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
55
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 hone-marrow biopsy (to work-up chronic anemia).
Despite this wearying schedule, he maintained an upbeat manner, walking the corridors daily with as sistance to chat with nurses and physician assistants. When he was discharged, follow-up visits were scheduled for him with seven specialists.
This man’s case, in which expert consultations sprouted with little rhyme, reason or coordination, reinforced 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 slew 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 mortality; 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.
Overeonsultation 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. Deeper 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."
The causes of the over-use of medical examinatins are all of the following EXCEPT that
选项
A、patients ask doctors to do more tests than necessary.
B、doctors want to make more money by using newer and more expensive technology.
C、doctors try to avoid being sued by their colleagues.
D、doctors want to prove to their patients they are competent.
答案
C
解析
细节题。第八段指出,医生给病人开过多的药是为了避免被起诉,这里是害怕被病人起诉,而不是被同事起诉,如果读文章认真的话,应该不难选出。从第八段里patients’demands可以知道,病人会主动要求增加检验,故排除A。从倒数第二段最后两句话可以看出,B“医生是会为了赚钱而对病人进行不必要的检验”也是致使过度医疗的原意,故排除B。在第十三段中.作者的医生朋友说,他意识到,如果自己不按病人的要求进行很多的检查,病人会去找别的医生,会夸赞自己的竞争者有多么棒,第十四段中,他的朋友还说这个不光是个钱的问题,还有名声的问题(both from a financial and a reputation standpoint),为了证明自己是称职的医生,也会选择过度医疗检查,故排除D。
转载请注明原文地址:https://kaotiyun.com/show/fGYO777K
0
专业英语八级
相关试题推荐
A、websetB、educationalschoolC、InternetportalD、foreigncompanyC
DuringtheBritishCivilWar,thesupportersofthekingwascalled______.
A、America’sB、Britain’sC、Russia’sD、Japan’sC新闻中的第一句就明确提到“Russia’sor-bitingMirSpaceStation…”,所以只要听到这句话就可以肯定地选择C。
OnewetnightIwascominghomethroughHydeParkfromworkinglateonajobinPaddington.Painandwindandsweptboughsands
ThatLouisNevelsonisbelievedbymanycriticstobethegreatesttwentieth-centurysculptorisallthemoreremarkablebecause
Patientstendtofeelindignantandinsultedifthephysiciantellsthemhecanfindnoorganiccauseforthepain.Theytendto
ItispossibleforstudentstoobtainadvanceddegreesinEnglishwhileknowinglittleornothingabouttraditionalscholarlyme
Proponentsofdifferentjazzstyleshavealwaysarguedthattheirpredecessors,musicalstyledidnotincludeessentialcharacte
A、Abombexplosion.B、Murder.C、Massacres.D、Air-crash.A
Somepeopleclaimthatcompetitionismoreimportantthanco-operationinthepresent-daysociety.HowfardoyouagreeORdisag
随机试题
我国法律规定,申请设立外资保险公司的外国保险公司其提出设立申请前1年年末总资产不得少于
甲状腺次全切除术后发生呼吸困难的原因有哪些?
患者,男,28岁。咳嗽、咳痰、咯血、胸痛,在右上肺尖段发现一直径约2cm球形阴影,周围有条索状阴影,边缘清楚,内可见点状钙化。最可能的诊断是
莱菔子的功效是麦芽的功效是
初中音乐欣赏课《卡门序曲》中,教师由情境创设法引入本节课主题《卡门序曲》,和学生一起将音乐完整地聆听2遍,并介绍了音乐背景和曲式结构,请学生一起学习了西班牙舞蹈,留下开放作业,请学生回家之后聆听其他乐章。上述案例当中,教师的课程当中缺少了(
古语有云:“泰山不拒细壤,故能成其高;江海不择细流,故能就其深。”请谈谈你对这句话的理解,并以此为主题进行演讲。
乒乓球教练将从右手执拍的选手A、B、C和左手执拍的W、X、Y、Z中选出四名队员参加奥运会,要求至少有两名右手执拍的选手,而且选出的四名队员都可以互相配对进行对打,已知B不能与W配对,C不能与Y配对,X不能与W或Y配对。若A不能入选,那么有几种选法?
(2012年法条分析58)《中华人民共和国侵权责任法》第6条规定:“行为人因过错侵害他人民事权益,应当承担侵权责任。“根据法律规定推定行为人有过错,行为人不能证明自己没有过错的,应当承担侵权责任。”请运用民法原理分析:(1)本条第1款
A、 B、 C、 D、 E、 B设展开式中x7项为Tr+1
请编写一个函数,用来删除字符串中的所有空格。例如,输入asdafaaz67,则输出为asdafaaz67。注意:部分源程序在文件PROG1.C中。请勿改动主函数main和其他函数中的任何内容,仅在函数fun的花括号中填入你编写的若干
最新回复
(
0
)