2. 外语
  3. A debate has erupted within medicine over how to ensure that physicians maintain their clinical skills throughout their careers.

A debate has erupted within medicine over how to ensure that physicians maintain their clinical skills throughout their careers.

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问题     A debate has erupted within medicine over how to ensure that physicians maintain their clinical skills throughout their careers. The American Board of Internal Medicine (ABIM) has long required internists to pass Maintenance of Certification exams every 10 years to keep their board-certified status. 【R6】________In response, the ABIM announced it would offer a new assessment option starting in January 2018, allowing doctors to be recertified through shorter, but more frequent, assessments. 【R7】________. In fact, it raises a couple of important questions; Are assessments even the most effective way to incentivize doctors to keep up with the latest medical knowledge and new technologies? Why don’t we directly measure physicians’ quality of care and patient outcomes as they grow older?
    While there is some evidence that physicians’ clinical knowledge, adherence with up-to-date standards of care, and performance on process measures may wane as they get older, little is known about whether and how age impacts physicians’ practice and their patient outcomes. 【R8】________. On the other hand, scientific knowledge, technology, and clinical guidelines change so regularly that keeping up with them and incorporating them into clinical practice can be overwhelming.
    As the physician workforce in the U.S. ages (approximately one-fifth of U.S. physicians are over 65 years old, and the size of the group has increased 27% since 2005) , it becomes even more important to understand how physician age might relate to patient outcomes.      【R9】________.
    The relationship between physician age and patient outcomes has not been empirically studied at a large scale. 【R10】________In our study, which was recently published in The BMJ, we found that U.S. Medicare patients treated by older physicians were more likely to die within 30 days of hospitalization, compared with patients treated by younger physicians — unless the older physicians were used to treating large numbers of patients each year.
    A.  We found that patients treated by older physicians experienced statistically significantly higher mortality rates than patients cared for by younger physicians
    B.  This would help inform new efforts to educate older physicians and improve clinical outcomes
    C.  However, this policy has recently come under scrutiny due to its high burden to doctors and the lack of sound evidence that recertification processes improve doctors’ quality of care
    D.  On one hand, skills and knowledge are accumulated through experience and can improve quality of care
    E.  But it’s not clear that this will make much difference
    F.  Therefore, we decided to investigate this issue by analyzing the outcomes of hospitalized Medicare patients and the age of their treating physicians

【R7】
选项
答案E
解析 除了把握文章第一段是如何使用转折关系来论证和推理的之外，还应关注一些指示代词(例如“this”)的衔接作用。
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