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With all the tools available to modern medicine--the blood tests and M.R.I.’
With all the tools available to modern medicine--the blood tests and M.R.I.’
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2024-03-01
19
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问题
With all the tools available to modern medicine--the blood tests and M.R.I.’s and endoscopes (内诊镜)--you might think that misdiagnosis (误诊) has become a rare thing. But you would be wrong. Studies of autopsies (尸体解剖) have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.
As shocking as that is, the more astonishing fact may be that the rate has not really changed since the 1930’s. "No improvement!" was how an article in the normally exclamation-free Journal of the American Medical Association summarized the situation. This is the richest country in the world--one where one-seventh of the economy is devoted to health care--and yet misdiagnosis is killing thousands of Americans every year.
How can this be happening? And how is it not a source of national outrage?
A big part of the answer is that all of the other medical progress we have made has distracted us from the misdiagnosis crisis.
Any number of diseases that were death sentences just 50 years ago---like childhood leukemia (白血病)--are often manageable today. But we still could be doing a lot better. Under the current medical system, doctors, nurses, lab technicians and hospital executives are not actually paid to come up with the right diagnosis. They are paid to perform tests and to do surgery and to give out drugs.
There is no bonus for curing someone and no penalty for failing, except when the mistakes rise to the level of malpractice. So even though doctors can have the best intentions, they have little economic incentive to spend time double-checking their instincts, and hospitals have little incentive to give them the tools to do so.
"You get what you pay for," Mark B. McClellan, who runs Medicare and Medicaid, told me. "And we ought to be paying for better quality."
There are some bits of good news here. Dr. McClellan has set up small pay-for-performance programs in Medicare, and a few insurers are also experimenting. But it isn’t nearly a big enough push. We just are not using the power of incentives to save lives. For a politician looking to make the often-bloodless debate over health care come alive, this is a huge opportunity. [br] According to the passage, misdiagnosis ______.
选项
A、has become a rare thing
B、takes up 20 percent of the diagnosis of deadly diseases
C、has aroused much attention
D、started since the 1930’s
答案
B
解析
细节题。第一段提到“you might think that misdiagnosis has.become a rare thing”,但最后指出“But you would be wrong”。故选项A不正确。第一段中指出:Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time,该句与选项B意思一致,故选项B正确。选项C说误诊问题引起了关注,与第四段和第五段内容不符:民众未对此感到愤慨,因为学的其他进步转移了人们的注意力,即人们未注意到此问题,故选项C不正确。第二段指出误诊问题令人更为震惊的是该问题从二十世纪三十年代起并没有改观,并非这一问题自二十世纪三十年代开始,故选项D不正确。
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