It requires great skill by an ENT surgeon to strike the right balance where patients can breath more easily but still maintain a quality voice.

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Therefore, it demands not only an academic skill--it also requires a personal ability to be able to form trust with people.

FORBES: Terry Waite On Negotiation

But these are big issues and it requires a certain amount of persuasion and skill and negotiating to get it done.

WHITEHOUSE: Press Briefing