首页
外语
计算机
考研
公务员
职业资格
财经
工程
司法
医学
专升本
自考
实用职业技能
登录
外语
I recently took care of a 50-year-old man who had been admitted to the hospital short of breath. During his monthlong stay he wa
I recently took care of a 50-year-old man who had been admitted to the hospital short of breath. During his monthlong stay he wa
admin
2011-02-11
76
问题
I recently took care of a 50-year-old man who had been admitted to the hospital short of breath. During his monthlong stay he was seen by a hematologist, an endocrinologist, a kidney specialist, a podiatrist, two cardiologists, a cardiac electrophysiologist, an infectious-diseases specialist, a pulmonologist, an ear-nose-throat specialist, a urologist, a gastroenterologist, a neurologist, a nutritionist, a general surgeon, a thoracic surgeon and a pain specialist.
He underwent 12 procedures, including cardiac catheterization, a pacemaker implant and a bone marrow biopsy (to work-up chronic anemia).
Despite this wearying schedule, he maintained an upbeat manner, walking the corridors daily with assistance to chat with nurses and physician assistants. When he was discharged, follow-up visits were sched- uled for him with seven specialists.
This man’s case, in which expert consultations sprouted with little rhyme, reason or coordination, rein forced a lesson I have learned many times since entering practice: In our health care system, where doctors are paid piecework for their services, if you have a stew of physicians and a willing patient, almost any sort of terrible excess can occur.
Though accurate data is lacking, the overuse of services in health care probably cost hundreds of billions of dollars last year, out of the more than $ 2 trillion that Americans spent on health.
Are we getting our money’s worth? Not according to the usual measures of public health. The United States ranks 45th in life expectancy, behind Bosnia and Jordan; near last, compared with other developed countries, in infant rfiortality; and in last place, according to the Commonwealth Fund, a health-care research group, among major industrialized countries in health-care quality, access and efficiency.
And in the United States, regions that spend the most on health care appear to have higher mortality rates than regions that spend the least, perhaps because of increased hospitalization rates that result in more life-threatening errors and infections. It has been estimated that if the entire country spent the same as the lowest spending regions, the Medicare program alone could save about $ 40 billion a year.
Overutilization is driven by many factors--"defensive" medicine by doctors trying to avoid lawsuits; patients’ demands; a pervading belief among doctors and patients that newer, more expensive technology is better.
The most important factor, however, may be the perverse financial incentives of our current system.
Overconsultation and overtesting have now become facts of the medical profession. The culture in practice is to grab patients and generate volume. "Medicine has become like everything else, ’a doctor told me recently. "Everything moves because of money."
Consider medical imaging. According to a federal commission, from 1999 to 2004 the growth in the volume of imaging services per Medicare patient far outstripped the growth of all other physician services. In 2004, the cost of imaging services was close to $100 billion, or an average of roughly $ 350 per person in the United States.
Not long ago, I visited a friend--a cardiologist in his late 30s--at his office on Long Island to ask him about imaging in private practices.
"When I started in practice, I wanted to do the right thing, "he told me matter-of-factly. "A young woman would come in with palpitations. I’d tell her she was fine. But then I realized that she’d just go down the street to another physician and he’d order all the tests anyway: echocardiogram, stress test, Holter monitor-stuff she didn’t really need. Then she’d go around and tell her friends what a great doctor--a thorough doctor--the other cardiologist was.
"I tried to practice ethical medicine, but it didn’t help. It didn’t pay, both from a financial and a reputation standpoint."
Last year, Congress approved steep reductions in Medicare payments for certain imaging services. Dee- per cuts will almost certainly be forthcoming. This is good; unnecessary imaging is almost certainly taking place, leading to false-positive results, unnecessary invasive procedures, more complications and so on.
But the problem in medicine today is much larger than imaging. Doctors are doing too much testing and too many procedures, often for the sake of business. And patients, unfortunately, are paying the price.
"The hospital is a great place to be when you are sick, "a hospital executive told me recently. "But I don’t want my mother in here five minutes longer than she needs to be."
What’s the main idea of the first three paragrahs?
选项
A、There are a lot of excessive services in American hospitals.
B、Doctors are over-loaded in American hospitals.
C、American hospitals are suffering great loss because of poor health conditinos.
D、The health-care service in the American hospitals is systematic and patient-oriented.
答案
A
解析
主旨题。前三段英文议论文中用anecdote(轶事)开篇,旨在引出作者真正的论点。论点在第四段中得到了阐述,即In our health care system…almost any sort of terrible excess can occur.Excess对应选项中的excessive。在第五段,“overuse"一词的使用,也对应了excessive,故答案为[A] [B]中提到的医生负担过重在文中没有提及,只是在第三段里,提到了医生们是按劳计酬的,有一定的迷惑性,故排除[B] [C]的内容前三段根本设用提及,故排除。[D]对美国的医疗系统赞誉有加,似乎是来自第四段的 if you have a slew of physicians and a willing patient,almost any sort of terrible excess can occur.但是从“terrible excess”可以看出,作者并非在夸赞美国的医疗系统完善、对病人照顾周到,而是在阐述可能出现的过度医疗,故排除[D]
转载请注明原文地址:https://www.kaotiyun.com/show/tceO777K
0
专业英语八级
相关试题推荐
Byascribingculturaltransmissiontolanguage,wemeanthat______.
Everyprofessionortrade,everyart,andeverysciencehasitstechnicalvocabulary.Differentoccupations,however,differwid
A、satisfiedwiththecurrentcivilianuseoftheelement.B、thedestructionofnucleararmssurpassescivilianproduction.C、con
1Duringtheadolescence,thedevelopmentofpoliticalideologybecomesapparentintheindividual;ideologyhereisdefined
1ApanelofthegreatandthegoodfromEuropeandtheUnitedStatesrecentlydrewupanelegantblueprintforremakingthe
DuringthereignofAugustustheRomearmybecameaprofessionalone.ItscoreoflegionaireswascomposedofRomancitizenswho
Thebizarreanticsofsleepwalkershavepuzzledpolice,perplexedscientists,andfascinatedwritersforcenturies.Thereisan
Kidnappingsaroundtheworldhavetypicallyhadoneoftwomajorgoals:publicityforalocalpoliticalcauseorasaformof"f
______isthecapitalofScotlandsincethe15thcentury.
随机试题
实体完整性规则是指关系中的元组在组成主键的属性上不能是_________。
MostAmericansdon’tliketogetadvicefrommembersoftheirfamily.Whentheyneedadvice,theydon’tusually【C1】______peoplet
患者,女性,38岁,上腹痛3d,1d前寒战高热,查体:右季肋下触及一包块,触痛,可随呼吸上下移动,该患者的诊断为
首先应进行基础治疗,下列做法中哪一项是错误的进行第二阶段的手术治疗的指征包括
代脉的脉象是()
中国人民银行的监督管理措施不包括()。
阿拉瓜利河位于巴西亚马孙河流域的北部,注入大西洋,全长只有220千米,下游河道宽约2千米,且河床较浅,沿河多沼泽。在特定时间,河口会出现涌潮。浩浩荡荡的潮水从河口沿河道逆流而上60千米,时速30余千米,潮高可达2~4米。下图示意阿拉瓜利河的中下游位置。据此
“授人以鱼仅供一饭之需,授之以渔则终身受用”说明教学应重视()
沟通网络是信息沟通的结构形式,常见的沟通网络有四种形式:在轮式网络中,一个下级同时与多个主管联系,但主管之间没有沟通的情形。在Y式网络中,第二级有两个上级与之联系,第三级与一个或更多下级发生联系。在环式网络中,每个成员仅与相邻者联系,而不能与更远的成员进行
Atpresent,therearemoreandmorewaysofgoingonholiday.Inmyopinion,therearetwotypesofholiday-makersHoliday-m
最新回复
(
0
)