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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.’
游客
2023-07-29
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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] What is the root of the misdiagnosis crisis?
选项
A、Lack of medical investment.
B、Lack of good medical professionals.
C、Lack of public attention.
D、Lack of reasonable medical system.
答案
D
解析
文章第六、第七、第八自然段讨论的都是现行医疗制度的不合理,即误诊问题产生的制度根源。故选D。
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