These patients are taken to the recovery room after().
A.surgery
B.check
C.injection
D.sleep
A.surgery
B.check
C.injection
D.sleep
第1题
A.the overtreatment for dying patients
B.the different attitude of doctor and patients toward death
C.the disproportionately high medicare expenditure in America
D.the unequal and non.transparent doctor—patient relationship
第2题
How Telemedicine Is Transforming Healthcare
A) After years of big promises,telemedicine is finally living up to its potential.Driven by faster internet connections,ubiquitous (无处不在的)smartphoncs and changing insurance standards,more healthproviders are turning to electronic communications to do their jobs—and it's dramatically changing thedelivery of healthcare.
B)Doctors are linking up with patients by phone,email and webcam(网络摄像头).They're also
consulting with each other electronically—sometimes to make split-second decisions on heart attack sand strokes.P atients,meanwhile,are using new devices to relay their blood pressure,heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Tele medicine alsoallows for better care in places where medical expertise is hard to come by. Five to 10 times a day,Doctors Without Borders relays questions about tough cases from its physicians in Niger,South Sudanand elsewhere to its network of 280 experts around the world,and back again via the internet.
C) As a measure of how rapidly telemedicine is spreading,consider:More than 15 million Americans received some kind of medical care remotely last year,according to the American Telemedicine Association,a trade group,which expects those numbers to grow by 30% this year.
D)None of this is to say that telemedicine has found its way into all corners of medicine. A recent survey of 500 tech-savvy(精通技术的)consumers found that 39% hadn't heard of telemedicine,and of those who haven't used it,42% said they preferred in-person doctor visits. In a poll of 1,500 family physicians,only 15% had used it in their practices—but 90% said they would if it were appropriately reimbursed(补偿).
E) What's more,for all the rapid growth,significant questions and challenges remain.Rules defining and regulating telemedicine differ widely from state to state. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver and in what form.
F)Some critics also question whether the quality of care is keeping up with the rapid expansion of telemedicinc. And there's the question of what services physicians should be paid for:Insurancecoverage varies from health plan to health plan,and a big federal plan covers only a narrow range ofservices. Telemedicine's future will depend on how—and whether—regulators,providers,payers and patients can address these challenges. Here's a closer look at some of these issues;
G)Do patients trade quality for convenience?The fastest-growing services in telemedicine connect consumers with clinicians they've never met for a phone,video or email visit—on-demand,24/7.Typically,these are for nonemergency issues such as colds,flu,ear-aches and skin rashes,and theycost around $45,compared with approximately $100 at a doctor's office,$160 at an urgent-care clinic or $750 and up at an emergency room.
H) Many health plans and employers have rushed to offer the services and promote them as a convenient way for plan members to get medical care without leaving home or work. Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year,up from 48% last year. Web companies such as Teladoc and American Well are expected to host some 1.2 million such virtual doctor visits this year,up 20%from last year,according to the American Tele me dicineAssociation.
I) But critics worry that such services may be sacrificing quality for convenience. Consulting a random doctor patients will never meet,they say,further fragments the health-care system,and even minorissues such as upper respiratory(上呼吸道的) infections can 't be thoroughly evaluated by a doctor who can't listen to your heart or feel your swollen glands.In a recent study,researchers posing as patients with skin problems sought help from 16 telemedicine sites—with unsettling results. In 62 encounters,f ewer than one-third disclosed clinicians’credential or let patients choose;only 32% discussed potential side effects of prescribed medications.Several sites misdiagnosed serious conditions,largelybecause they failed to ask basic follow-up questions,the researchers said.“Telemedicine holdsenormous promisc,but these sites are just not ready for prime time,”says Jack Resneck,the study'slead author.
J)The American Telemedicine Association and other organizations have started accreditation(鉴定)programs to identify top-quality telemedicine sites. The American Medical Association this month approved new ethical guidelines for telemedicine,calling for participating doctors to recognize thelimitations of such services and ensure that they have sufficient information to make clinicalre commendations.
K) Who pays for the services? While employers and health plans have been eager to cover virtual urgent-care visits,insurers have been far less willing to pay for telemedicine when doctors use phone,email orvideo to consult with existing patients about continuing issues.“It's very hard to get paid unless youphysically see the patient,”says Peter Rasmussen,medical director of distance health at the ClevelandClinic. Some 32 states have passed“ parity”(等同的) laws requiring private insurers to reimbursedoctors for services delivered remotely if the same service would be covered in person,though notnecessarily at the same rate or frequency.Medicare lags further behind.The federal health plan forthe elderly covers a small number of telemedicine services—only for beneficiaries in rural areas andonly when the services are received in a hospital,doctor's office or clinic.
L) Bills to expand Medicare coverage of telemedicine have bipartisan (两党的)support in Congress. Opponents worry that such expansion would be costly for taxpayers,but advocates say it would save money in the long run.
M)Experts say more hospitals are likely to invest in telemedicine systems as they move away from fee-for-service payments and into managed-care-type contracts that give them a set fee to provide care for patients and allow them to keep any savings they achieve.
N) Is the state-by-state regulatory system outdated? Historically,regulation of medicine has been left to individual states. But some industry members contend that having 50 different sets of rules,licensing fees and even definitions of“medical practice”makes less sense in the era of telemedicine and is hampering its growth.Currently,doctors must have a valid license in the state where the patient islocated to provide medical care,which means virtual-visit companies can match users only with locallylicensed clinicians. It also causes administrative hassles(麻烦)for world-class medical centers thatattract patients from across the country.At the Mayo Clinic,doctors who treat out-of-state patientscan follow up with them via phone,email or web chats when they return home,but they can onlydiscuss the conditions they treated in person.“If the patient wants to talk about a new problem,thedoctor has to be licensed in that state to discuss it. If not,the patient should talk to his primary-carephysician about it,”says Steve Ommen,who runs Mayo's Connected Care program.
O) To date,17 states have joined a compact that will allow a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move,some telemedicine advocates wouldprefer states to automatically honor one another's licenses,as they do with drivers' licenses.But statesaren't likely to surrender control of medical practice,and most are considering new regulations. Thisyear,more than 200 telemedicine-related bills have been introduced in 42 states,many regarding whatservices Medicaid will cover and whether payers should reimburse for remote patient monitoring.“Alot of states are still trying to define telemedicine,”says Lisa Robbin,chief advocacy officer for theFederation of State Medical Boards.
36. An overwhelming majority of family physicians are willing to use telemedicine if they are duly paid.
37. Many employers are eager to provide telemedicine service as a benefit to their employees because of its convenience.
38. Different states have markedly different regulations for telemedicine.
39. With telemedicine,patients in regions short of professional medical service are able to receive better medical care.
40. Unlike employers and health plans,insurers have been rather reluctant to pay for some telemedicine services.
41. Some supporters of telemedicine hope states will accept each other's medical practice licenses as valid.42. The fastest growing area for telemedicine services is for lesser health problems.
43. As telemedicine spreads quickly,some of its opponents doubt whether its service quality can be guaranteed.
44. The results obtained by researchers who pretended to be patients seeking help from telemedicine providers are disturbing.
45.Some people argue that the fact that different states have different regulations concerning medical services hinders the development of telemedicine.
第3题
It' s not entirely clear why medicine has been so slow to build on Anderson's early success. The National Institutes of Health budget office estimates it will spend $ 432 million on gene-therapy research in 2005, and there is no shortage of promising leads. The therapeutic genes are usually delivered through viruses that don't cause human disease. "The virus is sort of like a Trojan horse, " says Ronald Crystal of New York Presbyterian/Weill Cornell Medical College. "The cargo is the gene. "
At the University of Pennsylvania's Abramsoh Cancer Center, immunologist Carl June recently treated HIV patients with a gene intended to help their cells resist the infection. At Cornell University, researchers are pursuing gene-based therapies for Parkinson' s disease and a rare hereditary disorder that destroys children' s brain cells. At Stanford University and the Children' s Hospital of Philadelphia, researchers are trying to figure out how to help patients with hemophilia who today must inject themselves with expensive clotting drugs for life. Animal experiments have shown great promise.
But somehow, things get lost in the translation from laboratory to patient. In human trials of the hemophilia treatment, patients show a response at first, but it fades over time. And the field has still not recovered from the setback it suffered in 1999, when Jesse Gelsinger, an 18-year-old with a rare metabolic disorder, died after receiving an experimental gene therapy at the University of Pennsylvania. Some experts worry that the field will be tarnished further if the next people to benefit are not patients but athletes seeking an edge. This summer, researchers at the Salk Institute in San Diego said they had created a "marathon mouse" by implanting a gene that enhances running ability; already, officials at the World Anti-Doping Agency are preparing to test athletes for signs of "gene doping". But the principle is the same, whether you' re trying to help a healthy runner run faster or allow a muscular-dystrophy patient to walk. "Everybody recognizes that gene therapy is a very good idea, " says Crystal. "And eventually it's going to work. "
The case of Ashanthi Desilva is mentioned in the text to______.
A.show the promise of gene-therapy
B.give an example of modern treatment for fatal diseases
C.introduce the achievement of Anderson and his team
D.explain how gene-based treatment works
第4题
Mobile Phones: Are They about to Transform. Our Lives?
We love them so much that some of us sleep with them under the pillow, yet we are increasingly concerned that we cannot escape their electronic reach. We use them to convey our most intimate secrets, yet we worry that they are a threat to our privacy. We rely on them more than the Internet to cope with modern life, yet many of us don't believe advertisements saying we need more advanced services.
Sweeping aside the doubts that many people feel about the benefits of new third generation phones and fears over the health effects of phone masts(天线杆), a recent report clains that the long-term effects of new mobile technologies will be entirely positive so long as the public can be convinced to make use of them. Research about users of mobile phones reveals that the mobile has already moved beyond being a mere practical communications tool to become the backbone (支柱)of modern social life, from love affairs to friendship to work. One female teacher, 32, told the researchers: “I love my phone. It's my friend. ”
The close relationship between user and phone is most pronounced among teenagers, the report says, who regard their mobiles as an expression of their identity. This is partly because mobiles are seen as being beyond the control of parents. But the researchers suggest that another reason may be that mobiles, especially text messaging, are seen as a way of overcoming shyness. “Texting is often used for apologies, to excuse lateness or to communicate other things that make us uncomfortable, ”the report says, The impact of phones, however, has been local rather than global, supporting existing friendships and networks, rather than opening users to a new broader community. Even the language of texting in one area can be incomprehensible to anybody from another area.
Among the most important benefits of using mobile phones, the report claims, will be a vastly improved mobile infrastructure(基础设施), providing gains throughout the economy, and the provision of a more sophisticated location-based services for users. The report calls on government to put more effort into the delivery of services by mobile phone, with suggestions including public transport and traffic information and doctors' text messages to remind patients of appointments. “I love that idea, ”one user said in an interview. “It would mean I wouldn't have to write a hundred messages to myself. ”
There are many other possibilities. At a recent trade fair in Sweden, a mobile navigation product was launched. When the user enters a destination, a route is automatically downloaded to their mobile and presented by voice, pictures and maps as they drive. In future, these devices will also be able to plan around congestion(交通堵塞)and road works in real time. Third generation phones will also allow for remote monitoring of patients by doctors. In Britain scientists are developing a asthma(哮喘)management solution, using mobiles to detect early signs of an attack.
What does the writer suggest in the first paragraph about our attitudes to mobile phones?
A.We can't live without them.
B.We are worried about using them so much.
C.We have contradictory feelings about them.
D.We need them more than anything else to deal with modem life.
第5题
It is physically impossible for a well-educated, intellectual(理性的), or brave man to make money the chief of his thoughts; as physically impossible as it is for him to make his dinner the principal object of them. All healthy people like their dinner, but their dinner is not the main object of their lives. So all healthy-minded people like making money but the main object of their lives is not money; it is something better than money.
A good soldier, for instance, mainly wishes to do his fighting well. He is glad for his pay very properly so, and justly grumbles (抱怨) when you keep him ten months without it; still his main motion of his life is to win battles, not to be paid for winning them.
So of doctors. They like fees no doubt-ought to like them; yet if they are brave and well-educated, the entire object of their lives is not fees. They, on the whole, desire to cure the sick, and they are good doctors, and the choices were fairly put to them would rather cure their patients and lose their fees than kill him and get it. And so with all other brave and rightly trained men, their work is first, their fee second, very important always, but still second.
The main idea of the text is that _______.
A.people can't live without money.
B.money is as important as work.
C.the main object of the people's lives should not be money but work.
D.the entire object of the people's lives is making money.
第6题
Questions are based on the following passage.
Saying they can no longer ignore the rising prices of health care, some of the most influentialmedical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.The shift, little noticed outside the medical establishment but already controversial inside it,suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how healthcare dollars are spent.In practical terms, the new guidelines being developed could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment—at the end of life, for example—is too expensive.In the extreme, some critics have said that making treatment decisionsbased on cost is a form. of rationing.Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones areexpected to make doctors more conscious of the economic consequences of their decisions, even though there"s no obligation to follow them.Medical society guidelines are also used by insurancecomoanies to help determine reimbursement (报销) policies.Some doctors see a potential conflict in trying to be both providers of patient care and fmancial
Overseers."There should be forces in society who should be concerned about the budget, but they shouldn"t be functioning simultaneously as doctors," said Dr.Martin Samuels at a Boston hospital.He said doctors risked losing the trust of patients if they told patients, "I"m not going to do what I think is best for you because I think it"s bad for the healthcare budget in Massachusetts." Doctors can face some grim trade—offs.Studies have shown, for example, that two drugs are about
equally effective in treating macular degeneration, and eye disease.But one costs $ 50 a dose and the other close to $ 2,000.Medicare could save hundreds of millions of dollars a year if everyone used the cheaper drug, Avastin, instead of the costlier one, Lucentis.But the Food and Drug Administration has not approved Avastin for use in the eye.and using it rather than the alternative, Lucentis, might carry an additional, although slight, safety risk.Should doctors consider Medicare"s budget in deciding what to use?"I think ethically (在道德层面上) we are just worried about the patient in front of us and not trying to save money for the insurance industry or society as a whole," said Dr.Donald Jensen.Still, some analysts say that there"s a role for doctors to play in cost analysis because not many others are doing so."In some ways," said Dr.Daniel Sulmasy, "it represents a failure of wider society
to take up the issue."
What do some most influential medical groups recommend doctors do? 查看材料
A.Reflect on the responsibilities they are supposed to take.
B.Pay more attention to the effectiveness of their treatments.
C.Take costs into account when making treatment decisions.
D.Readjust their practice in view of the cuts in health care.
第7题
Will the AIDS patients benefit ______ the new drug?
A of
B from
C by
第8题
Doctors have their own special sleep problems. Residents are famously short of sleep. It is not unusual for. them to work 40 hours in a row without rest. They are not in the least worried about it, confident they can still deliver the highest quality of medical care. But an article in the Journal of the American Medical Association points out that in the morning after 24 hours of sleeplessness, a person' s motor performance is comparable to that of someone who is drunk. Curiously, surgeons who believe that operating under the influence of alcohol is grounds for sacking often don' t think twice about operating without enough sleep.
"I could tell you horror stories," says Jaya Agrawal, president of the American Medical Student Association, which runs a website for residents. Some are terrifying." I was operating after being up for over 36 hours," one writes. "I literally fell asleep standing up and nearly planted my face into the wound."
"Practically every surgical resident I know has fallen asleep at the wheel driving home from work," writes another. "I know of three who have hit parked cars. Another hit a 'Jersey gate' on the New Jersey Expressway, going 105kin/h."
"Your own patients have become the enemy," writes a third, because they are "the one thing that stands between you and a few hours of sleep."
The U.S. controls the hours of pilots and truck drivers. But until such a system is in place for doctors, patients are on their own. If you're worded about the people treating you or a loved one, you should feel free to ask how many hours of sleep they have had and if more rested staffers are available.
Sleep is a funny thing because ______.
A.the longer one sleeps, the less sound sleep he gets
B.the more sleep one gets, the more likely a stroke occurs
C.many people stick to about eight hours of sleep to stay fine
D.many people who sleep six hours a night still feel energetic in the day
第9题
A.perceives
B.prescribes
C.treats
D.prospects
第10题
A.giving
B.regarding
C.following
D.considering