans and we're trying to see if we can28:17somehow28:18compensate on other side of our commercial payors business28:22tomb at least afford make this thing affordable to the patient one in28:26government plans28:27so I would subsidize I would I would have to make up on the commercial side28:31essentially by the people who who actually pay for the job pay outta28:35pocket28:35the PR to the park it to see operation for his government pays28:39yeah little sis television I'm trying to work because28:43II occurs end of the day my reputation at stake in a van people start talking28:47he doesn't take my insurance doesn't sound right yeah they're gonna28:51dehumanize28:52private practice doctors that don't take it and say well you hate poor pure greed28:57you know I kill you28:58a I think that yet brand new agreement they're gonna say they don't know the29:02RDR Senate they've been saying it and then the people out there don't29:06understand the young operating expenses you have to make a profit for your time29:10to keep the lights on your other administrative staff and what not to pay29:14for29:14and people just don't understand that you're just bad because you won't take29:18their plan29:19that a sixteen dollars and and yes that's that's truly the case29:23but I have I have you know I've engage people enough try to29:26explain them and there's been occasion I knew that person walked into my clinic29:31will not be me but payment is not an issue I had a lady who was having29:35difficulty breathing29:36and I knew I had to do something about yours so I saw her and when I saw shoes29:40with and the next time she said29:41you don't take my angel eyes at you forget about the bill you're not getting29:44anything29:45Bob from me I won't I'm on chargeable you anything the reason is that29:49I want that person to go and tell to others that29:53be a not bad we are good doctors yeah is just that29:56but be just cannot operate with the regulations and whatever we r30:01be at their own at us you have to make your staff writer30:05the and up goes with the California salary minimum age going up30:09yeah in the next few months you know how would you also have to pay for a lot of30:12these people that don't have jobs there on government assistance and they have30:15government health care I made you got you have to pay out your pic taxes30:19the proper you make you have to pay for them to live in an apartment30:22I don't have control on the hike the exact good people30:25know it's terrible and so yes you you like you said you're gonna see someone30:29if they need help30:30and because you're good doctor in any and thats30:34that's the standard that you hold yourself to but it's just unbelievable30:37that that like to work for it for instance if if you wanna do30:42you know with others regulation I mean just for you to sit down with me NCAA I30:45wanna30:46have you do this operation or whatever I want to have you look at this um30:49and we just had a pocket or or I mean what is it what is the kind of30:53regulations you have to to go through do I have to sign a bunch of paperwork and30:58you have to make sure that30:59you know I me is is this massive contract to make sure that31:02you know you're not violating the government regulations and31:06I'm protected because I'm the patient the patient has to be protected31:09like can I J K which is are you know have a mi31:12a mutual business agreement I mean in the free market can I say I want your31:15service31:16and I'm gonna pay for it I mean it's just why is it so difficult31:19why is there so much red solid regulation was essentially when31:22insurance was not mandatory you know it was not mandatory and I i think i31:26believe you know some of the money that is being generated31:29art from making it I mandatory is31:32you know it it's basically for the healthy adult healthy adults who really31:36did not have insurance are being31:38asked to pay for people who are the engine using a to utilizing it31:42will give you an example I had a a young girl the twenty twenty one-year-old walk31:47in my office31:48and she couldn't really bear weight on her legs and by doing a basic clinical31:52exam31:53I knew there was a problem in the spine and I want in an MRI31:57all man that MRI they will not all you guys need to do next the first I said32:01I'm a doctor32:02somebody sitting and on the other end of the phone tells me that II said if I32:06don't do anything32:07she would possibly paralyze both her legs32:10for god sake let me do an MRI and a32:13it took me at least a half be to convince somebody32:17in the insurance company to get an MRI done for that person32:20so hall while always and when thankfully it was done and we took it over the32:25matter right away32:26the same day but hall can we function32:29I know there are doctors who would who would use or abuse the system %uh the32:34the percentage is very minuscule and very limited people who does32:38most of the doctors act in good faith32:41the really want best over their patients and that's when we we should32:45focus on on those doctors not on the ones that are resisting32:48that other ways to get all love them you know if they're wasting taxpayers32:51dollars up government knows about it32:53of course a and we do and I'm sure most to the public are the least they should32:57know that doctors are not32:58they're not super greedy they they went into medicine for a reason they wanted33:02to learn33:02I mean it's very important we you know that's how people we've saved so many33:06lives in technology and33:08and so for people to think the doctors on actually want to help people that's33:12that I think that's just ridiculous especially ones that that33:15that C33:16why universal health care is such a problem and government run healthcare33:20the is such an issue but go walk us through33:23so yeah if someone needs an MRI you have to call the insurance company33:27and then and then you have to debate with them yeah I mean you don't have to33:31I have to bend my case lay a foundation for my argument and then talk to them33:35and have them can33:36commented it it came with only take it cuz its ration care now right it they33:41have to approve every little thing that you do33:43yet they have to prove every little thing to some degree you know when it's33:47a routine practice33:48but see you know I jacked up well you know if I want MRI next three weeks I33:52really don't care33:53and have them look in my documents and approve it but something so totally when33:56I am actually getting on the for myself on my position time34:00trying to convince somebody sitting was just pushing the paper34:04that I need this thing done yeah and I'm not getting an answer I get frustrated34:08because34:09I here and I'm trying to get something accomplished imagine waif34:13if I'm not able to get that done something bad happened the post in34:17first person was getting it from it is Mimi the malpractice lawsuit nobody's34:21going to question insurance companies that they were not willing to pay for it34:24that just sounds terrible all this map I mean that do you have another americana34:29me the right34:30a private I think the ninth socialize the losses yeah34:34so the insurance companies make a bad you know to the money34:37because we have to buy the product but they don't get sued right there just34:40basically34:41tamarisk know hundreds in fact human doctor signs a contract with them34:45they basically said bill you'll hold us harmless you know34:49it's the whole that's that's an MD saying that folks that literally34:53insurance companies a say you have to buy a product34:56and the doctors are the ones that are gonna get sued the people that actually35:00you know the insurance companies they don't do jack they don't do anything for35:03the patients35:04nothing literally they restrict care the other restrict can I i think a process35:08to buy their care35:09I adaptation the other day in my clinic in a Medicare runs35:12couple programs one is fee-for-service program it's basically35:15ICU you pay be kind of a deal your comment and the other programs are35:19Medicare Advantage plans35:21bitch is covered under medicare Part C and what you would you notice for those35:25plans is and a lot of seniors are convinced to35:28going to those plan because the cost from their daughter pocket expenses35:32minimal35:32or sometimes you and what these people don't realize is the tradeoff is the35:38access to care35:39the quality of positions %um so a lot of people who changed to these plans35:43are tied up with the company and I would name a few United humana35:47are blue shield these are the companies who who have a battle business35:51in addition to commercial reach me in you by yeah35:54on contracting with medicare and be paid monthly basis to manage these Beijing35:59would be manages36:00they're dead they're be created administrative hurdles to get some36:04expensive desert lands36:05they create hurdles in terms of all the patients would be to forward in which36:09doctors would flee36:10to an extent that in Fresno if you are on some of these plans36:14you do not have a choice of hospital on an ambulatory surgery center36:18you just go with Monday tell you to and really36:22bit out good doctors in the town were not contracted with those plans36:26and it's so unfortunate that patients are36:29the only one suffering positions do so for your for us it's a monetary loss36:33but patient 3 loss yeah know exactly if someone has a serious health issue they36:38get get hit care36:39I mean that doesn't they're gonna die I mean it's possible that it's happening a36:42lot of the people get cancer36:44treatment and they just they just I guess say goodbye36:47here you know and the the thing is VB me being present when we look at the36:51hospital group we have here36:52we have the community hospital group in the scene Agnes Hospital Group36:55and with you on the advent of the Obamacare one has36:59edge over the other I don't know call for me all Hall you37:02how you view the news but if you been a hearing the news37:06sandy and children's there have been a tussle going on for last 2-3 months37:10sandy had lunch in an article a Madera to an extent they've split now37:14and the Children Hospital is coming up with their own group on training37:17programs37:18and this is burried Affordable Care is the basis of it37:22and you not have kids that you want to see specialists37:26you know the special inside the children and and you have to read for one company37:30to one insurance company to prove but affordable37:34to be seen in children hospital how far is my data from here37:37it's so unfortunate that our kids are not getting the care because of37:41something37:41more affordable is being planned for them into bed these37:45the these insurance companies are for-profit businesses so they have it37:49all37:49actuary doubt to where they are not going to lose money37:52there yet these hospitals operate as37:55nonprofit hospitals the majority around here like say37:59kaiser for instance or community there for 3 non-profit but yet38:04they have a profit motive behind the care their audited38:07that bloomin seed the only people who do not have a group of emotive oppositions38:12and the thing is that38:14the reason they don't have a clue profit motive is they don't split38:17the loyalty towards separation and the day even38:21the day even positions would split the alloy be38:24between the companies that the getting the money from38:27worse is who they are who they have their beauty devote38:31yeah that would be a day when really medicine would die you know we don't38:35want to see even physician has to decide between a patient38:38and the beer page position shouldn't even be thinking38:41right now position is with the with a hand on forehead your kind of thinking38:45what should I do38:46should I think but the patient but the real point in having insurance read is38:50that you buy it in so you don't have to worry38:52when you get to the doctor is all taken care of on foot38:56this is what is happening these people were sending these covered California38:59plans39:00do not poop in the real world the picture to the people who are39:03subscribing to your house39:05I have no information people not around a bit39:08where we talk about last year they spent $350 million dollars on advertising39:13and recover California yet such as propaganda that could have had money in39:18our pockets that itself giving it to them39:20advertise the yet and and the thing is insurance companies have been given this39:25I you know pat on the back a if you guys going to last because I've covered39:29California39:29bill be built a church about we will build pitch in and will cover your39:33losses so they have nothing to lose39:35the people who have to lose at the patient and though the positions39:38I don't know fight mention earlier on the program I had a patient39:43who lost her Medicare to one of these plans I39:46a Medicare managed my advantage plant she said the broker39:50Sat three and a half hours and her house39:54to convince her to sign up for that plan while and then she lost her and she39:58lasted and shit with such a surprise40:01when she walked and coughing to my office and I said I don't be a ticket40:04and Giselle she's you that medicare Ronald so many years and why don't you40:08dig it I thought I'd take medicare40:10but I don't take this personally many give you bought for shoes like40:13when can I change that said you have to wait for the next enrollment fee to40:17riches to at the end of this year now40:19so that lady poor lady stuck with a plan that was sold to herd40:23without going over the details of it and the coverage in the local40:27regional position areas Gabby I've dealt with some of these40:31covered California people when I was working in the health care industry40:36and a yeah I did I don't see how they40:39they have no ethics and they're very unscrupulous people are just farmers are40:44used car salesman on nightly40:45I have few friends who are insurance brokers and they have only40:48I'm up a jobby the heavenly so late in the Punjabi community40:52um but they said BP really good on the brokerage fetal40:57so the alarm should for that occurred to me and they're prolly earning commission41:01on every sale date yet honoring those heels people who are41:04well we're meeting the code as an going above and beyond the code as there are41:08being actually41:09car lenin's on it vid I mean awards yet there are actually41:13their pictures have them receiving awards bigger then roll the most number41:16of covered California be yeah41:18helping destroyed a America's health care industry and a minute so41:23doctor gil is the the free market doesn't exist in health care than any41:27more minutes government-run41:28there's too many regulations for people that actually wanna practice enough41:31the private market I mean is just but is there is there a free will there be a41:36free market at twenty years like you said for our41:37here that will be given it will be non-existent41:41dev now do you feel like like41:44like a lot of people are saying that it's designed this way to collapse the41:48system to bring in41:49a single-payer cover perforce rise many think government run healthcare41:55business it is unfortunately not it is a feeler41:59arm you know i i don't know how to42:02it's a it's a post dated check and it's drawn on a crashing bank42:07sorry no one understands what happened that's a good way to present the host42:12its second aggressing baked42:14school you can enter 88 is going to end up in that direction Harbor you would42:18date you know government steps in to save the system42:21our government takes control of the system but that's what today's42:24in a Medicare party which basically our42:28finds the hospital was was initially gonna go insolvent in42:332024 I know they said dole42:36the we've been able to extend six years and it's gonna good in Thailand and42:4020 E body so my question to you both a few is42:44if you were to drop from a 10,000 feet high42:48all water do you care if you draw four feet ahead of42:52what you were planning the at No it doesn't matter if they're just black is42:56so stupid42:56so it we have to recognize that is a problem43:00yeah I and we have to put ourselves 15 20 30 years ahead43:04and see that whatever that fixes the applying to plan43:07arm are actually working on it will work43:11in good faith and not and and we should think bipartisan43:14you know this is specifically and see that how they'd this is not even a43:18political issue and try to see Anna as43:20all with your on the ride a Republican you're against the poor people there43:25poised are cut from the lapd et al no immediate rush the frame this issue and43:30it's not even political43:31it's not a political it so it's more both melodic everybody's health care43:34personally43:35not because I'm a profession but in general as a human being so it's not43:39it's not really need to sit together we need to look at43:42what out but I did these would be our priorities are43:45to take you to people who helped build this nation43:48and will be out thirty forty years ago you know those are the people who are43:52sick in hospitals43:53and we need to BrdU me need to make sure we are there for their43:58and the time they need us that's what the goal should be and that's where the44:02focus should be44:03anybody who tries to make money order those sick people44:07is not a good human being and we need to end of the day be a good human being44:10and we have we have a social responsibility towards everyone relive44:14it be a civilized society44:16claim your we are super pirate we need to stand as every american we need to be44:21glued together in what we do and what we aim for ball of Oz44:25and I think you know maybe we can me can make things happen we make so many44:29things happen44:30and this is one of those things which we come together be44:33beat me we should find a middle ground I'm willing to cut my44:37my contract creates you check my mother the middle you know I'm I'm44:42the idea would work with patients didn't have insurance right if I came to you44:45work with not always on always I never even though I usually44:48up until then I started to get ahead from it financially44:52I was not even enquiring about a patient Scorpio and insurance44:56when I started to feel it on my you know on my44:59account statements II part in a man what I've been doing45:03is good for a humanitarian oh yeah but your life you gotta make money you gotta45:07you after you know I want you living in a tent and and giving charity hey45:11everyone has someone needs the Paiute you're giving a service45:14that's the free market that is americana free-market you work for your45:18what you what you are you learn every dollar45:21and if I wanna come see you I can just say oh I you know45:24you get need to get bigger I'm entitled to your care know you're giving me a45:28service45:28and if it's a good service I'm gonna pay for it and that's the way it should be45:32you shouldn't be livin45:33like you said you lost your login to your account you know your accounting45:36and this is department this is the45:38this is Anna this is something not only meets a lot of doctors are feeling it45:43somehow vocal about it others on talk about it from the fear of government45:47so-so will tell us a little bit about that I R is they're kinda the unanimous45:51consent that dates45:53people don't really want to you're one of the few that I've heard that are both45:55open is speaking out against it and45:57can you not everybody speaking out against it but I know either a doctors46:01are you heard you know other doctors will talk at dinner tables and46:04conferences and stuff you need to have to46:06bring it to the attention of journal Public talk to people you know people46:09out the 10 gonna46:10make the change happen yeah people are the one who have a lot of power to the46:14awards46:14do you make that change happen you know they are the one who were able to46:18convince and mass46:19armed the opinions that are performed at the national level46:23so it's if if BP's every single patient count in this46:26this whole I effort that we're trying to create a wave that46:30eight this is our business this is our bodies la route46:34be we want to be involved in what decisions are being made about our46:38health care46:39so that's where bid I think be all are talking about it46:43armed ID doctors would I think patients would appreciate what you're doing right46:48now and and as you can they come in your office46:51you probably do tell hey will this is exactly why can't take your plan because46:54I've46:55Obamacare I can't take it doesn't pay me enough so and then46:58it makes them think we need to start informing we need doctors started47:01forming say hey look47:02your care is not gonna be your not gonna have cheap care if you go private47:06and if you go get with the government plan it's gonna be terrible care47:09and you may not never even see a doctor your but they don't know that it's47:13clearly it's a packaged47:14sometimes I'm I'm crossing the waiting area and you know in the discussion47:18I get so embarrassed when I have to tell someone because I'm single father for47:22something and they they have47:24covered California and I i little league at Marienbad as47:27when I have to tell them that I don't take that insurance oh yeah it's got all47:31its all the truth they did you know many doctors we had pantheon any commercial47:35billboards radio yeah telling the truth with47:39paid actors are no doctors actually speaking about what this whole cover Cal47:43I'm I don't see many doctors talking about how great it is I personally like47:47the green in the yellow in the white47:49the use in the Flyers here that early it's rape very very poorly lighting47:53yes it's a non-threatening right it's it's not threatening like there's47:57you know Obamacare clubs at how employees are48:00Catholic earth right yeah but but but in in then we get into48:04that when you talk about the IRS how it ties in queue oh yeah it's48:09now do on your taxes you up to there's a line item on your tax return that you48:13have to say48:14if you have insurance or not and the straight up call it48:17shared responsibility payment48:20that's that's very socialist term terminology that the IRS is using48:25and so it's our share responsibility for everyone's health in America now48:30your responsibility to have everyone outside and ours48:34another language today yeah it's very social thing is that48:37when we all pay non-medicare dollars every paycheck48:40we expect something would be the living room where you know it on a partial to a48:44girl so you really already are pulling in money when you were gonna need it the48:48most48:48and this this whole thing i'd up Asian walking last year it was last year48:53I said you don't have insurance she says she doesn't get I said you know you48:56gonna be playin penalized for it she said she'll pay the fine men to buy49:00insurance49:01so her head parts with that even if I had an insurance I wouldn't have been49:05able to see you49:06this way at least and maybe BBQ energy has paid the fine49:10yeah she would see yeah bakula see how the government health care you can see a49:14doctor49:15it's easier to just pay the fine so they're just screwing us every you said49:18ways WN their number so as individuals we have to run our own numbers and49:22figure out the best cost-benefit for49:24ourselves as individuals now so that that that's what it is you know you have49:29to49:29see what what is going to be the utilization most people49:33don't go to doctor does that work Lt maybe once or twice unless you49:39you know you do something to your heart break a leg again a car wreck I49:42and that that is a catastrophe that's kind of awake alert insurance we have49:45yeah I'm so why don't just take a catastrophe insurance at a high49:48deductible one49:49and and pair it with the position plan positions are not allowed to have49:54plans because they have to have five million dollars in resolves49:58to offer those kinda plans so that is50:01again the law so really no small person can all for it50:05I have it for myself you know they do this they the insurance companies came50:09up to me and they said50:10he when we tried to negotiate with you50:13are you offer us a higher rate worse is50:16when we try to negotiate need be cash to you I said see i don't have to deal with50:20administrative hassle50:22you would deny my claim twenty times before you pay for it and it's not worth50:26it50:26to offer you the same rate as if I would be made them50:29offer it to a catch basin so my mind n you know50:32whole discussion we reason50:35this whole discussion we applied to focus on what matters most to us is good50:39patient care50:40yeah unfortunately money is so closely tied50:44that'd it comes up in our discussions yell US insurance premiums are50:48Penelope's50:48for me as a visit charge for hospitals as50:52if they are able to make any profit or at all50:55so v beyond know that it's all about money50:59yeah if we come up with a plan where everybody's happy51:03at least decent you know you don't wanna cry don't want to drive an ass class51:07along that the bid on it on to the end when you would want to see i I'm willing51:11to pitch in on my lifestyle51:13the area I'm willing to worked with people who are willing to work today51:17but it should not be in control of of men and women51:21who do not know what it feels like to be in trenches51:25yeah like the insurance company government bureaucrats51:28Washington Washington DC but no idea he said earlier in this interview there's a51:33quote doctors who are not practicing but they're trying it51:37now are you how to practice acting as government purity ahead and politicians51:42with an MD license51:43I they are the ones who %ah term be a51:47shaping the policy at the national level it looks like from a layman's and Dom51:52viewpoint that they had a position talking about something but they're51:55essentially51:56people hired for a job to should reshape52:00opinions and policies at a national level and sounded like as if those are52:04coming from doctors mild52:05essentially those people don't know they haven't seen patients in a while52:09they don't come and work with us or sea bass is a human and a half day a week52:14so they really don't know what it peeled what it was52:17they probably have some idea from twenty years ago when they were practicing52:20but they have no idea no clue what we do on a daily basis52:24yeah52:2578 who he really is what where these pure with the bureaucracy is done to52:29health care in this country52:30that's unbelievable folks52:34we have a couple minutes left but I'd like to thank doctor52:37Kanwar Gill and the what did you wanna pluginid you have a website you have a52:41new phone number you like this52:43arm I have an urgent get your own hun an investor vignettes call around the clock52:47Mb52:48the goal is to be available around the clock initially just the name52:52so I like BBBB would want to offer you Kelly Madison what what it would mean to52:58you is that52:58if you are an existing patient you call a lot of is and more likely than not you53:02would get prescription filled over the phone and you may not have to come to53:05our office53:06government had made a legislation in 201153:09unfortunately the regulation is such that we cannot make this happen53:14there is a law but is too much of a regulation53:17that is preventing it from happening someone on the first one in Fresno53:21arm who actually looked at the law that exist lol can't stop it yes and I'm53:26gonna start operating within this and you said the regulars more regulations53:30on top of that the don't allow it to happen53:31the the there there is a payment payment53:35in I barrier that basically nobody in Fresno can be53:39paid for it but if the patient is in Dubai really53:42we can get the payment whites letterman jackets it's it's a link to where you53:47live53:47it's not linked to its geographical limitation we have to show that53:52and I knew by that person would have a difficulty in getting to a doctor worse53:56isn't real a53:57thats price-fixing is right it is based on geographic location54:01yet that there is a new law that is going to became because you know I'm54:05emergency will look we are serving the poor because54:08the demographics in those areas are lower income than they are in Fresno54:12North a look54:13look how good we are we're helping poor people let me tell you54:16in India there was caste system in the lower castes were granted privileges in54:19the voting system54:20arm the dock system54:23those people over a period of fifty years are the World Bank54:27and we don't want the same thing happening in this country54:30that54:31you have an entitlement mom privilege people54:34who would have these like you know it's it's it's good to be on medi-cal54:38meant to be paying on covered California because you get everything achieved an54:42accomplished with that so we want this country to be leading innovation we just54:46don't want this country to be54:48following absolutely absolutely thank you so much talk to go54:53heard in the west is your practice are was a call around the clock54:57its call around the clock Mb and the website is it on the clock and the55:00dot-com55:01awesome we thank you so much yuppers patient that's right55:05we appreciate it social see on the second hour55:08weaponize news hello friends a 17 per mg for weaponize news dot com55:14today is january 15 201555:18and as you can see I'm reporting on an article published55:22in the washington times the headline reads55:25George Soros bones Ferguson protests hopes to spur55:30civil action liberal billionaire55:33gave unleashed 33 million dollars55:38in one year two groups that emboldened55:41activists you can scroll down here in he55:45it continues on to read there's eighty solid55:49Terry Mann at the financial center55:52other the for December protest movement no55:56it's not victim Michael Brown or officer Darryl Wilson56:01it's not even the reverend56:05al Sharpton despite his ubiquitous56:09campaign on TV and56:12this streets rather it's liberal billionaire George Soros56:18who's built a business empire that dominates across the ocean in Europe56:24well 4G a political machine powered56:27by non-profit foundations the impact56:31American politics and policy not unlike56:34what he did with me56:36move on dot or under you can scroll down and read56:40the rest of the article but mister George Soros56:44is a globalist billionaire piece of trash56:48who has no business bonini political movement56:51in the United States and no matter how you feel about producing we saw56:56how militarize the police were but there's a lot of evidence now officer56:59Darren brown57:00was justified in issue teen other I'm sorry officer down Wilson was57:06just fighting issuing up Michael Brown57:09the jury did not indict okay57:12you scroll down read the rest this story but this guy right here george soros57:18is bundy with this tax-exempt through his tax exempt57:23non-profit foundations major political movement in this country to undermine57:30America okay you want this stir up civil unrest57:34and start a civil war with the people against the police57:38wake up people don't buy on this garbage or I57:43there's a difference between legitimate protest in protest57:46funded by George soros subscribe to this channel go to weaponize57:52news dot com speak out and take action58:01your tab58:51with59:22the59:29of

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Around The Clock MD Urgent Care and Occupational Health Clinic (Fresno, CA)  


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7035 N. West Avenue, Suite 101, Fresno, CA 93711

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Wed 1:00 - 1:30 pm
Thu 1:00 - 1:30 pm
Fri 1:00 - 1:30 pm
Sat 1:00 - 1:30 pm
Sun 1:00 - 1:30 pm

Office Details

Doctor Specialties Urgent Care & Family Medicine
Accepting New Patients? Yes
Practice Specialty Family Medicine
Languages Spoken English, Hindi, Punjabi, Urdu

We are located on North West Corner of Herndon Ave and N. West Ave.

We are behind Walgreens and adjacent to Quest Diagnostics and Me and Eds.

Ample free parking

Insurance Accepted  

  • Aetna
  • Ameritas
  • Assurant Health
  • Avesis
  • AvMed
  • Blue Cross Blue Shield
  • Cigna
  • Coventry Health Care
  • Davis Vision
  • Dearborn National
  • Delta Health Systems
  • Dental Network of America
  • DenteMax Dental PPO Network
  • EyeMed Vision Care
  • GEHA Connection
  • Guardian
  • Health Alliance
  • Health Net
  • Humana
  • Lincoln Financial
  • Magellan Health
  • Medicare
  • MetLife
  • MultiPlan
  • MVP Health Care
  • Priority Health
  • Self-pay
  • Spectra
  • Superior HealthPlan
  • UnitedHealthcare (formerly The Principal)
  • WebTPA
  • WellPoint
  • Other

About Dr. Gill
Dr. Gill


My style of practice is warm and compassionate. My practice philosophy is being a strong advocate for my patients and always keep working in their best interests. I keep patients well informed about their healthcare by providing them with education and unbiased information derived from evidence based medicine.

Around The Clock MD is a full service medical organization that serves patients from Fresno, Clovis and Madera, CA . We are here to take care of your medical needs whether they be family practice, primary care, urgent care or occupational medicine services. Our providers and staff at our Urgent Care and Occupational Medicine Centers are eager to assist patients in a friendly and efficient manner.


Special Interests  

  • Adolescent Medicine
  • Family Medicine
  • Geriatrics
  • Occupational Medicine
  • Primary Care
  • Telemedicine
  • Urgent Care

Education & Training  

Medical School


  • University of California, San FranciscoFresno, CA
    Residency in Family Medicine • 2008 - 2010

Languages Spoken  

  • English
  • Hindi (India)
  • Punjabi (India)
  • Urdu (Islamic Republic of Pakistan)

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