1 . Huge health care bills, long emergency-room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily.
Primary care should be the backbone of any health care system. Countries with appropriate primary care resources score highly when it comes to health outcomes and cost. The U.S. takes the opposite approach by emphasizing the specialist rather than the primary care physician.
A recent study analyzed the providers who treat Medicare beneficiaries (老年医保受惠人). The startling finding was that the average Medicare patient saw a total of seven doctors—two primary care physicians and five specialists—in a given year. Contrary to popular belief, the more physicians taking care of you don’t guarantee better care. Actually, increasing fragmentation of care results in a corresponding rise in cost and medical errors.
How did we let primary care slip so far? The key is how doctors are paid. Most physicians are paid whenever they perform a medical service. The more a physician does, regardless of quality or outcome, the better he’s reimbursed (返还费用). Moreover, the amount a physician receives leans heavily toward medical or surgical procedures. A specialist who performs a procedure in a 30-minute visit can be paid three times more than a primary care physician using that same 30 minutes to discuss a patient’s disease. Combining this fact with annual government threats to indiscriminately (任意地) cut reimbursements, physicians are faced with no choice but to increase quantity to boost income.
Primary care physicians who refuse to compromise quality are either driven out of business or to cash-only practices, further contributing to the decline of primary care.
Medical students are not blind to this scenario. They see how heavily the reimbursement deck is stacked against primary care. The recent numbers show that since 1997, newly graduated U. S. medical students who choose primary care as a career have declined by 50%. This trend results I emergency rooms being overwhelmed with patients without regular doctors.
How do we fix this problem?It starts with reforming the physician reimbursement system. Remove the pressure for primary care physicians to squeeze in more patients per hour, and reward them for optimally (最佳的) managing their diseases and practicing evidence-based medicine. Make primary care more attractive to medical students by forgiving students loans for those who choose primary care as a career and reconciling the marked difference between specialist and primary care physician salaries.
We’re at a point where primary care is needed more than ever. Within a few years, the first wave of the 76 million Baby Boomers will become eligible for Medicare. Patients older than 85, who need chronic care most, will rise by 50% this decade.
Who will be there to treat them?
1. We learn from the passage that people tend to believe that ________.A.the more costly the medicine, the more effective the cure |
B.seeing more doctors may result in more diagnostic errors |
C.visiting the same doctor on a regular basis ensures good health |
D.the more doctors a patient sees, the better |
A.increase their income by working overtime |
B.improve their expertise and service |
C.see more patients at the expense of quality |
D.make various deals with specialists |
A.Bridge the salary gap between specialist and primary care physicians. |
B.Extend primary care to patients with chronic diseases. |
C.Recruit more medical students by offering them loans. |
D.Reduce the tuition of students who choose primary care as their major. |
A.The Health Care in Trouble | B.The Imbalance System |
C.The Declining Number of Doctors | D.The Ever-rising Health Care Costs |
New Drug Slows Alzheimer, But Not a Cure
What a good piece of news! Last week, United States health officials finally
The Alzheimer’s Association describes Alzheimer
The newly approved Leqembi is a long-needed new treatment for the disease. But Dr. Joy Snider,
The U. S. Food and Drug Administration (FDA) approved the drug through a speedier-than-usual process, which permits drugs
A.The final begins next week. |
B.The man should check with his doctor again. |
C.She wants the man to attend the final with her. |
D.She hopes the man will be able to play in the final. |
4 . It all began with an experience one of us (Arinzeh) had more than two decades ago. In 1991, a summer research experience at the University of California at Berkeley demonstrated how engineering could improve the lives of patients. Instead of working in a more traditional area such as automobile design, Arinzeh spent the summer after her junior year of college working in a rehabilitation laboratory.
Engineers there were designing new prosthetic (修复的) devices for patients who had lost limbs, and new assistive devices to help paralyzed patients move. The engineers would then collaborate with clinicians at a rehabilitation center to test their developments. Before that summer she hadn’t connected traditional engineering principles with the opportunity to solve biomedical problems. But by the end of those short months, Arinzeh was hooked on the promise of using mechanical engineering to help people move better.
Tissue engineering, a budding field at that time, offered a chance to move beyond building prosthetics. Damage to musculoskeletal tissues, such as bone and cartilage, and nervous tissue, such as the spinal cord, can be debilitating and can severely limit a person’s quality of life. In addition, such tissues cannot fully regenerate after a severe injury or in response to disease. Tissue engineers aim to fully repair and regenerate that tissue so that it regains complete function, but at that time researchers still had a lot to learn about cells and their support structures to solve these problems.
The earliest successes were with skin, in which researchers used dermal cells to generate grafts, leading to the first commercial products in the late 1990s. Researchers imitate nature, using cells as building blocks and developing strategies to guide the cells to form the appropriate tissue. Because stem cells (干细胞) are precursor (前身) to almost all tissue types, such cells are a promising source of these critical building blocks. But cells don’t grow and differentiate on their own. The cell’s microenvironment can influence stem-cell function in critical ways. Engineered microenvironments, or scaffolds, can effectively promote stem cells and other cell types to form tissues. To construct such scaffolds, some important tools are what are called functional biomaterials. These materials respond to environmental changes such as PH, enzymatic activity, or mechanical load, and their composition can mimic or replicate components of native tissue.
One of us (Arinzeh) wanted to use functional biomaterials to create three-dimensional tissue-like structures where cells can grow, proliferate (增殖), and differentiate, ultimately forming and regenerating tissue. Our group’s work started with bone studies in the 1990s, eventually moving into cartilage and the spinal cord over the past decade. The overall goal is to produce structures that could someday help patients struggling with severe injuries and movement disorders to move freely. For bone repair, our group has studied composite scaffolds consisting of polymers and ceramics that provide both mechanical and chemical cues to repair bone. Piezoelectric materials, which respond to mechanical stimuli by generating electrical activity, are used to encourage the growth of nerve tissue as well as cartilage and bone. Glycosaminoglycans (GACs), a major component of native cartilage tissue, provide growth factors to promote tissue formation, and Arinzeh has designed biomimetic scaffolds that incorporate these molecules. After all these years, the promise that seemed so enticing in 1991 is becoming a practical reality, with huge implications for human health.
1. Which of the following statements is TRUE?A.Before working with patients, Arinzeh was an automobile designer. |
B.Since 1991, tissue engineering has been mainly applied to building prosthetics. |
C.It’s hard for musculoskeletal tissues to fully recover from disease or injury. |
D.In the late 1990s, the lack of knowledge about cells and their support structures prevented researchers from making any achievement in tissue engineering. |
A.change | B.divide | C.alternate | D.reproduce |
A.tissues from one part of a person’s body used to repair another damaged part |
B.stem cells and other cell types in an engineered microenvironment |
C.structural support for damaged tissue repair |
D.functional biomaterials to replace native tissues. |
A.It was inspired by the team members’ internship. |
B.So far, the study has covered multiple musculoskeletal tissues, including bone, cartilage and nervous tissues. |
C.The electrical activity caused by Piezoelectric materials will generate mechanical stimuli that encourage the growth of musculoskeletal tissues. |
D.The researchers of this study are the best designers of modern tissue engineering. |
A.Salesman and customer. | B.Professor and student. |
C.Nurse and patient. | D.Doctor and patient. |
A. accompanied B. allowed C. feasibly D. fueled E. intensity F. option G. prompting H. routine I. surgically J. underlying K. varied |
Brain Signals for Lasting Pain
Brain signals that reveal how much pain a person is in have been discovered by scientists who say the work is a step towards new treatments for people living with lasting pain.
It is the first time researchers have decoded the brain activity
Lasting pain affects nearly 28 million adults in the UK alone, and the causes are
For the latest study, Shirvalkar and his colleagues
A.Doctor and patient. | B.Teacher and student. |
C.Policeman and thief. | D.Husband and wife. |
8 . Global Rise of TCM
Phan Thi Kim Chi’s connection with Traditional Chinese Medicine (TCM) began at an early age. Growing up in a small village in Vietnam, it was inconvenient for Phan to travel to hospitals in neighboring cities. Whenever she caught a cold or experienced a headache as a child, her family would seek the help of a local TCM practitioner.
As a foreign student, Phan finds the TCM basic theory course to be the most challenging one in the curriculum.
The booming situation of TCM is not limited to schools and clinics. It has also become a lifestyle choice for many young people. There is a trend among young people to place more emphasis on health conditioning and preservation. However, experts remind that TCM emphasizes the importance of diagnosing and treating based on identifying syndromes (症状). It is impossible to offer a one-size- fits-all approach to all patients.
A.They highly recognized the effectiveness of TCM, especially its use in pain treatment. |
B.Even when drinking herbal milk tea, it’s best to make choices accordingly. |
C.Being extensive and far-reaching, TCM is deeply connected with Chinese philosophy. |
D.Overseas students of TCM, like Phan, are not rare. |
E.This led her to major in TCM at a traditional medical school in China. |
F.Many other Chinese medicine institutions have adopted similar strategic initiatives. |
A. launched B. utilized C. complete D. jointly E. further F. realized G. currently H. accessible I. specifically J. recognized K. reliable |
Sanofi Launches Grant (拨款) to Help Children with Dlabetes (糖尿病)
To celebrate the 60th anniversary of China-Franco diplomatic ties, the French pharmaceutical giant Sanofi cooperated with the Shanghai Soong Ching Ling Foundation to
As one of the first French companies to enter China, Sanofi has continuously increased investment and promoted innovation in the health care sector over the past few decades. The company has been committed to making innovative medicine and medical services more
Olivier Charmel, the company’s executive vice-president, said Sanofi has benefited a lot from its long-term investment in China and will always stand as a
Shi said the company
Ji Linong, director of Department of Endocrinology at Peking University People’s Hospital, highly
With the help of the charity grant, Ji said he expects China to establish a more
In addition to diabetes, the Sanofi China Charity Grant will also be
10 . A cure for the future in the past?
For over fifty years, the people of Britain have relied on the welfare state to make sure they have adequate health services. But now the National Health Service is sick. Government
For some, however, there are
Consider these case studies:
Maude is 76 years old and has been suffering from arthritis for almost ten years. “The pain in my joints was almost
Ron is 46. His high-powered city job was
So is there still a place in our lives for modern medicine? While it is true that some infections and viruses may be
A.support | B.restrictions | C.cutbacks | D.concern |
A.programs | B.alternatives | C.measures | D.scales |
A.comeback | B.living | C.change | D.mess |
A.unique | B.uncertain | C.universal | D.unbearable |
A.permission | B.surgery | C.supervision | D.strength |
A.condition | B.desperation | C.general | D.particular |
A.protect | B.recover | C.relieve | D.treat |
A.eager | B.grateful | C.famous | D.responsible |
A.treatments | B.sources | C.spirits | D.comments |
A.supervised | B.declared | C.recommended | D.tempted |
A.contributing | B.adapting | C.subjecting | D.objecting |
A.moderate | B.active | C.negative | D.suitable |
A.identifying | B.investigating | C.estimating | D.worsening |
A.prevented | B.empowered | C.indicated | D.restored |
A.undertaking | B.invading | C.investing | D.evolving |