Passage Two Questions 51 to 55 are based on the following passage. Online programs to fight depression are already commercially available. While they sound efficient and cost-saving, a recent study reports that they are not effective, primarily because depressed patients are not likely to engage with them or stick with them. The study looked at computer-assisted cognitive(认知的) behavioral therapy(CBT) and found that it was no more effective in treating depression than the usual care patients receive from a primary care doctor. Traditional CBT is considered an effective form of talk therapy for depression, helping people challenge negative thoughts and change the way they think in order to change their mood and behaviors. However, online CBT programs have been gaining popularity, with the attraction of providing low-cost help wherever someone has access to a computer. A team of researchers from the University of Y ork conducted a randomized(随机的) control trial with 691 depressed patients from 83 physician practices across England. The patients were split into three groups: one group received only usual care from a physician while the other two groups received usual care from a physician plus one of two computerized CBT programs. Participants were balanced across the three groups for age, sex, educational background, severity and duration of depression, and use of antidepressants(抗抑郁药). After four months, the patients using the computerized CBT programs had no improvement in depression levels over the patients who were only getting usual care from their doctors. “It’s an important, cautionary note that we shouldn’t get too carried away with the idea that a computer system can replace doctors and therapists, ” says Christopher Dowrick, a professor of primary medical care at the University of Liverpool. “We do still need the human touch or the human interaction, particularly when people are depressed.” Being depressed can mean feeling “lost in your own small, negative, dark world,” Dowrick says. Having a person, instead of a computer, reach out to you is particularly important in combating that sense of isolation. “When you’re emotionally vulnerable, you’re even more in need of a caring human being ,” he says. 51.What does the recent study say about online CBT programs? A)Patients may not be able to carry them through for effective cure. B)Patients cannot engage with them without the use of a computer. C)They can save patients trouble visiting physicians. D)They have been well received by a lot of patients. 52.What has made online CBT programs increasingly popular? A)Their effectiveness in combating depression. B)The low efficiency of traditional talk therapy. C)Their easy and inexpensive access by patients. D)The recommendation by primary care doctors. What is the major finding by researchers at the University of York? Online CBT programs are no more effective than regular care from physicians. The process of treating depression is often more complicated than anticipated. The combination of traditional CBT and computerized CBT is most effective. Depression is a mental condition which is to be treated with extreme caution. What is Professor Dowrick’s advice concerning online CBT programs? They should not be neglected in primary care. Their effectiveness should not be overestimated. They should be used by strictly following instructions. Their use should be encouraged by doctors and therapists. What is more important to an emotionally vulnerable person? A positive state of mind. Appropriate medication. Timely encouragement. Human interaction.
举一反三
- Crippling 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. Combine this fact with annual government threats to indiscriminately 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 in 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 (最佳地) managing their diseases and practicing evidence-based medicine. Make primary care more attractive to medical students by forgiving student 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 What suggestion does the author give in order to provide better health care（） A: Bridge the salary gap between specialists 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.
- Questions 57 to 61 are based on the following passage.Crippling 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. TheU.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. Combine this fact with annual government threats to indiscriminately 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 graduatedU.S.medical students who choose primary care as a career have declined by 50%. This trend results in 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 (最佳地) managing their diseases and practicing evidence-based medicine. Make primary care more attractive to medical students by forgiving student 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?______ 57. The author’s chief concern about the currentU.S.health care system is __________.A) the inadequate training of physiciansB) the declining number of doctorsC) the shrinking primary care resourcesD) the ever-rising health care costs______ 58. We learn from the passage that people tend to believe that __________.A) the more costly the medicine, the more effective the cureB) seeing more doctors may result in more diagnostic errorsC) visiting doctors on a regular basis ensures good healthD) the more doctors taking care of a patient, the better______ 59. Faced with the government threats to cut reimbursements indiscriminately, primary care physicians have to __________ .A) increase their income by working overtimeB) improve their expertise and serviceC) make various deals with specialistsD) see more patients at the expense of quality______ 60. Why do many new medical graduates refuse to choose primary care as their career?A) They find the need for primary care declining.B) The current system works against primary care.C) Primary care physicians command less respect.D) They think working in emergency rooms tedious.______ 61. What suggestion does the author give in order to provide better health care?A) Bridge the salary gap between specialists 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.
- Apart from philosophical and legal reasons for respecting patients’ wishes, there are several practical reasons why doctors should ___________ to involve patients in their own medical care decisions.
- What can we learn from the passage? A: A lot of people in the West do not visit doctors when they have a cold. B: Americans think vitamins can cure a lot of illnesses. C: Chinese patients trust doctors more than the Americans. D: Asian patients try to keep their discomfort to themselves unless they are very sick.
- To which of the following is the author likely to agree? A: Patients should control the hours of their doctors. B: Pilots and truck drivers work in safer environments than that of doctors. C: Patients are facing more risks if their doctors are not adequately-rested. D: People concerned have the right to remove their doctors from their positions.