本文節(jié)選自《經(jīng)濟(jì)學(xué)人》2019.06.29期Britain版塊的一篇文章，講述了英國的醫(yī)療體系正面臨改變
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The?national health service?is free, so it is also?rationed. Family doctors,?known as?general practitioners?(GPS),?act as?the ?rst port of?call for patients; friendly gatekeepers to the rest of the service who?refer people to specialists?only if?needed. “You can’t?book an appointment?to see me here,” explains Stewart Smith, a 39-year-old GP, one of a team in charge of an innovative new medical centre. “You go on a list and then we?triage?you.”
national health service：國家醫(yī)療服務(wù)體系
ration：配給钮蛛、限量供應(yīng)。Something is rationed剖膳，指的是某物被限量供給魏颓，這里指的是國外的醫(yī)療服務(wù)雖然是免費(fèi)的，但是確實(shí)有一定量限制的吱晒，及醫(yī)療資源不足【詞匯積累】
known as：以……而聞名甸饱，這里的意思是為人所知
general practitioner：全科醫(yī)生a doctor who is trained in general medicine. general medicine是全科醫(yī)學(xué)，special medicine則是專科醫(yī)學(xué)叹话。全科醫(yī)生指的是who treats patients in a local community rather than at a hospital（在社區(qū)而不是在醫(yī)院里和治療病人）【詞匯積累】
act as：充當(dāng)偷遗，擔(dān)當(dāng)【詞組積累】
the ?rst port of call for patients：port意為避風(fēng)港，這里指的是病人尋求幫助時(shí)的首個(gè)避風(fēng)港【詞匯積累】
refer people to specialists：refer A to B指的是讓A到B尋求幫助驼壶，這里指的是讓病人到專家處求助【詞組積累】
only if：表示只有當(dāng)鹦肿，而if only表示只要【詞組積累】
book an appointment：book在這里是預(yù)定，預(yù)約的意思
triage：分診辅柴，患者鑒別分類【詞匯積累】
國家醫(yī)療服務(wù)體系是免費(fèi)的箩溃，因此也是限量供給的。家庭醫(yī)生碌嘀，以全科醫(yī)生為人所知涣旨，擔(dān)當(dāng)病人求醫(yī)時(shí)的首個(gè)避風(fēng)港。至于剩下的醫(yī)療資源股冗，只有當(dāng)有需要的時(shí)候霹陡，“友好的看門人”才會(huì)讓病人去專家處求診≈棺矗“你不能預(yù)約和我見面烹棉，你要先在等待列表上，然后我們會(huì)對你進(jìn)行分診”怯疤。創(chuàng)新醫(yī)學(xué)中心的成員浆洗，一個(gè)39歲的全科醫(yī)生Stewart Smith解釋道。
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Simon Stevens, chief executive of?NHS?England, has said that being a GP is?arguably?the most important job in the country.?There is, however,?a severe shortage of them. According to theNu?eld Trust, a?think-tank, there are 58 GPS per 100,000 people, down from 66 in 2009— the ?rst?sustained fall?since the 1960s. Only half of patients say they almost always see theirpreferred?doctor,?down from?65% six years ago. The average?consultation?lasts just nine minutes,?among?the quickest in the rich world.
NHS：National Health Service (NHS)?英國公立醫(yī)療體系
arguably：按理來說【詞匯積累】
There is?a severe shortage of them：缺乏某事物集峦，可以用severe表示缺乏的程度【句式】
Nu?eld Trust：trust表示信托基金伏社。Nuffield Trist is a charitable trust with the mission of improving health care in the UK through evidence and analysis.
think-tank：智庫，智囊團(tuán)a group of experts who provide advice and ideas on political, social or economic issues
a sustained fall：一個(gè)持續(xù)的下降塔淤。sustained表示持續(xù)的摘昌，如a sustained fall in prices價(jià)格的持續(xù)下降【詞匯積累】
preferred：prefer表示更喜歡，這里加ed是形容詞性高蜂，但表示的意思為“首選的”聪黎，one’s preferred doctor即首選的醫(yī)生【詞匯積累】
數(shù)字……, down from?數(shù)字+時(shí)間：與某個(gè)時(shí)間段的某個(gè)數(shù)字相比，有所下降备恤「迨危【句式】
among sth：included in sth，文中among the quickest in the rich world表示英國全科醫(yī)生接診時(shí)間是發(fā)達(dá)國家中最快的國家之一
consultation：（向?qū)＜艺埥痰模┳稍儠?huì)烘跺；（尤指）就診a meeting with an expert, especially a doctor, to get advice or treatment湘纵，consultation雖然是咨詢，商討的意思滤淳，但這里表達(dá)的是其就診的意思【熟詞僻義】
英國公立醫(yī)療體系首席執(zhí)行官Simon Stevens說過全科醫(yī)生按理說來一個(gè)國家最重要的工作梧喷。然而全科醫(yī)生資源卻嚴(yán)重匱乏。根據(jù)Nuffield Trust，每100000人中僅分配有58個(gè)全科醫(yī)生铺敌，與2009年的66個(gè)相比有所下降汇歹，是自上世紀(jì)60年代以來的第一個(gè)持續(xù)下降。只有一半的病人說他們幾乎總是能看到自己喜歡的醫(yī)生偿凭，與6年前的65%相比也有所下降产弹。其平均接診時(shí)間僅持續(xù)9分鐘，是發(fā)達(dá)國家中最快的國家之一
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The GPS kept a diary, noting?precisely?what they got up to?during the day.?It turned out thatlots could be done by others: administrators could take care of some communication with hospitals,?physios?could see people with?bad backs?and?psychiatric?nurses those with anxiety. So now they do. Only patients with the most complicated or urgent problems?make it to?a doctor. As a result, each GP is responsible for 3,800 locals, compared with an average of 2,000 in the rest of Cornwall.
precisely：precise是精確的弯囊，準(zhǔn)確的痰哨，這里并不是你這個(gè)意思，precisely這里強(qiáng)調(diào)真是或明顯匾嘱，解釋為“正是斤斧，確實(shí)”。這里以nothing precisely?what they ……?來強(qiáng)調(diào)醫(yī)生們整天忙于的并不是治病霎烙。下文以it turned out that（事實(shí)證明撬讽，原來）?……與之承上啟下，引出很多事情可以由其他人做悬垃，而不是醫(yī)生【熟詞僻義】
what they got up to：get up to指的是忙于游昼，從事，如he is getting up to his tasks他忙于自己的任務(wù)尝蠕『嫱悖【詞組積累】
physio：physiotherapist理療師
bad backs：背痛
make it to：make it表示成功，做成趟佃，make it to a doctor表示條件足以達(dá)到看醫(yī)生扇谣∶两荩【詞組積累】
全科醫(yī)生有著寫日記的習(xí)慣闲昭，但卻不是記錄他們一天所從事的事情。事實(shí)證明很多事可以由其他人來完成：管理人員可以處理與醫(yī)院的交流任務(wù)靡挥，理療師可以處理背痛的病人序矩，精神師看護(hù)那些焦慮的病人。所以他們現(xiàn)在這么做了跋破，只有那些有最復(fù)雜的以及最緊急的問題的病人可以看到醫(yī)生簸淀。結(jié)果，每個(gè)全科醫(yī)生對3800名當(dāng)?shù)厝素?fù)責(zé)毒返，康沃爾剩余地區(qū)則平均為2000人租幕。
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The NHS estimates that 30% of GPS’ time is spent on?musculoskeletal problems, for instance, which could often?be handled by?a physiotherapist. Another estimate suggests 11% of their dayis taken up by?paperwork. Doctors complain that they are overworked, and growing numbers retire early. They are also expensive:?the starting salary?for a GP is ￡57,655, whereas a physio costs around half as much.
musculoskeletal problems：肌肉骨骼疾病
be handled by：由……處理【詞組積累】is taken up by：被……占據(jù)【詞組積累】
the starting salary：起薪【詞匯積累】
NHS估計(jì)全科醫(yī)生30%的時(shí)間用在了肌肉骨骼疾病上，這些通撑◆ぃ可以由理療師處理劲绪。另一個(gè)估算表明他們一天的11%的時(shí)間被書面工作占據(jù)。醫(yī)生埋怨他們勞累過度，提前退休的人數(shù)也在增長贾富。但他們也很貴歉眷，每個(gè)全科醫(yī)生起薪為57655英鎊（1英鎊=9.4844人民幣元），然而一個(gè)理療師大約只有一半颤枪。
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The shortage of GPS?leaves the NHS with?little choice but to try something new. “A lot of the world has?either?copied?or?is trying to copy English?primary care,” in particular its openness to all and?the continuity of?care?that it provides, says Dr Chana. Keeping these strengths, while changing how primary care works, is the task NHS o?cials are now?facing up to. Even if they succeed,?it will take time for?the public to adjust.
leaves the NHS with little choice but to do：使某人沒有選擇只能【詞組積累】
primary care：基礎(chǔ)醫(yī)療
either do or…...：要么……汗捡，要么……
the continuity of care：醫(yī)療服務(wù)的持續(xù)性【詞組積累】
face up to：面對的
it will take time for……：需要一段時(shí)間
全科醫(yī)生的短缺使NHS沒有選擇只能嘗試一些新的措施。Chana醫(yī)生說畏纲，世界上很多國家要么已經(jīng)復(fù)制了扇住，要么正試圖復(fù)制英國的基礎(chǔ)醫(yī)療，尤其是其開放度和服務(wù)的連續(xù)性盗胀。保持這些優(yōu)勢的時(shí)候台囱，要改變基礎(chǔ)醫(yī)療的運(yùn)行模式，是NHS人員現(xiàn)在正面臨的問題读整。即使成功了簿训，人們也要花費(fèi)一段時(shí)間來適應(yīng)。
總結(jié)
ration：配給米间、限量供應(yīng)强品。Something is rationed，指的是某物被限量供給屈糊，這里指的是國外的醫(yī)療服務(wù)雖然是免費(fèi)的的榛，但是確實(shí)有一定量限制的，及醫(yī)療資源不足【詞匯積累】
general practitioner：全科醫(yī)生a doctor who is trained in general medicine. general medicine是全科醫(yī)學(xué)逻锐，special medicine則是尫蛏危科醫(yī)學(xué)。全科醫(yī)生指的是who treats patients in a local community rather than at a hospital（在社區(qū)而不是在醫(yī)院里和治療病人）【詞匯積累】
the ?rst port of call for patients：port意為避風(fēng)港昧诱，這里指的是病人尋求幫助時(shí)的首個(gè)避風(fēng)港【詞匯積累】
triage：分診晓淀，患者鑒別分類【詞匯積累】
arguably：按理來說【詞匯積累】
a sustained fall：一個(gè)持續(xù)的下降。sustained表示持續(xù)的盏档，如a sustained fall in prices價(jià)格的持續(xù)下降【詞匯積累】
preferred：prefer表示更喜歡凶掰，這里加ed是形容詞性，但表示的意思為“首選的”蜈亩，one’s preferred doctor即首選的醫(yī)生【詞匯積累】
the starting salary：起薪【詞匯積累】
act as：充當(dāng)懦窘，擔(dān)當(dāng)【詞組積累】
refer people to specialists：refer A to B指的是讓A到B尋求幫助，這里指的是讓病人到專家處求助【詞組積累】
only if：表示只有當(dāng)稚配，而if only表示只要【詞組積累】
make it to：make it表示成功畅涂，做成，make it to a doctor表示條件足以達(dá)到看醫(yī)生道川∥缢ィ【詞組積累】
be handled by：由……處理【詞組積累】is taken up by：被……占據(jù)【詞組積累】
leaves the NHS with little choice but to do：使某人沒有選擇只能【詞組積累】
the continuity of care：醫(yī)療服務(wù)的持續(xù)性【詞組積累】
what they got up to：get up to指的是忙于苹丸，從事，如he is getting up to his tasks他忙于自己的任務(wù)苇经∽咐恚【詞組積累】
數(shù)字……, down from?數(shù)字+時(shí)間：與某個(gè)時(shí)間段的某個(gè)數(shù)字相比，有所下降扇单∩棠＃【句式】
There is?a severe shortage of them：缺乏某事物，可以用severe表示缺乏的程度【句式】
consultation：（向?qū)＜艺埥痰模┳稍儠?huì)蜘澜；（尤指）就診a meeting with an expert, especially a doctor, to get advice or treatment施流，consultation雖然是咨詢，商討的意思鄙信，但這里表達(dá)的是其就診的意思【熟詞僻義】
precisely：precise是精確的瞪醋，準(zhǔn)確的，這里并不是你這個(gè)意思装诡，precisely這里強(qiáng)調(diào)真是或明顯银受，解釋為“正是，確實(shí)”鸦采。這里以nothing precisely?what they ……?來強(qiáng)調(diào)醫(yī)生們整天忙于的并不是治病宾巍。下文以it turned out that（事實(shí)證明，原來）?……與之承上啟下渔伯，引出很多事情可以由其他人做顶霞，而不是醫(yī)生【熟詞僻義】
