24 Questions
24 Questions
To Do – 15
Target – 99% accuracy
History has shaped academic medical centers (AMCs) to perform 3 functions: patient care, research,
and teaching. These 3 missions are now fraught with problems because the attempt to combine them
has led to such inefficiencies as duplication of activities and personnel, inpatient procedures that
could and should have been outpatient procedures, and unwieldy administrative bureaucracies.
One source of inefficiency derives from mixed lines of authority. Clinical chiefs and practitioners in
AMCs are typically responsible to the hospital for practice issues but to the medical school for
promotion, marketing, membership in a faculty practice plan, and educational accreditation.
Community physicians with privileges at a university hospital add more complications. They have
no official affiliation with the AMC’s medical school connected, but their cooperation with faculty
members is essential for proper patient treatment. The fragmented accountability is heightened by
the fact that 3 different groups often vie for the loyalty of physicians who receive research. The
medical school may wish to capitalize on the research for its educational value to students; the
hospital may desire the state-of-the-art treatment methods resulting from the research; and the grant
administrators may focus on the researchers’ humanitarian motives. Communication among these
groups is rarely coordinated, and the physicians may serve whichever group promises the best perks
and ignore the rest—which inevitably strains relationships.
Another source of inefficiency is the fact that physicians have obligations to many different groups:
patients, students, faculty members, referring physicians, third-party payers, and staff members, all
of whom have varied expectations. Satisfying the interests of one group may alienate others. Patient
care provides a common example. For the benefit of medical students, physicians may order too
many tests, prolong patient visits, or encourage experimental studies of a patient. If AMC faculty
physicians were more aware of how much treatments of specific illnesses cost, and of how other
institutions treat patient conditions, they would be better practitioners, and the educational and
clinical care missions of AMCs would both be better served.
A bias toward specialization adds yet more inefficiency. AMCs are viewed as institutions serving the
gravest cases in need of the most advanced treatments. The high number of specialty residents and
the presence of burn units, blood banks, and transplant centers validate this belief. Also present at
AMCs, though less conspicuous, are facilities for ordinary primary care patients. In fact, many
patients choose to visit an AMC for primary care because they realize that any necessary follow—up
can occur almost instantaneously. While AMCs have emphasized cutting-edge specialty medicine,
their more routine medical services need development and enhancement.
A. AMCs would make more money if they focused mainly on primary care.
B. Burn and transplant patients need specialty care more than primary care.
C. AMCs offer the best primary care for most patients.
D. lnefficiencies at AMCs would be reduced if better primary care were offered.
Q2. The author’s primary purpose in this passage is to
2. When it comes to the English language, long words are a clear enemy, say most of the style
guides.
3. They remind you that concrete words like ‘stony’ evoke the thing itself, while abstract words like
‘lapidarian’ convey nothing unless you know them.
4. They tell you to take out every extra word, starve your sentences, murder your pet phrases.
Q23. PJ
1. The British Empiricists, following Locke, subscribed to a tabula rasa theory, denying innate ideas
and maintaining that our knowledge must ultimately be based on sense experience.
2. Descartes and his followers were convinced that a priori knowledge of the existence of God, as an
infinitely perfect Being, was possible and favored (what Kant would later call) the Ontological
Argument as a way to establish it.
3. The Continental Rationalists, following Descartes, subscribed to a theory of a priori innate ideas
that provide a basis for universal and necessary knowledge.
4. By contrast, Locke and his followers spurned such a priori reasoning and resorted to empirical
approaches, such as the Cosmological Argument and the Teleological Arguments or Design
Arguments.
5. Before Kant, modern European philosophy was generally split into two rival camps.
Q24. PJ
1. In some fields, however, Japan still allows itself some swagger: it is, for example, happy
to describe itself as a “robotics superpower”.
2. The robotic exoskeleton can add strength and stamina to healthy limbs, restore movement
to enfeebled ones and aptly serves as a symbol of Japanese ingenuity in overcoming debility.
3. Japan’s economic pride has suffered many years of deflation, a form of macroeconomic
self-deprecation, in which firms and workers continuously discount what they do.
4. In a speech early this year Shinzo Abe, the Prime Minister, praised a “dream robot suit”
made by Cyberdyne as a prime example of the country’s technological advances.
5. Japan is not, by nature, a boastful country: its opportunities for bombast have shrunk
along with its population.