VOA标准英语2010年-Doctors in America in Short Supply

Data from the US Census¹ bureau, found that doctor's hours declined while at the same time their incomes dropped 25 percent between 1995 and 2006

In the U.S., doctors are known for working extraordinarily² long hours, seeing patients in the office and then at the hospital.  But in the last decade American doctors have been either retiring or putting in shorter work weeks while fewer Americans are entering medical school.

There's a shortage of students in American medical schools and that is one of the issues. In recent years, U.S. medical colleges have graduated an insufficient³ number of students. 

Experts say the United States needs at least 50,000 more doctors, and if nothing is done about it there could be a shortage of 200,000 by the year 2025.

The drop in the number of physicians is acute in rural areas. In addition, there are two growing segments of the population in greater need of medical care: the elderly and the uninsured, largely made up of immigrants and the poor.

So, if there's a huge demand for medical services, why aren't doctors putting in longer hours?

Professor Douglas Staiger of Dartmouth College in New Hampshire was the lead author of a study in the Journal of the American Medical Association.

Douglas Staiger

"We think that probably the changing financial and competitive pressures on physicians are just discouraging long work hours," Staiger said.  "They are making that last hour of work less pleasant, less rewarding."

Residents, who are hospital doctors in training, have historically worked long hours.  But in 2003, their hours were cut as a result of mandated⁴ limits imposed nationwide.
 
Dr. Betsy O'Donnell is at Beth Israel Deaconess Medical Center in Boston.  She says a shorter work week of 80 hours helps her function better. "I'm the mother of two, so I think that it enables me to balance those responsibilities much better than a 100 hour work week would probably allow me to do," she said.

At first, researchers thought the limits on residents' hours were the main reason why physicians' hours were dropping. 

But the decline in hours has been throughout the profession, including doctors who do not work in hospitals.

Using data from the US Census bureau, the researchers found that doctor's hours declined while at the same time their incomes dropped 25 percent between 1995 and 2006.

The loss in income was most likely the result of cuts in private and government insurance reimbursements⁵, the authors said. 

One doctor put it this way: the less you are paid, the less incentive⁶ there is to work harder.

In addition, American students have found it difficult for decades to get into medical school in their own country. That's a prime reason for the shortage of new doctors.

The medical profession now says something must be done. 

The Association of American Medical Colleges says a 30 percent increase in enrollment⁷ is necessary to replenish⁸ the supply of doctors.

For the first time in half a century, several new medical schools are planned or already opening.

But some experts worry those students won't graduate soon enough to resolve the crisis.
 

1 census   

n.(官方的)人口调查，人口普查

参考例句：

• A census of population is taken every ten years.人口普查每10年进行一次。
• The census is taken one time every four years in our country.我国每四年一次人口普查。

2 extraordinarily   

adv.格外地；极端地

参考例句：

• She is an extraordinarily beautiful girl.她是个美丽非凡的姑娘。
• The sea was extraordinarily calm that morning.那天清晨，大海出奇地宁静。

3 insufficient   

adj.(for，of)不足的，不够的

参考例句：

• There was insufficient evidence to convict him.没有足够证据给他定罪。
• In their day scientific knowledge was insufficient to settle the matter.在他们的时代，科学知识还不能足以解决这些问题。

4 mandated   

adj. 委托统治的

参考例句：

• Mandated desegregation of public schools. 命令解除公立学校中的种族隔离
• Britain was mandated to govern the former colony of German East Africa. 英国受权代管德国在东非的前殖民地。

5 reimbursements   

n.偿还( reimbursement的名词复数 )；退款；补偿；赔偿

参考例句：

• We had to put in for the food reimbursements again. 我们不得不再次申请食物赔偿。 来自互联网
• Have you figured up the total of the reimbursements I gave you? 你有没有把我给你的报销账目全部加总了呢？ 来自互联网

6 incentive   

n.刺激；动力；鼓励；诱因；动机

参考例句：

• Money is still a major incentive in most occupations.在许多职业中，钱仍是主要的鼓励因素。
• He hasn't much incentive to work hard.他没有努力工作的动机。

7 enrollment   

n.注册或登记的人数；登记

参考例句：

• You will be given a reading list at enrollment.注册时你会收到一份阅读书目。
• I just got the enrollment notice from Fudan University.我刚刚接到复旦大学的入学通知书。

8 replenish   

vt.补充；(把…)装满；(再)填满

参考例句：

• I always replenish my food supply before it is depleted.我总是在我的食物吃完之前加以补充。
• We have to import an extra 4 million tons of wheat to replenish our reserves.我们不得不额外进口四百万吨小麦以补充我们的储备。