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Self-employed private physicians who charge a fee for each patient visit are the foundation of medical practice in the United States. Most physicians have a contract relationship with one or more hospitals in the community. They send their patients to this hospital, which usually charges patients according to the number of days they stay and the facilities(operating room, tests, medicines that they use). Some hospitals belong to a city, a state or, in the case of veteran's hospitals, a federal government agency. Others are operated by religious orders(教会) or other non-profit groups.

Some medical doctors are on salary. Salaried physicians may work as hospital staff members, or residents, who are often still in training. They may teach in medical schools, be hired by corporations to care for their workers or work for the federal government's Public Health Service.

Physicians are among the best paid professionals in the United States. In the 1980s, it was not uncommon for medical doctors to earn incomes of more than $ 100 000 a year. Specialists, particularly surgeons, might earn several times that amount. Physicians list many reasons why they deserve to be so well rewarded for their work. One reason is the long and expensive preparation required to become a physician in the United States. Most would be physicians first attend college for four years, which can cost nearly $ 20 000 a year at one of the best private institutions. Prospective physicians then attend medical school for four years. Tuition alone can exceed $ 10 000 a year. By the time they have obtained their medical degrees, many young physicians are deeply in debt. They still face three to five years of residency(实习阶段) in a hospital, the first year as an apprentice physician. The hours are long and the pay is relatively low.

Setting up a medical practice is expensive, too. Sometimes several physicians will decide to establish a group practice, so they can share the expense of maintaining an office and buying equipment. These physicians also take care of each other's patients in emergencies.

Physicians work long hours and must accept a great deal of responsibility. Many medical procedures, even quite routine ones, involve risk. It is understandable that physicians want to be well rewarded for making decisions which can mean the difference between life and death.

41. According to the passage, it is very unlikely that an American hospital is owned by _______.

A. a church            B. a corporation            C. a city                       D. a state

42. The expenses for becoming a doctor are spent on _______.

A. schooling and retraining                        B. practice in a hospital

C. facilities he or she uses                          D. education he or she receives

43. According to the passage, how long does it take for a would-be physician to become an independent physician in the USA?

A. About seven years.                                B. Eight years.

C. Ten years.                                             D. About twelve years.

44. Sometimes several physicians set up a group medical practice mainly because _______.

A. there are so many patients that it is difficult for one physician to take care all of them

B. they can take turns to work long hours

C. facilities may be too much of a burden for one physician to shoulder

D. no one wants to assume too much responsibility

45. Which of the following statements could fully express the author's view towards physicians’ payment in the USA?

A. For their expensive education and their responsibility, they deserve a handsome pay.

B. It is reasonable for physicians to have a large income because their work is very dangerous.

C. Physicians should be better paid because they work long hours under bad conditions.

D. Physicians have great responsibility, so it is understandable that they should be well rewarded.

【小题1】B

【小题2】D

【小题3】D

【小题4】C

【小题5】A

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