摘要：Patient–physician relationship is a complex psychosocial interplay of vulnerability, trust, and authority in a professional settin

高效记单词：《新概念英语1词汇专练》

英汉双语阅读101：“海上巨兽” 瓦萨号为何20分钟就沉没了？

一、生词准备

1. psychosocial [ˌsaɪkoʊˈsoʊʃəl] adj. 心理社会的；涉及心理和社会因素的

2. interplay [ˈɪntərpleɪ] n. 相互作用；相互影响

3. fiduciary [fɪˈduːʃieri] adj. 信托的；受信托的

4. specialization [ˌspeʃələˈzeɪʃn] n. 专门化；专业化

5. obligations [ˌɑːblɪˈɡeɪʃnz] n. 义务；责任

6. informed consent [ɪnˈfɔːrmd kənˈsent] n. 知情同意

7. asymmetrical [ˌeɪsɪˈmetrɪkl] adj. 不对称的；不均衡的

8. vulnerability [ˌvʌlnərəˈbɪləti] n. 脆弱性；易受伤害性

9. keystone [ˈkiːstoʊn] n. 基石；关键

10. engender [ɪnˈdʒendər] v. 产生；引起

11. paternalistic [pəˌtɜːrnəˈlɪstɪk] adj. 家长式的；专制的

12. therapeutic alliance [ˌθerəˈpjuːtɪk əˈlaɪəns] n. 治疗联盟

13. equation [ɪˈkweɪʒn] n. 等式；平衡

14. compliance [kəmˈplaɪəns] n. 依从性；顺从

15. negligence [ˈneɡlɪdʒəns] n. 疏忽；过失

16. regimens [ˈredʒɪmənz] n. 治疗方案；制度

17. clinical outcomes [ˈklɪnɪkl ˈaʊtkʌmz] n. 临床结果

18. perception [pərˈsepʃn] n. 感知；看法

19. loyalty [ˈlɔɪəlti] n. 忠诚；忠实

20. longitudinal [ˌlɑːndʒɪˈtuːdnl] adj. 纵向的；长期的

21. consultation [ˌkɑːnslˈteɪʃn] n. 咨询；会诊

22. encounter [ɪnˈkaʊntər] n. 遭遇；会面

23. defensive medicine [dɪˈfensɪv ˈmedsn] n. 防御性医疗

24. Orthopedic Surgeons [ˌɔːrθəˈpiːdɪk ˈsɜːrdʒənz] n. 骨科医生

25. satisfactorily [ˌsætɪsˈfæktərəli] adv. 令人满意地

26. categories [ˈkætəɡɔːriz] n. 类别；分类

27. continuity [ˌkɑːntɪˈnuːəti] n. 连续性；持续性

28. distract [dɪˈstrækt] v. 分散注意力；使分心

29. evident [ˈevɪdənt] adj. 明显的；显然的

30. facilitator [fəˈsɪlɪteɪtər] n. 促进者；推动者

二、短文内容

Patient–physician relationship is a complex psychosocial interplay of vulnerability, trust, and authority in a professional setting. It has been legally defined as “a consensual relationship in which the patient knowingly seeks the physician's assistance and the physician knowingly accepts the person as a patient.” Patient–physician relationship is fiduciary, in which a physician is trusted to provide an accepted standard of medical care in his or her area of specialization. Physician's obligations are to duly inform the patient of the medical condition, to provide optimal treatment, to refer the patient to an appropriate specialist if necessary, and to obtain the patient's informed consent for medical treatment or surgery. Physicians are influential in deciding if, when, and how healthcare services are delivered, and the balance of power is tipped in favor of the physician. Patients are, therefore, vulnerable when they entrust physicians with their health and lives. Trust is the keystone in such an asymmetrical relationship.

If trust is the defining element of patient–physician relationship, communication is the means to engender trust. Effective communication improves patient and physician satisfaction, reduces medical errors, decreases patient complaints and medical negligence claims, improves patient compliance to medication and treatment regimens, and has an impact on the overall clinical outcomes and patients’ physical and mental health related to their diseases. As we move away from the paternalistic approach to the practice of patient-centered medicine (treating the patient as a person with shared power and responsibility and forming a therapeutic alliance), ongoing communication becomes the facilitator in cementing the new equation of equality and partnership in patient–physician relationship.

An open two-way communication has an important bearing on all the four vital aspects of the depth of patient–physician relationship that govern patient satisfaction – trust (those who trust that the physician has the highest level of satisfaction), knowledge (patients report a high level of satisfaction when the physician allows the patient to give information and understands and specifically addresses their concerns), regard (perception of physician's friendliness, warmth, emotional support, and caring are directly associated with patient satisfaction), and loyalty (continuity of care improves patient satisfaction). Apart from the depth of patient–physician relationship, longitudinal care (seeing the same doctor with ensured continuity of communication and medical care) and consultation experiences (patient's encounter with the doctor at the time of medical consultation) are the main processes by which patient–doctor relationships are promoted. All these obviously would deeply involve elements of communication.

Physicians, however, do not seem to be very good communicators. They receive very limited formal coaching in patient communication skills, yet perform an average of 100,000 sessions of patient communications in their professional span. Apart from the lack of formal training in communication skills, undue reliance on tests and investigations, practice of defensive medicine, conflicting interests of clinical and financial targets, and the influence of print, electronic, and social media act as barriers and distract from the core human interaction between the physician and the patient. In 1998, the American Academy of Orthopedic Surgeons conducted a survey which found that the patients perceived technical skills as important but valued communication skills equally important. According to this survey, while 75% of the surgeons believed that they had communicated satisfactorily with their patients, only 21% of the patients expressed satisfaction with their surgeons’ communication skills. This gap in perception between the surgeons and their patients was most evident in categories such as listening and caring, and the time spent with the patient.

三、短文注释

1. patient-physician relationship：医患关系。一种基于信任和专业互动的法律关系，患者寻求医生的帮助，医生接受患者并提供医疗服务。

2. fiduciary relationship：信托关系。医生有法律和道德义务为患者的最大利益服务，提供符合标准的医疗护理。

3. standard of medical care：医疗标准。医生在专业领域内应提供的合理且被广泛接受的医疗服务质量。

4. informed consent：知情同意。医生必须向患者充分解释治疗方案、风险和替代方案，患者自愿同意后才能进行治疗。

5. asymmetrical relationship：不对称关系。医患关系中，医生在专业知识和决策权上占据优势，患者处于相对弱势地位。

6. trust as the keystone：信任是关键。医患关系的核心是患者对医生的信任，直接影响治疗效果和患者满意度。

7. patient-centered medicine：以患者为中心的医疗。强调医患平等合作，患者参与医疗决策，而非传统的家长式医疗模式。

8. therapeutic alliance：治疗联盟。医生与患者建立的合作关系，共同制定治疗目标并执行医疗计划。

9. two-way communication：双向沟通。医患之间开放、互动的交流方式，有助于提高治疗效果和患者依从性。

10. patient satisfaction：患者满意度。患者对医疗服务的整体评价，受信任、知识传递、情感支持和连续性护理等因素影响。

11. continuity of care：连续性护理。患者长期由同一位医生诊治，确保医疗服务的连贯性和一致性。

12. longitudinal care：纵向护理。长期跟踪患者的健康状况，提供持续性的医疗服务。

13. consultation experience：就诊体验。患者在就医过程中与医生的互动体验，直接影响其对医疗服务的评价。

14. defensive medicine：防御性医疗。医生为避免法律风险而采取的过度检查或治疗行为，可能影响医患信任。

15. communication barriers：沟通障碍。医生因缺乏培训或外部干扰（如媒体影响）而难以与患者有效沟通。

16. technical vs. communication skills：技术技能与沟通技能。患者认为医生的沟通能力与技术能力同等重要，但医生往往高估自己的沟通效果。

17. listening and caring：倾听与关怀。患者特别重视医生是否认真倾听其诉求并表现出同理心。

18. perception gap：认知差距。医生和患者对沟通质量的评价存在显著差异，尤其在情感支持方面。

19. clinical outcomes：临床结果。医疗干预对患者健康状况的实际影响，良好的沟通可改善治疗效果。

20. patient compliance：患者依从性。患者遵循医嘱的程度，受医患沟通质量的直接影响。

21. medical negligence claims：医疗过失索赔。因沟通不足或医疗错误导致的法律纠纷。

22. shared power and responsibility：权力与责任共享。现代医疗模式强调医患共同决策，而非医生单方面主导。

23. emotional support：情感支持。医生通过语言和行为给予患者的心理安慰，增强治疗信心。

24. paternalistic approach：家长式医疗。传统模式中医生单方面决策，患者被动接受，逐渐被以患者为中心的模式取代。

25. optimal treatment：最优治疗。医生根据患者情况提供的最佳医疗方案，需平衡效果与风险。

26. referral to specialists：转诊。当患者需要专科治疗时，医生将其转介给相关领域的专家。

27. medical errors：医疗错误。因沟通或技术失误导致的诊疗偏差，可能引发不良后果。

28. conflicting interests：利益冲突。医生在临床目标（如患者健康）与外部压力（如经济指标）之间的权衡困境。

29. print/electronic/social media influence：媒体影响。新闻报道和社交媒体对医患关系的干扰，可能加剧不信任。

30. time spent with patient：问诊时间。患者认为医生花足够时间沟通是体现关怀的重要标志，但现实中常因忙碌而受限。

【Source】www.pmc.ncbi.nlm.nih.gov

【Translated by】Spark Liao (廖怀宝)

【Illustration】From Bing

来源：新概念英语的教学