Question

    The clock always seems to be ticking rather too fast in the doctor's office and the queue of patients outside the door seems to be pressing rather too hard. Some say it's high time for the model of short, sharp one-to-one appointments to give way to shared medical appointments(SMAs).

SMAs are doctor-patient visits in which a group of patients receive patient education and counseling (咨询),physical examination and medical support in a group setting. Typically SMAs are designed to have one or more doctors attend to a group of patients who share a common illness or medical condition. In contrast to one-to-one visits, SMAs provide a longer appointment time-frame as well as the opportunity for patients to have improved access to their physicians and meanwhile pick up additional information and support from peers.

However, doctors who have pioneered the shared appointment approach report that there are significant challenges involved. Dr. Sumego , director of shared medical appointments, Cleveland Clinic,identifies culture change as the most significant challenge. Physicians and nurses are trained in a model of personal service and privacy; the SMA approach is a fundamental challenge to those fixed ideas. They need shared goals and a way of testing the innovation against agreed standards. Dr. Sumego says,“The physicians may be worried about the possible chaos and efficiencies that are marketed. They also have to make the patients understand what their appointment is, and what the expectation is.”

“So, if an organization was looking to start shared medical appointments, I would advise them to start the buy-in from a few champion physicians, develop the work-flow and develop some experience. Provide some support behind what that best practice should look like. Create some standards so that, as the concept spreads, you can employ that experience to start the next shared medical appointments and the next.”

1.What is the purpose of the SMA approach?

A. To improve medical service. B. To promote doctors' reputation.

C. To conduct medical research. D. To meet patients' expectation.

2.According to Dr.Sumego, what prevents the SMA approach from being widely adopted?

A. Personal service. B. Fixed ideas.

C. Lack of equipment. D. Shared goals.

3.What can the underlined“buy-in”in Paragraph 4 be replaced by?

A. Support. B. Organization.

C. Purchase. D. Practice.

4.What can be learned about the SMA approach in the last paragraph?

A. It is currently being questioned.

B. It is impractical in some areas.

C. It will enjoy wide popularity soon.

D. It should be carried out step by step.

Answer

1.A

2.B

3.D

4.D

【解析】

这是一篇说明文。一些人认为到了该要应用SMA的时候了。SMA的设计目的是让一名或多名医生照顾一群有共同疾病或疾病的病人。文章介绍了SMA的理念，推广过程中遇到的挑战以及解决办法。

1.推理判断题。根据第二段中的“Typically SMAs are designed to have one or more doctors attend to a group of patients who share a common illness or medical condition. In contrast to one-to-one visits, SMAs provide a longer appointment time-frame as well as the opportunity for patients to have improved access to their physicians and meanwhile pick up additional information and support from peers.”可知，SMA的设计目的是让一名或多名医生照顾一群有共同疾病或疾病的病人。相对于一对一的就诊，SMAS提供了更长的预约时间框架，也为患者提供了更好的就医机会，同时也从同龄人那里获得了更多的信息和支持。由此推知，SMA的目的是提高医疗服务。故A选项正确。

2.细节理解题。根据第三段中的“the SMA approach is a fundamental challenge to those fixed ideas”可知，SMA是对这些固定观念的根本挑战。由此可以推知，SMA既然挑战了固定观念，那么这些固定的观念肯定会阻止SMA广泛推广。故B选项正确。

3.词义猜测题。上一段介绍了SMAs推广过程中可能遇到的问题。针对这些问题，Dr. Sumego建议从一些顶尖医师那里开始实践SMA，开发工作流程，积累经验。要给这种实践提供支持。逐步展开SMA这种理念。根据这个上下文可知，该划线部分应该指针对SMAs的实践。故D选项切题。

4.推理判断题。根据最后一段中的“So, if an organization was looking to start shared medical appointments, I would advise them to start the buy-in from a few champion physicians, develop the work-flow and develop some experience. Provide some support behind what that best practice should look like. Create some standards so that, as the concept spreads, you can employ that experience to start the next shared medical appointments and the next.””可知，如果一个组织希望开始SMA，Dr. Sumego建议他们开始从几个顶尖医生那里开始实践，开发工作流程，并积累一些经验。在最佳实践的背后提供一些支持。创建一些标准，以便随着SMA理念的扩展，您可以利用这种经验开始下一个共享医疗，然后再开展下一个……。由此可以推知，SMA应该被逐步实施。