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Saying they can no longer ignore the rising prices of health care, some of the most influential medical 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 decisions based on cost is a form of rationing.Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones are expected 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 insurance companies to help determine reimbursement(报销)policies.Some doctors see a potential conflict in trying to be both providers of patient care and financial 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 dollars and the other close to 2, 000 dollars. 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."(1)What do some most influential medical groups recommend doctors do? 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.(2)What were doctors mainly concerned about in the past? A.Specific medicines to be used.B.Effects of medical treatment.C.Professional advancement.D.Patients' trust.(3)What may the new guidelines being developed lead to? A.The redefining of doctors' roles.B.Overuse of less effective medicines.C.onflicts between doctors and patients.D.The prolonging of patients' suffering.(4)What risk do doctors see in their dual role as patient care providers and financial overseers? A.They may be involved in a conflict of interest.B.They may be forced to divide their attention.C.They may have to use less effective drugs.D.They may lose the respect of patients.(5)What do some experts say about doctors' involvement in medical cost analysis? A.It may add to doctors' already heavy workloads.B.It will help to save money for society as a whole.C.It results from society's failure to tackle the problem.D.It raises doctors' awareness of their social responsibilities..

Saying they can no longer ignore the rising prices of health care, some of the most influential medical 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 decisions based on cost is a form of rationing.

Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones are expected 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 insurance companies to help determine reimbursement(报销)policies.

Some doctors see a potential conflict in trying to be both providers of patient care and financial 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 dollars and the other close to 2, 000 dollars. 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."

(1)

What do some most influential medical groups recommend doctors do?

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.(2)

What were doctors mainly concerned about in the past?

A.Specific medicines to be used.B.Effects of medical treatment.C.Professional advancement.D.Patients' trust.(3)

What may the new guidelines being developed lead to?

A.The redefining of doctors' roles.B.Overuse of less effective medicines.C.onflicts between doctors and patients.D.The prolonging of patients' suffering.(4)

What risk do doctors see in their dual role as patient care providers and financial overseers?

A.They may be involved in a conflict of interest.B.They may be forced to divide their attention.C.They may have to use less effective drugs.D.They may lose the respect of patients.(5)

What do some experts say about doctors' involvement in medical cost analysis?

A.It may add to doctors' already heavy workloads.B.It will help to save money for society as a whole.C.It results from society's failure to tackle the problem.D.It raises doctors' awareness of their social responsibilities.

.

题目解答

答案

  • (1)
    C
  • (2)
    B
  • (3)
    A
  • (4)
    D
  • (5)
    C

.

解析

考查要点:本题主要考查学生对文章主旨、细节理解及推理判断的能力。需要结合上下文,准确提取关键信息,并理解作者观点。

解题核心思路:

  1. 定位关键句:每道题均需快速定位原文对应段落,抓住核心观点。
  2. 区分干扰项:注意选项中可能存在的绝对化表述或过度推断。
  3. 逻辑关系:理解医生角色转变(从个体治疗到成本控制)引发的争议,是解题的关键线索。

破题关键点:

  • 第(1)题:抓住“recommend”后的动词短语,明确医生被建议考虑成本。
  • 第(2)题:通过“exclusively about individual patients”反向推断过去关注点。
  • 第(5)题:注意“failure of wider society”与选项中“society's failure”的对应关系。

第(1)题

关键句:首段首句明确指出,权威医学团体建议医生在治疗决策中同时考虑成本和疗效。
干扰项排除:

  • A选项“反思责任”未提及;
  • B选项“更关注疗效”与原文“not just effectiveness”矛盾;
  • D选项“因医疗削减调整实践”未涉及预算削减。

第(2)题

关键句:第二段“concerned exclusively about individual patients”表明过去医生仅关注治疗效果。
干扰项排除:

  • A、C选项未提及;
  • D选项“患者信任”是结果而非关注点。

第(3)题

关键句:第二段“redefine their roles”直接对应选项A“重新定义医生角色”。
干扰项排除:

  • B、C、D选项均未在原文中体现。

第(4)题

关键句:Dr. Martin Samuels指出,若医生因预算限制治疗,可能失去患者信任。
干扰项排除:

  • A选项“利益冲突”未提及;
  • B、C选项与原文矛盾。

第(5)题

关键句:Dr. Daniel Sulmasy认为医生参与成本分析是“society's failure to take up the issue”的体现。
干扰项排除:

  • A、B、D选项均未被支持。

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