最后一句,理解的对吗?
Outcomes-Based Care and Payment
Efforts to heal disease and overcome the effects of trauma have been an integral part of civilization since before recorded history [8]. For those cultures with historical records of their approach to sickness, health, and healing, there is clear documentation that some healers and treatments were felt to produce better outcomes than others [9]. Well-regarded healers were accorded a higher status and in many cases paid more, than others. For example, Hammurabi’s Code (c. BCE) stipulated the fee allowed for surgical procedures according to their complexity, the social and economic standing of the patient, the skill of the provider, and whether special equipment was employed [10]. However, this code punished surgeons whose operations were followed by the patient’s death by amputation of both hands. Plato’s dialogues contain many references to the practice of medicine in ancient Greece, including its two-tiered medical system.Citizens received time-consuming, individualized assessment and care, but slaves were treated in an empirical, hurried fashion in crowded clinics [9]. Physicians who treated citizens were state appointees with an annual term and high socioeconomic status. Their reappointment depended upon citizens’ satisfaction with their results in the prior year, as voiced in a community gathering convened annually for this purpose.Socrates made reference to outcomes- based reappointment when he asked, “If you and I were physicians, and were advising one another that we were competent to practice, should I not ask you, and would you not ask me, well, what about Socrates himself, has he not good health? And was anyone else ever been known to be cured by him, whether slave or freeman?”

预后导向的医疗和支付
有史以来,努力治愈疾病和克服创伤的影响一直是文明不可或缺的一部分[8]。在那些对疾病、健康及康复方法有历史记录的文明中,明确记载着某些医治者和治疗方法比其他医治和方法效果更好[9]。受人尊敬的医治者赋予了更高的地位,且在多数情况下,薪酬比其他人更高。例如,《汉谟拉比法典》(The Code of Ham- murabi,公元前1695年)记载,根据外科手术的复杂性、患者的社会和经济地位、操作者的技能及是否使用了特殊设备而定手术费用[10]。该法典还记载了对术后患者死亡的外科医师处于双手截肢的惩罚。柏拉图的对话中涉及许多古希腊医学实践的内容,包括基本治疗和更好治疗的两级医疗体系。公民可有较长时间的个体化评估和治疗,但奴隶只能在拥挤的诊所中接受经验性的、匆忙的治疗[9]。治疗公民的医师是国家任命的,具有年度任期和较高的社会经济地位。他们的连任取决于公民对其前一年治疗的满意程度,为此每年举行一次社区聚会进行表决。苏格拉底曾经提及基于预后的连任:“如果你我都是医师,互相承认我们都是个合格的医生,是否我不应该问你,你也不应该问我,苏格拉底自己怎么样,他自己健康吗,还有人(无论是奴隶还是自由人)被他治好过病吗?”[9]。
整个一段,看得模糊,尤其是最后一句,理解的对吗?什么叫:是否我不应该问你,你也不应该问我,苏格拉底自己怎么样?
谢谢
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