学术英语(医学)Unit.ppt

1、学术英语 医学,Health Care System,Unit 10,Health Care System The United States is one of the wealthiest countries in the world and its medical expenditure is also among the highest, but still many American citizens are inadequately insured or not insured at all. What is the root of this problem? This unit

2、looks into the problems with the American medical system and suggests ways and strategies to change the situation.,Unit Contents,Lead-in,Text A,Text B,Text C,Listening,Speaking,Writing,Unit 10 Health Care System,Lead-in,Issues to be covered Suggested answers,Unit 10 Health Care System,Lead-in,Issues

3、 to be covered,the status quo of American healthcare system 2. the problems existing in the American healthcare system and strategies to be taken to address those problems 3. the consequences incurred by long waits in emergency department 4. the four basic models of health care system 5. embolic str

4、oke in terms of its signs and symptoms, causes, treatment and prevention,Unit 10 Health Care System,Lead-in,Suggested answers,Task : Listen to a talk about American health care system and answer the following questions.,What is the annual expenditure of the US on health care? 2. What are the researc

5、hers findings about the health care performance of the US? 3. What is the major cause of the problem discussed in the talk?,Unit 10 Health Care System,the rising number of uninsured citizens in America,The US has poorer performance in preventable deaths than other industrialized nations.,$ 2.1 trill

6、ion,Text A,Critical reading and thinking Topics for presentation Useful expressions Difficult sentences Language building-up Medical terminology Signpost language Formal English Vocabulary test Suggested answers,Unit 10 Health Care System,Text A Critical reading and thinking,Topics for presentation,

7、1 Give a brief explanation of Medicare and Medicaid.,Medicare for people age 65 or older people under age 65 with certain disabilities people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) Medicaid available only to certain low-income in

8、dividuals and families who fit into an eligibility group that is recognized by federal and state law,Unit 10 Health Care System,2 Compare the American model and the European model.,Topics for presentation,Text A Critical reading and thinking,Unit 10 Health Care System,Text A,Topics for presentation,

9、3 What are the problems with the fragmented American health care system?,Critical reading and thinking,Complicated rules: it needs a genius to know the rules for treating or taking care of each patient without getting questioned by the insurance companies or others Involvement of private and public

10、bureaucracies in deciding which patient can get what treatment Unhappiness of Americans about health care system Need to cover all Need to get more value for the money spent currently on health care,Unit 10 Health Care System,Text A,Topics for presentation,3 What are the problems with the fragmented

11、 American health care system?,Critical reading and thinking,Money is also part of the problem. The governments inability to subsidize the covered Americans unwillingness to pay more taxes and pour more money into the broken healthcare system,Unit 10 Health Care System,Text A,Useful expressions,The A

12、merican medical system is highly fragmented. Americans are more comfortable with fragmentation than other nationalities. Even Americans who are covered think the U.S. medical system is broken. The majority of them want to tear it up and start over. As a nation, we are suspicious about a “single” any

13、thing like a single-payer system for health insurance.,Critical reading and thinking,Unit 10 Health Care System,Text A,Topics for presentation,4 Why is “rationalizing the medical system” the key to the present problem?,Critical reading and thinking,Benefits to gain by rationalizing the system Saving

14、 money Delivering better care to more people Blanket allocation of care being never a good idea,Unit 10 Health Care System,Text A,Useful expressions,Americans are not very excited about paying more taxes and pouring more money into a healthcare system they rightly feel is broken in the first place.

15、The answer hinges on what we economists call rationalizing the healthcare system.,Critical reading and thinking,Unit 10 Health Care System,Text A,Topics for presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,1 Wire up the medical system by adopting IT. 2 Undertake a

16、sustained study of comparative effectiveness by tracking effectiveness of care over time. 3 Do a better job of managing chronic diseases, especially the prevention of them. 4 Change the incentives in medicine by paying doctors for what they do well and make insurance companies focus more on taking c

17、are of the sick.,Unit 10 Health Care System,Text A,Topics for presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,Knowledge of subject matter Doctors will be much more efficient when they have computerized their patients medical records and can get away from writing e

18、verything on small scraps of paper that have to be physically transferred from place to place. Are you for or against electronic health record (EHR)? Why?,Unit 10 Health Care System,Text A,Topics for presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,Knowledge of sub

19、ject matter,Unit 10 Health Care System,Text A,Useful expressions,to undertake a sustained study of comparative effectiveness Are newer procedures really worth much relative to older procedures? If we can track effectiveness of care over time, we can get a handle on the new drugs, the spiffy diagnost

20、ics, new medical devices, and treatment protocols to determine which really deliver better results.,Critical reading and thinking,Unit 10 Health Care System,6 Do you support “the other voices”? Why?,Text A,Topics for presentation,Critical reading and thinking,The “Other Voices” More should be done t

21、o limit demand for healthcare. Americans are wasteful of their healthcare. Cover the things that are medically necessary,Unit 10 Health Care System,（The answer may vary. ）,6 Do you support “the other voices”? Why?,Text A,Topics for presentation,Critical reading and thinking,Knowledge of Subject Matt

22、er,Unit 10 Health Care System,because most of us receive them (health care dollars) as a benefit, not as a bill. If healthcare were like other markets, healthcare would work better. People need help managing their chronic illness; leaving them adrift is not the way to go.,6 Do you support “the other

23、 voices”? Why?,Text A,Topics for presentation,Critical reading and thinking,Knowledge of Subject Matter,Unit 10 Health Care System,the medically necessary list is long, and the optional list is far too small. In healthcare, it is very difficult to draw bright lines between what is medically valuable

24、 and what is not. Some things are valuable for some patients and not for others. Allocating medical care is very difficult proposition, no matter where and how it is proposed.,Text A,Useful expressions,people take charge of what they get and what they buy This idea does not work for me. I am not a b

25、ig fan of putting consumers in charge of paying money for their healthcare ,Critical reading and thinking,Unit 10 Health Care System,Text A,Difficult sentences,We know, for example, that people are very bad at undertaking actions with costs in the short term and benefits only down the road (witness

26、saving for retirement). 例如，我们知道人们很不愿意做眼下要付出代价、而长期会获益的行为（例如为退休存钱。,Critical reading and thinking,Unit 10 Health Care System,Have a whole picture!,Text A,Text Analysis,Critical reading and thinking,Qualities of a true physician much of the knowledge many of the skills caring inquisitiveness civic-minde

27、dness,Unit 10 Health Care System,A Brief Glance at the Medical System of America,Text A,Text Analysis,Critical reading and thinking,Almost US$2 trillion per year on healthcare, nearly one in every seven dollars in the economy Not automatic medical coverage for all citizens Health insurance as a perk

28、 most often tied to their job, or as a result of a government programs such as Medicare and Medicaid,Unit 10 Health Care System,To Sum Up :,Text A,Text Analysis,Critical reading and thinking,getting the money and knowledge right get the healthcare system flowing in the right direction deliver a heal

29、thier America and gradually reduce the average cost of family health insurance making it easier to cover everyone in the country making the U.S. system the best and most sensible healthcare system in the world.,Unit 10 Health Care System,Text A,Suggested answers,Task 1 Overview: Summarize the main i

30、deas in Text A by completing the following diagrams.,Critical reading and thinking,Unit 10 Health Care System,Text A,Suggested answers,Unit 10 Health Care System,uninsured,fragmented,rationalized,Wire up,comparative effectiveness,chronic diseases,prevention,incentives,cost,Text A,Task 1/ Medical ter

31、minology Match each definition with its corresponding English term and Chinese equivalent.,coverage,承保范围，承保险别,（美国）医疗补助制度,Medicaid,二重的，双重的,duplicative,effectiveness,有效,Suggested answers,Language building-up,2,Unit 10 Health Care System,Text A,prevention,预防,hospitalization,住院,diagnostics,诊断学,treatment

32、 protocol,治疗方案,Task1 / Medical terminology Match each definition with its corresponding English term and Chinese equivalent.,Suggested answers,2,Language building-up,chronic,慢性的,Unit 10 Health Care System,Text A Language Building-up,Signpost Language,Listing,Unit 10 Health Care System,Text A,Task 2

33、/ Signpost language,In Text A, the author puts forward a list of solutions to the problems of the American health care system. Pay attention to how he signifies the order of the list and complete the following sentences. Compare your answers with the original sentences in the text.,_ thing we can do

34、 is wire up the medical system. (Para.4) A _ important strategy is to undertake a sustained study of comparative effectiveness. (Para.5) A _ strategy is to do a better job of managing chronic diseases, spending more time and energy on prevention. (Para.6) 4 That leads to the _ set of reforms to chan

35、ge the incentives in medicine. (Para. 7 ),Language building-up,Suggested answers,second,One,Unit 10 Health Care System,third,fourth,Text A,Task 3 / Formal English,Replace the underlined words and expressions in the following sentences with more formal ones.,_1 It is ironic that the United States, a

36、nation that spends the most money per person on health care, (Para.1) _2 The difference in our health care outcomes is a product of both public health and social issues. (Para.1) _3 , we will know what really needs to be done for individual patients, and patients will be involved with their care. (P

37、ara.4) _4 A second important strategy is to begin a sustained study of comparative effectiveness. (Para.5),Language building-up,Suggested answers,Unit 10 Health Care System,per capita,variance,engaged,undertake,Text A,Task 3 / Formal English,Replace the underlined words and expressions in the follow

38、ing sentences with more formal ones.,_5 If we can track effectiveness of care over time, we can understand the new drugs, the spiffy diagnostics, new medical devices, and treatment protocols to determine which really deliver better results. (Para.5) _ 6 We can give insurance companies incentives to

39、focus more on taking care of the sick than on coming up with reasons to insure only the healthy. (Para.7) _ 7 The common feature in these strategies for changing the American medical system is getting the money and knowledge right. (Para.11),Language building-up,Suggested answers,Unit 10 Health Care

40、 System,get a handle on,rationales,commonality,Group presentation,Text A,Additional activity,The embolic stroke accounts for about 15-20% of all strokes in the U.S. Work in a small group and explore the media and literature for information about the embolic stroke in the following aspects: 1. defini

41、tion 2. signs and symptoms 3. causes 4. treatment 5. prevention,Unit 10 Health Care System,medical _ (医疗保险支付范围) medical and _ (医疗保险和医疗救助) a(n) _ system (单一支付者系统) to _ the uncovered (补助无保险的人) to _care (提供医疗) _ tests (重复的检查) a(n)_study (长期的研究) vision _ (视力缺陷),Text A Language Building-up,Vocabulary Tes

42、t,coverage,Medicaid,sustained,single-payer,deficits,subsidize,value,deliver,Unit 10 Health Care System,Text B,Critical reading and thinking Language building-up Suggested answers,Unit 10 Health Care System,Text B,Group discussion:,Additional activity,Think out the occasions where waiting matters and

43、 share your experience with the class if any. Queuing for food when starving a ticket home Waiting for your date to show up Others?,Unit 10 Health Care System,Text B,Critical Reading and Thinking,1 patients condition before hospitalization,In excellent health except for mild heart disease Irregular

44、heartbeat Slightly short of breath Pulse as high as 130 Stable blood pressure,Write down the information on the following topics. Then compare your answers with your partner.,Unit 10 Health Care System,Text B,Useful expressions,she decided to forgo a call to 911 the most highly regarded academic med

45、ical centers on the West Coast,Critical reading and thinking,Unit 10 Health Care System,Text B,Critical Reading and Thinking,2. the initial diagnosis and ensuing treatment,Initially diagnosed with rapid atrial fibrillation Intravenous heparin for anticoagulation Electrical cardioversion the followin

46、g day if a transesophageal echocardiogram(TEE) confirmed the absence of an atrial thrombus,Write down the information on the following topics. Then compare your answers with your partner.,Unit 10 Health Care System,Text B,Useful expressions,she was diagnosed with rapid atrial fibrillation Given her

47、age, the emergency department (ED) staff and the consulting cardiologist decided to admit her to the hospital. no inpatient bed was available shortly before noon the cardiologist stopped by to let her know that would undergo TEE and cardioversion the following Monday.,Critical reading and thinking,U

48、nit 10 Health Care System,Text B,Critical Reading and Thinking,3. critical condition of the patient,A massive embolic stroke Occlusion of the right common carotid artery and the intracranial branches Signs of middle cerebral artery syndrome Internal carotid artery being tore during operation Rapid i

49、ntracranial bleeding and brain-stem herniation Intubated in the ICU without evidence of neurologic recovery,Write down the information on the following topics. Then compare your answers with your partner.,Unit 10 Health Care System,Text B,Useful expressions,Within moments, signs of middle cerebral a

50、rtery syndrome developed. For the next 2 days, the patient lay intubated in the ICU without evidence of neurologic recovery. life support was withdrawn prevented the development of the thrombus that subsequently broke loose Had cardioversion been performed shortly after the patient entered the ED, s

51、he might be alive and healthy today. If cardioversion had been performed an academic surgeon because I practice in a different city, His words stung, but they were true.,Critical reading and thinking,Unit 10 Health Care System,Text B,Critical Reading and Thinking,4 causes of ED crowding in hospitals

52、,The number of patients The number of the doctors Severity of the conditions Inefficiency of hospital operation,Write down the information on the following topics. Then compare your answers with your partner.,Unit 10 Health Care System,Text B,Useful expressions,The factors that contribute to ED crow

53、ding and its consequences have been amply documented in reports by the Institute of Medicine, become so commonplace that it is accepted as the norm . (习以为常),Critical reading and thinking,Unit 10 Health Care System,Text B,Useful expressions,The factors that contribute to ED crowding and its consequen

54、ces have been amply documented in reports by the Institute of Medicine, become so commonplace that it is accepted as the norm . (习以为常),Critical reading and thinking,Unit 10 Health Care System,Text B,Critical Reading and Thinking,5. the urgent health care issues nowadays,Background: successful aging

55、of the population as a whole less urgent: to elucidate the molecular basis of high blood pressure critical points: more social, health care issues the shortage of primary care physicians the lack of accessible health care and providers in certain areas of the country; and the yawning disparity betwe

56、en racial and economic backgrounds of those who become doctors and those who are their patients,Write down the information on the following topics. Then compare your answers with your partner.,Unit 10 Health Care System,Text B,Critical Reading and Thinking,Defibrillation for out-of-hospital cardiac

57、arrest Surgical management of traumatic injuries Initiation of antibiotic treatment for meningitis and other deadly infections Percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation,Write down the information on the following topics. Then compare your answers wi

58、th your partner.,5. conditions requiring emergency treatments,Unit 10 Health Care System,Text B,Useful expressions,as 32 million more Americans seek access to an emergency care system that is already overwhelmed,Critical reading and thinking,Unit 10 Health Care System,Text B,Critical Reading and Thinking,6. solution to the problem in discussion,Write down the information on the following topics. Then compare your answers with your partner.,Discharging patients recovering from elective surgery Priorit