新編臨床醫(yī)學(xué)英語.doc

學(xué)習(xí)資料收集于網(wǎng)絡(luò)，僅供參考新編臨床醫(yī)學(xué)英語 第1期:病患的問題與訴求Unit1TextAInternalMedicineandTodaysInternist第1單元 文章A內(nèi)科與內(nèi)科醫(yī)生Questions/PleasofthePatient病患的問題與訴求HowcanIfindagooddoctor?我如何找到一位良醫(yī)？HowcanIfindagooddoctorwhomIcanafford?如何能夠碰到一位價格親民的醫(yī)生？HowcanIfindagooddoctorwhocaresaboutmeasaperson?又如何能夠遇見一位把我當(dāng)成“人”看待的醫(yī)生？HowcanIfindagooddoctorwhowilltakethetimetolistenandunderstand?如何找到一位能夠花時間傾聽我的訴說，了解我的名醫(yī)？Peoplewhoneedmedicalcareaskthesequestionsthroughouttheworldeveryday.每天，全球有許多病患都在詢問這些問題。Theyaskthembecausetheyfaceahealthcaresystemthatisscientificallycomplex,organizationallyoverloaded,andgenerallynotorientedtothepatientasaperson.他們之所以問這些問題， 是因為他們所面對的醫(yī)療保健體系技術(shù)深奧、機(jī)構(gòu)臃腫，而且一般都沒有意識到病人首先是一個“人”。Whenanindividualfirstbecomesill,regardlessofthesymptoms,heorsheneedsmostsomeonewhoseemstosay,如果有人生了病，不管癥狀如何，他們最希望聽到的是：Iamagooddoctor；Ichargeareasonableamountformyservices；Icareaboutyou，thepatientandIwilltakethetimetolistenandunderstand.“我是醫(yī)生；我只收取親民價格，我關(guān)心病患，我將傾聽你的訴求，理解你?！盇prominentteacher/physicianinamajormedicalcentertaughthisstudentstolistentothepatientandhewilltellyouwhatiswrong,andhewilltellyouwhatheneeds.主要醫(yī)療中心的知名學(xué)者/內(nèi)科醫(yī)生都會教授學(xué)生要學(xué)會傾聽，病人會告訴你哪里不舒服，也將會告訴你他們的需求。Havingfoundaphysicianwhoanswerssoprofoundlytotheirneeds,somepatientsareextremelygratefulbutmostareutterlyoverwhelmed.有些內(nèi)科醫(yī)生完全滿足了病患的需求，有些患者表現(xiàn)出了極大的感激之情，但是絕大部分都激動不已。Withthediscoveryofthatrelationship,thedifferencebetweenasuperbtechnicianandatruephysicianreallybecomesevidenttothepatient.有了這層關(guān)系之后，專業(yè)技師和內(nèi)科醫(yī)生的區(qū)別在病患面前展露無遺。Thatphysician/teacherwasascholarlygentlemanwithdeepscientificinsightandanactive andstimulatingclinicalandresearchpractice.內(nèi)科醫(yī)生/教授都是學(xué)術(shù)人才，他們對學(xué)科有著科學(xué)的深刻見解，并活躍在臨床和研究領(lǐng)域中。Unfortunatelyhedevelopedcripplingrheumatoidarthritisinthemidstofhiscareer.但是，他們在工作期間不幸患上了風(fēng)濕性關(guān)節(jié)炎。Beyondquestion,hisowndiseasesensitizedhimtothecomplexmixofexpectations,needs, fears,毫無疑問，他自身的疾病使他對病人交織著期待、需要、恐懼和感激的復(fù)雜心情十分敏感，andappreciationthatpatientsfeelwhenfacingaphysical-mentaltrialwhileatthesametime lookingfor thatperfectphysiciantohelpthem.這是患者們在經(jīng)歷身心煎熬、同時又盼望有那么一位德高望重的名醫(yī)能給他進(jìn)行診治時所共有的感覺。Patientsflockedtothisdoctor，notjustforhisaccuratediagnoses,hiscorrecttherapies,or evenhiswarmth,患者都去找這樣的醫(yī)生看病，并不是因為他們準(zhǔn)確無誤的診斷，正確的治療方法，甚至是所給予的溫暖，butfortheintellectheexpressedandthesheerjoyoflivingthatheextendedinevery encounterwithanotherhumanbeing.而是他們所散發(fā)的智慧之光，以及他在面對每一個“人”時所展現(xiàn)的喜悅之情。HehadaShakespeareangraspofthequalitiesofbeinghumanandanuncommonabilityto transmitloveandrespectforhisfellowhumanbeings.他既能像莎翁那樣對人性特點(diǎn)有著深刻的了解，又身具異秉能把關(guān)愛和尊重傳遞給全人類。Heexhibitedtheidealallphysiciansshouldemulate.他展現(xiàn)了所有內(nèi)科醫(yī)生應(yīng)該展現(xiàn)的最理想的一面。Manyreadersknowaphysicianwiththesecharacteristicsallshouldseektoknowoneandto developtheirownprofessionalpersonasothathumanqualitiesarenotlosttotechnical acumen.許多讀者都認(rèn)為擁有這些特征的內(nèi)科醫(yī)生都應(yīng)該去了解，并培養(yǎng)自己的職業(yè)形象，只有這樣，人類的本質(zhì)才不會在技術(shù)面前甘拜下風(fēng)。1.beorientedto面向,本句中的them是指上句的thesequestions.原文：Theyaskthembecausetheyfaceahealthcaresystemthatisscientificallycomplex, organizationallyoverloaded,andgenerallynotorientedtothepatientasaperson.他們之所以問這些問題， 是因為他們所面對的醫(yī)療保健體系技術(shù)深奧、機(jī)構(gòu)臃腫，而且一般都沒有意識到病人首先是一個“人”。2.inthemidstof：在中，在當(dāng)中原文：Unfortunately,hedevelopedcripplingrheumatoidarthritisinthemidstofhiscareer.但是，他們在工作期間不幸患上了風(fēng)濕性關(guān)節(jié)炎。3.beyondquestion的意思是“毫無疑問地”；sensitizesbtosth意思是“使某人對某事敏感起來”。原文：Beyondquestion,hisowndiseasesensitizedhimtothecomplexmixofexpectations, needs,fears,andappreciationthatpatientsfeelwhenfacingaphysical-mentaltrialwhileat thesametimelookingfor thatperfectphysiciantohelpthem.毫無疑問，他自身的疾病使他對病人交織著期待、需要、恐懼和感激的復(fù)雜心情十分敏感。這是患者們在經(jīng)歷身心煎熬、同時又盼望有那么一位德高望重的名醫(yī)能給他進(jìn)行診治時所共有的感覺。4.rheumatoidarthritis風(fēng)濕性關(guān)節(jié)炎例句：ThestudywasalsotooshorttoshowwhetherTwHFcanslowthejointdamagecaused byrheumatoidarthritis.這項研究時間也太短，不能顯示雷公藤是否能減緩由風(fēng)濕性關(guān)節(jié)炎引起的關(guān)節(jié)損傷。第2期:好醫(yī)生的科學(xué)和技術(shù)專業(yè)背景THESCIENTIFICANDTECHNOLOGICBACKGROUNDOFAGOODDOCTOR“好醫(yī)生”的科學(xué)和技術(shù)專業(yè)背景SinceFlexnerissuedhisfamousreportin1910,Americanmedicaleducationhasstriventoward thedevelopmentofastrongscientificbase.自從1910年弗萊克斯納的著名研究報告問世以來，美國的醫(yī)學(xué)教育致力于培養(yǎng)深厚的科學(xué)基礎(chǔ)。Thisintellectualprerequisite, therefore, hasbecomeanintegralpartofpremedical, undergraduate, graduate,and,indeed,continuingmedicaleducation.所以，以學(xué)術(shù)知識為前提的教育就成為了醫(yī)學(xué)預(yù)科、本科生、研究生以及繼續(xù)醫(yī)學(xué)教育的主要組成部分。Biomedicalscienceisfundamentaltounderstandingdisease,makingdiagnoses,developing newtherapies,andappreciatingthecomplexitiesandcontributionsofnewtechnologies.生物醫(yī)學(xué)是掌握病情、作出診斷、研究新型治療方法的基礎(chǔ)，同時它還是研發(fā)新技術(shù)的基礎(chǔ)。Physicianscannotbesatisfiedwithsimplyknowingthatacertainformoftherapyworks80to90percentofthetime.內(nèi)科醫(yī)生不能夠只滿足于掌握某領(lǐng)域治療方法的80-90%。Theymustunderstandthebasicphysiologyandpharmacologyofanyapproachtheyuse.他們必須對所應(yīng)用的生理學(xué)和藥物學(xué)的基本療法了如指掌。Theymustpossesstheintellectualtoolstofollowreportsofcurrentresearchinmedical journals他們必須能夠利用學(xué)術(shù)方法來掌握醫(yī)學(xué)雜志的最新研究成果，sothattheycancontinuetograspthenewestandlatestapproaches,nomatterhow complicatedthefieldmaybecome.不管該領(lǐng)域變得多么復(fù)雜多變，他們都能夠掌握最新的治療方法。Thatiswhy,inatextbookofmedicinelikethis,strongemphasisisgiventohowthingswork, whatgoesamisswhenpathologicprocessesensue,這就是為什么像這樣的醫(yī)學(xué)教科書要著重強(qiáng)調(diào)事物的運(yùn)作方法，以及在病理過程中所出現(xiàn)的差錯，andwhateffectagiventherapyhasincorrectingthatdefect.以及特定治療方法對糾正差錯所帶來的影響。Weseektocreatewithinthemindsofourreadersayearningforagreaterdepthof understandingandacontinuingcommitmenttostayatthefrontierofscientificknowledge.我們希望我們的讀者能夠從內(nèi)心有著更加深入的了解，并繼續(xù)處在科學(xué)的最前沿。Theseare,infact,amongthehallmarksofaprofessionalinanyscientificfield.事實上，任意科學(xué)領(lǐng)域?qū)I(yè)都包含了這些特點(diǎn)。Wearemovingintoanerawhenpharmacotherapeuticagentsarenolongermerelywondersof organicchemistry,butincreasinglyoftenarebiologicproducts.當(dāng)今時代，藥劑已經(jīng)不僅僅是有機(jī)化學(xué)的奇跡，它也逐漸變成了生物制品。SomeoftheseareisolatedfromnatureothersaredevelopedbyrecombinantDNA technology.許多產(chǎn)品已經(jīng)脫離自然，有些是DNA技術(shù)重組的產(chǎn)物。Onthehorizonistheavailabilityofatruereplacementorsupplementfordefectiveor deficientbiochemicalconstituentsofthebody.我們即將要面對的是真正能夠替代或是能夠補(bǔ)充生物化學(xué)成分中不足的產(chǎn)品。Nophysiciancan,withintellectualhonesty,usethesenewclassesofagentswithoutfully understandingtheiraction,theirmeaning,andtheirpotentialsideeffects.任何一位有學(xué)術(shù)誠信的醫(yī)生都不會在沒有充分了解這些新型藥劑的功能、作用以及潛在副作用的情況下就使用它們。Thediagnosticandtherapeuticcontributionsandpotential,inclinicalsituations, of biocompatibleprostheticdevices,nuclearmagneticresonancespectroscopy,通過一系列的發(fā)展（還沒有被確認(rèn)），診療對未來臨床中的生物兼容性假肢器官、核磁共振譜、high-frequencylaserbeams,andsoonthroughdevelopmentsnotyetconceived appreciatedonlybythemindthatisdisciplinedinfundamentalscience.高頻激光等所作出的貢獻(xiàn)只有在基礎(chǔ)科學(xué)中才能得以實現(xiàn)。1.percapita每人，按人口（計算）例句：TheUnitedStatesspendsmorepercapitaonhealthcarethananyothernationintheworld.美國是全球個人醫(yī)療開銷最大的國家。2.Medicaidplan醫(yī)療補(bǔ)助制度例句：WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthepoorbyCongressin1965,1965年，美國國會通過了補(bǔ)助老人的退休醫(yī)療福利，以及補(bǔ)助窮人的窮人醫(yī)療補(bǔ)助，3.dentalcare牙齒護(hù)理例句：Yoursmiledependsonsimpledentalcarehabits,suchasbrushingandflossing.自信的笑容取決于簡單的牙齒護(hù)理習(xí)慣，如刷牙和使用牙線。4.cost-efficient有成本效益的例句：Italsohelpsthearchitectmanageresourcesinaverycost-efficientmanner.它還有助于架構(gòu)師采用一種非常具有成本效益的方式來管理各種資源。第3期: THEORGANIZATIONANDFINANCINGOFTODAYSMEDICINE當(dāng)代醫(yī)療制度與資金投入Patients,aswellastheirrepresentativesingovernment,industry,andmanaged-care organizations,areconcernedabouttherisingcostofmedicalcare.政府、產(chǎn)業(yè)、管理型醫(yī)療保險代表以及病患都對不斷增加的看病價格給予了高度關(guān)注。ThetotalbillforhealthcareinAmericanowrisesatarateofabout10percentperyear,an increasethatseemstocontinueunabated.在美國，醫(yī)療開銷以每年10%的價格增長，而這一趨勢還將繼續(xù)下去。Federallegislationinstitutingdiagnosis-relatedgroups(DRCs)hasclearlymoderatedtherise ofhospitalcosts,butphysiciancostscontinuetoriseatanever-increasingrate.聯(lián)邦立法已經(jīng)開設(shè)了診斷相關(guān)組，并已經(jīng)降低了醫(yī)院開銷，但是內(nèi)科醫(yī)生的開銷仍然在不斷增加。Everystudentofmedicineshouldaskifthisisrealistic.每一名醫(yī)學(xué)學(xué)生都在問這是不是真的。Isitsustainable?Isitdefensible?是可持續(xù)性的？還是有可解決的辦法？Whatwillbethelimits?范圍到底在哪？Patientsalreadyask, “CanIreallyaffordthebestdoctorsinthemostprestigiouspractices,in themostfamousmedicalcenters?”病患在問，“我能去最好的醫(yī)療中心，最好的科室，找最好的醫(yī)生看病嗎？”“CanIaffordtobereferredtoasubspecialist?”我有錢去看那些專業(yè)醫(yī)師嗎？“CanIaffordtobeoutofworkandinthehospital?”我能支付得起不上班在醫(yī)院看病的開銷嗎？“CanIaffordtopaymyrisinginsurancepremiums?”“我有錢支付不斷增長的保險嗎？”“HowmuchdeductibleonmyinsurancecanIafford?”“保險中的扣除條款我能支付得起多少？”Worseyet,anincreasingnumberofpatientshavetomakechoicesbetweenseekingmedicaland dentalcareandgettingfood,clothing,shelter,andotheressentialsofdailyliving.更糟糕的是，有許許多多的病患不得不在看病，看牙和基本日常生活之間做出選擇。TheseissueshavebecomemajorconcernsinAmericanhouseholdsandclearlyrepresentoneof themostdisturbingweaknessesinoureconomy,這些問題已經(jīng)成為美國家庭關(guān)心的主要問題,并且是美國經(jīng)濟(jì)中最令人擔(dān)心的薄弱環(huán)節(jié)，ofwhichnownearly12percent(byannualgrossnationalproduct)isdevotedtohealthcare, upfrom8percentin1975.醫(yī)療費(fèi)用所占每年國民生產(chǎn)總值的比例已由1975年的8%增加到現(xiàn)在的12%。OverthelasttwotothreedecadesithasbeenagoaloftheUnitedStatestopromoteever increasingqualityandcost-effectivenessofhealthcareforall.在過去的二三十年中，美國的目標(biāo)就是要為全體民眾提供質(zhì)量高，成本高效益的醫(yī)療制度。Unfortunately,wehavefailedmiserably.不幸的是，我們遭遇了慘敗。TheUSAspendsmorepercapitaonhealthcarethananyothernationintheworld.美國是全球個人醫(yī)療開銷最大的國家。Yetinthemajorindicesofhealthourpopulationranksnineteenth！但是在主要醫(yī)療指數(shù)上，美國民眾排在了第19位！Atthesametimewecontinuetoseeawastefulmaldistributionofphysiciansbothbyspecialty andgeographicallyandagrowingnumberofmedicallyindigentandmedicallyuninsuredpeople inournation.與此同時，無論在專業(yè)還是在地域上，內(nèi)科醫(yī)生的分配不合理，沒有保險，沒錢看病的人數(shù)還在不斷增加。Somehow,thecostsofwhatwearetryingtoachieveeventhoughthegoaliscommendablearenotbeingplacedinproperperspectivebythemedicalprofession,health-caremanagers, andrepresentativesofthepeopleinordertoprovidesuitablecareforall.盡管我們要實現(xiàn)的目標(biāo)值得贊揚(yáng)，但是我們要實現(xiàn)的看病價格并沒有得到醫(yī)療人士、醫(yī)療衛(wèi)生監(jiān)管人士、以及代表的認(rèn)真對待。Unfortunately，inthepresentsystemtherealneedsofthepopulacearenotalwaysmetby affordableservices.不幸的是，就目前的制度而言，大眾所能夠支付得起的醫(yī)療費(fèi)用無法滿足人們的要求。Atthesametime,overutilizationofmedicalservicesmaybetheveryenginethatdrivesupthe totalcostofhealthcaredelivery.與此同時，醫(yī)療服務(wù)的過度使用或許也是增加醫(yī)療費(fèi)用的引擎。WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthepoorby Congressin1965,1965年，美國國會通過了補(bǔ)助老人的退休醫(yī)療福利，以及補(bǔ)助窮人的窮人醫(yī)療補(bǔ)助，wehadhopedasanationthatweweremovingtowardamorejustandefficientsystem.我們希望美國的醫(yī)療系統(tǒng)能夠變得更加公正，更加有效。Infact,theoppositehasbeenthetrend.但是事實上，我們卻背道而馳。Thissocietalgoalmustnowbereaddressedreformulated,andrestructedintermsofmodern needs,就社會需求來講，我們應(yīng)該通過重組來實現(xiàn)社會目標(biāo)，reflectingfairlyandfullymeasuredcost-benefitratiosforeveryformofmedicalservice.全面反映醫(yī)療服務(wù)的成本與效益比例。1.percapita每人，按人口（計算）例句：TheUnitedStatesspendsmorepercapitaonhealthcarethananyothernationinthe world.美國是全球個人醫(yī)療開銷最大的國家。2.Medicaidplan醫(yī)療補(bǔ)助制度例句：WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthe poorbyCongressin1965,1965年，美國國會通過了補(bǔ)助老人的退休醫(yī)療福利，以及補(bǔ)助窮人的窮人醫(yī)療補(bǔ)助，3.dentalcare牙齒護(hù)理例句：Yoursmiledependsonsimpledentalcarehabits,suchasbrushingandflossing.自信的笑容取決于簡單的牙齒護(hù)理習(xí)慣，如刷牙和使用牙線。4.cost-efficient有成本效益的例句：Italsohelpsthearchitectmanageresourcesinaverycost-efficientmanner.它還有助于架構(gòu)師采用一種非常具有成本效益的方式來管理各種資源。第4期:Medicalprofessionalsoftenattributeoverutilizationtopatientbehavior.醫(yī)療專業(yè)人士經(jīng)常將過度使用歸罪于病患的行為。Infact,however,physicianscontrol70percentofhealthexpenditures.但是，事實上，醫(yī)護(hù)人員卻掌控者70%的醫(yī)療支出。Afewpatientswithhypochondriasis,forexample,mayvisitphysicianstoooften,例如，少數(shù)患有疑病癥的病患會經(jīng)常就醫(yī)。andmanyolderpatientsmayseekmedicalhelpattimeswhenafriendly,reassuringchatis theirrealdesire,許多老年患者有時也會尋求醫(yī)療幫助，他們希望能夠得到友好，舒心的交談，butinthefinalanalysisutilizationofthehealthcaresystemisinthehandsofphysicians.歸根結(jié)底，醫(yī)護(hù)系統(tǒng)的利用問題掌控在醫(yī)護(hù)人員手中。Ironically,althoughphysiciancompetenceisoftenequatedtomasteryofexpensive techniquesandtechnologies,具有諷刺意味的是，雖然醫(yī)術(shù)常常等同于掌握價格高昂的儀器設(shè)備和科技手段，physiciansareactuallyattheirprofessionalbestwhenlisteningtothepatientandresponding towhattheyhearandseewithmedicinemostcomprehensivearmamentarium.但醫(yī)生達(dá)到爐火純青境地，往往是在能夠傾聽患者心聲并應(yīng)用最先進(jìn)的醫(yī)療設(shè)備對他們聽到、看到的患者狀況采取相應(yīng)措施的時候。Overutilization,whenitoccurs,isthusmostlikelytobeourfaultasphysicians.當(dāng)出現(xiàn)過度使用問題時，醫(yī)護(hù)人員是最有可能出錯的。Ourresponsibilityasprofessionalsistobeabsolutelycertainthatourerrorsinthisdirection aredrivenbywell-foundedconcernforthehealthofourpatients,作為專業(yè)人士，我們的責(zé)任就是要堅決確保這些錯誤是建立在對病患健康的關(guān)心之上，notbythefinancialinterestsofourpracticesorthehospitalswherewework.而不是建立在經(jīng)濟(jì)效益或是醫(yī)院之上。Individualphysicians,then,musttakeapersonalandprofessionalinterestinthecontrolof healthcarecostsnotonlybecauseitisrightforthenation,butbecauseitisrightforthe patient.對于個體醫(yī)護(hù)人員來說，他們必須從專業(yè)角度和個人角度來對醫(yī)療費(fèi)用產(chǎn)生興趣，這不僅對國家有益，還將有益于病患。Inourlitigioussociety,alegalisticallydefensiveapproachtomedicalpracticehasbecometoo prevalent.在我們這個喜歡訴訟的社會里，有關(guān)醫(yī)療的法律保護(hù)方法就變得非常普遍了。Theconditionsthatengenderthistendencymustbealtered.我們必須對這一趨勢進(jìn)行糾正。Physiciansmustusealloftheirdiagnosticskillstofocusontheverybestapproachtomedical diagnosisandtherapy醫(yī)護(hù)人員必須使用其所有的診斷技能來關(guān)注醫(yī)療診斷和理療方法，andtosteerawayfromunnecessaryuseorrepetitionofexpensiveproceduressuchas computedtomography,magneticresonanceimaging,andcardiaccatheterization.并避免不必要的使用，或是重復(fù)價格昂貴的診治，例如計算機(jī)體層攝影、核磁共振成像或是心導(dǎo)管插入術(shù)。Thephysicianmustuseintellectscientificknowledgeandanalyticalskills tobestservethe patientwithoutinundatingthesystemwithunnecessarycosts醫(yī)生必須運(yùn)用智慧（包括科學(xué)知識和分析能力）來為病人提供最佳服務(wù)，既不要給醫(yī)療保健體系增加不必要的費(fèi)用，andthepatientwithafinancialburdenhesimplycannotcontinuetobear.也不要給病人造成不必要的、無法繼續(xù)承受的經(jīng)濟(jì)負(fù)擔(dān)。1.take（an）interest in 對發(fā)生興趣例句：Wetake interest inyour canned goods and wish to have the catalogues.我們對你方的罐頭食品有興趣，希望能收到目錄。2.on the final analysis 歸根結(jié)底例句：Nowadays, the competition of technology and strength is the competition of humans and human capitalon the final analysis.當(dāng)今世界科技和實力的競爭，歸根到底是人的競爭，是人力資本的競爭。3.steer away from 避開例句：We wanted to make a clean break from actresses andsteer away fromblondes and cleanse the palette.我們不想再用女演員代言，也不想要金發(fā)女郎，我們重新做出選擇。4. financial burden 財政負(fù)擔(dān)例句：Bearing thefinancial burdenof commercial and investment arbitrations is difficult for any country, but most especially so for a small country like Uruguay.承擔(dān)商業(yè)和投資仲裁決定的財政負(fù)擔(dān)對任何國家都很艱難，對于烏拉圭這樣的小國來說更是如此。第5期:Costs can be controlled only if physicians are convinced of the need and are willing to participate in providing this vital service.只有醫(yī)護(hù)人員能夠真正明白這些需求，并愿意參與到提供重大服務(wù)上來，價格才能夠得到控制。One aspect of this control is attention to various possible means of health care finance,控制價格的其中一個方面就是要重視各種衛(wèi)生保健,including prepaid plans, preferred provider organizations health maintenance organizations, and other managed care systems.包括重點(diǎn)服務(wù)計劃、優(yōu)先醫(yī)療服務(wù)提供者組織、健康維護(hù)組織以及其他管理式醫(yī)療系統(tǒng)。All of these must be carefully explored with a view to making health care accessible where it is most needed.為了讓最需要醫(yī)療保障的民眾接受到該服務(wù)，我們必須對這些系統(tǒng)進(jìn)行細(xì)致地探究。Clearly, multiple tools and programs may be necessary, but they should not be thrust upon the patient simply to satisfy doctrines of free enterprise.顯然，這些措施和項目或許是不可或缺的，但是不能夠僅僅是為了滿足自由主義的信條而將其強(qiáng)加于病患身上。To provide the best health care in a finite economy we need systems that provide such care in the most efficient way, regardless of the payment scheme.為了在有限的經(jīng)濟(jì)體中提供最好的醫(yī)療保障，不論支付計劃如何，我們需要利用最有效的措施來提供醫(yī)療服務(wù)Another aspect of our cost-control job is to support and participate in research on outcomes,在這項成本控制工作中，另一個方面就是要參與到對支出的研究上來，aiming toward systematic evaluation of cost-effectiveness of the medical procedures we choose in the light of all the interests of our patient.考慮到病患的利益，我們的目的就是要對醫(yī)療程序的成本效益進(jìn)行系統(tǒng)的評估。For example, we do not know why treatment of prostatic hypertrophy is more commonly medical in some parts of the nation, surgical in others.例如，我們不知道為什么有些地區(qū)對會利用內(nèi)科的方式來治療前列腺增生，有的地方會利用手術(shù)的治療方式。Why does the incidence of caesarean sections vary so widely?為什么實施剖腹產(chǎn)的范圍會如此之廣？The costs and benefits of coronary angioplasty versus bypass surgery remain obscure.冠狀動脈成形術(shù)和心臟搭橋手術(shù)的成本和效益仍然不明確。Every year billions of dollars are spent as a result of clinical decisions that may hinge on these or similar issues.每年，政府都會在相似的臨床問題上花費(fèi)數(shù)十億美金。Physicians must involve themselves in the processes of change with an eye first to the individual patient and then to society.內(nèi)科醫(yī)生必須親身參與到變革的過程中來，這么做首先是為了病患，其次這也有利于社會。1.withaviewto為了要例句：Timeaftertime,hereadsuchsentencesas: “Pleasecauseaninvestigationbemadewith aviewtoascertainingthetruth.馬弗里克一次又一次看到這樣的句子：“敬請以查明事實真相為宗旨，展開一番調(diào)查。”2.bethruston把強(qiáng)加于例句：SpecificchallengeswillbethrustonMrsClintonfromDay1.希拉里從第一天開始就會面臨具體的挑戰(zhàn)。3.inthelightof根據(jù)例句：Theywilladjusttheirbequestsinthelightofyours.他們將根據(jù)你的贈予調(diào)整自己的遺產(chǎn)分配。4.hingeon靠.轉(zhuǎn)動例句：Somewhatsurprisingly,theanswerturnsouttohingeonwhatyoumeanbybestand whatyoumeanbylong-run.有些令人驚訝的是，答案取決于在你看來最好的和長期的是一個什么概念。第