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美国医疗工作者抗议工作压力(下)
- Authors
我最终意识到，我们所有人都是工人，尽管外界以为我们是精英。
双语精读
For years, many doctors and pharmacists believed they stood largely outside the traditional management-labor hierarchy. Now, they feel smothered by it.
多年来，许多医生和药剂师认为，他们在很大程度上不受传统的劳资等级制度约束。现在，他们感觉要被这一制度窒息了。
The result is a growing worker consciousness among people who haven't always exhibited one -- a sense that they are subordinates constantly at odds with their overseers.
其结果是，这些并不常常表现出工人意识的人，现在愈加意识到自己是工人，即他们感觉自己是下属，且总是与上级有矛盾。
"I realized at end of the day that all of us are workers, no matter how elite we're perceived to be," said Dr. Alia Sharif, a colleague of Dr. Wust's at Allina who was heavily involved in the union campaign.
"我最终意识到，我们所有人都是工人，尽管外界以为我们是精英。"艾莉亚·谢里夫医生说，她是伍斯特医生在阿尼娜的同事，也深度参与了工会活动。
"We're seen as cogs in the wheel. You can be a physician or a factory worker, and you're treated exactly the same way by these large corporations."
"我们被当作轮子上的一个齿轮。你是医生还是工厂工人都没有区别，这些大公司会以同样的方式对待你。"
As a pharmacy intern and pharmacist at CVS in Massachusetts beginning in the late 1990s, Dr. Ed Smith found the stores consistently well staffed. He said pharmacists had time to develop relationships with patients.
从20世纪90年代末开始，埃德·史密斯医生就在马萨诸塞州CVS担任药房实习生和药剂师，当时他发现药店的工作人员配备一直很齐全。他说，当时药剂师还有时间与患者建立关系。
Around 2004, he became a district manager in the Boston area, overseeing roughly 20 locations for the company. Dr. Smith said CVS executives were attentive to input from pharmacists -- raising pay for technicians if there was a shortage, or upgrading clunky software.
2004年左右，他成为波士顿地区的地区经理，负责公司大约20个地方的业务。史密斯说，CVS的高管很重视药剂师的意见，如果出现人员短缺，就会提高技术人员的工资，或者升级不灵敏的软件。
"Every decision was based on something that we said we needed," he recalled. Over time, however, consolidation and the rise of ever-larger health care corporations left workers with less influence.
"每一个决定都是基于我们的需求。"他回忆道。然而，渐渐地，企业开始合并，规模越来越大的医疗保健公司开始崛起，让工人的影响力变得越来越小。
As so-called pharmacy benefit managers, which negotiate discounts with pharmacies on behalf of insurers and employers, bought up rivals, retail giants like Walgreens and CVS made acquisitions as well, to avoid losing market power.
随着药房福利经理（代表保险公司和雇主与药房谈折扣）收购了许多竞争对手药房，沃尔格林和CVS等零售巨头也进行了收购，以避免失去市场支配力。
The chains closed many of their newly owned locations, driving more customers to existing stores. They sought to cut costs, especially labor costs, as the benefit managers reined in drug prices.
这些连锁店关闭了许多新收购的药房，驱使更多顾客来到它们的现有门店。福利经理要控制药品价格，于是这些药房就努力削减成本，特别是劳动力成本。
Around 2015, Dr. Smith stepped down from his role as a district manager and became a frontline pharmacist again, reluctant to supervise co-workers under conditions he considered subpar.
2015年左右，史密斯卸任地区经理的职务，再次成为一线药剂师，他不愿在他认为不合理的条件下去管理同事。
Among his frustrations, he said, was the need to strictly limit the number of workers each pharmacy could schedule. "Every week that you're over your labor budget, you get a call, regardless of prescription volume, from your district manager," Dr. Smith said.
他说，让他失望的事情之一是他需要严格限制每家药店可以安排的工作人员数量。"只要你的劳动力预算超支，你每周就会接到地区经理打来的电话，不管我们那周开了多少药。"史密斯说。
The pharmacists also described being held to increasingly strict performance metrics, such as how quickly they answered the phone, the portion of prescriptions that are filled for 90 days rather than 30 or 60 days (longer prescriptions mean more money up front) and calls made urging people to fill or pick up prescriptions.
史密斯还说他们被要求遵守越来越严格的绩效指标，比如接电话的速度、90天处方而非30天或60天处方的占比(疗程更长的处方意味着有更多的预付款)，以及为了催促人们完成疗程或取药而打了多少电话。
词汇预习
increasingly [高考]
美[ɪnˈkriːsɪŋli] | 英[ɪnˈkriːsɪŋli]
adv. 逐渐地；越来越多地
haven [高考]
美[ˈheɪvn] | 英[ˈheɪvn]
n. 港口；避难所 v. 安置 ... 于港中；庇护
constantly [高考]
美[ˈkɑːnstəntli] | 英[ˈkɒnstəntli]
adv. 不断地；经常地
largely [高考]
美[ˈlɑːrdʒli] | 英[ˈlɑːdʒli]
adv. 大部分；主要地
roughly [高考]
美[ˈrʌfli] | 英[ˈrʌfli]
adv. 粗略地；大约；粗暴地；粗糙地；粗鲁地
volume [高考]
美[ˈvɑːljəm] | 英[ˈvɒljuːm]
n. 卷；体积；册；音量；容量
input [高考]
美[ˈɪnpʊt] | 英[ˈɪnpʊt]
n. 投入；输入信息；输入数据；信息输入端 v. 输入
consistently [高考]
美[kənˈsɪstəntlɪ] | 英[kən'sɪstəntlɪ]
adv. 一贯地，始终；一致地
reluctant [高考]
美[rɪˈlʌktənt] | 英[rɪˈlʌktənt]
adj. 不情愿的；勉强的
attentive [高考]
美[əˈtentɪv] | 英[əˈtentɪv]
adj. 注意的；留意的
portion [高考]
美[ˈpɔːrʃn] | 英[ˈpɔːʃn]
n. 部分；命运；分担的责任；份 v. 分配；命运注定
colleague [高考]
美[ˈkɑːliːɡ] | 英[ˈkɒliːɡ]
n. 同事
regardless [高考]
美[rɪˈɡɑːrdləs] | 英[rɪˈɡɑːdləs]
adj. 不顾的；不注意的 adv. 不顾
union [高考]
美[ˈjuːniən] | 英[ˈjuːniən]
n. 结合；工会；联盟；和睦；连接轴；【数】并，并集 adj. 联邦政府的；工会的
budget [高考]
美[ˈbʌdʒɪt] | 英[ˈbʌdʒɪt]
n. 预算 vt. 编预算；为 ... 做预算 vi. 节省开支 adj. 廉价的；不贵的
software [高考]
美[ˈsɔːftwer] | 英[ˈsɒftweə(r)]
n. 软件
physician [高考]
美[fɪˈzɪʃn] | 英[fɪˈzɪʃn]
n. 内科医生
negotiate [高考]
美[nɪˈɡoʊʃieɪt] | 英[nɪˈɡəʊʃieɪt]
vi. 谈判；协商；交涉 vt. 谈判达成；成功越过；议价出售
prescription [高考]
美[prɪˈskrɪpʃn] | 英[prɪˈskrɪpʃn]
n. 处方；药方；对策
behalf [高考]
美[bɪˈhæf] | 英[bɪˈhɑːf]
n. 代表；利益；方面
regardless of [高考]
美[rɪˈɡɑːrdləs əv] | 英[rɪˈɡɑːdləs əv]
不管； 不顾
on behalf of [高考]
美[ɑːn bɪ'hæf əv] | 英[ɒn bɪ'hɑːf əv]
代表；为了...的利益
so-called [四级]
美[ˌsoʊ ˈkɔːld] | 英[ˌsəʊ ˈkɔːld]
adj. [贬]号称的；所谓的
consciousness [四级]
美[ˈkɑːnʃəsnəs] | 英[ˈkɒnʃəsnəs]
n. 意识；知觉；自觉；觉悟
strictly [四级]
美[ˈstrɪktli] | 英[ˈstrɪktli]
adv. 严格地；完全地
retail [四级]
美[ˈriːteɪl , rɪˈteɪl] | 英[ˈriːteɪl , rɪˈteɪl]
n. 零售 vt. 零售；传述 adv. 以零售形式
hierarchy [四级]
美[ˈhaɪərɑːrki] | 英[ˈhaɪərɑːki]
n. 等级制度；统治集团；[生]级系
supervise [四级]
美[ˈsuːpərvaɪz] | 英[ˈsuːpəvaɪz]
vt. 监督；管理；指导
involved in [四级]
美 | 英
涉及； 包含在 ... 中
existing [四级]
美[ɪɡˈzɪstɪŋ] | 英[ɪɡˈzɪstɪŋ]
adj. 现存的；现有的
involved [四级]
美[ɪnˈvɑlvd] | 英[ɪnˈvɒlvd]
adj. 涉及的；牵连的；复杂的；感情投入的；有密切关系的
odds [四级]
美[ɑːdz] | 英[ɒdz]
n. 机率；可能性；差别；投注赔率；让步；优势
elite [四级]
美[eɪˈliːt , ɪˈliːt] | 英[eɪˈliːt , ɪˈliːt]
n. 精英 adj. 精英的；优秀的
based on [六级]
美[best ɑn] | 英[beɪst ɔn]
以 ... 为基础； 基于
pharmacist [专八]
美[ˈfɑrməsɪst] | 英[ˈfɑ:məsɪst]
n. 药剂师；药商
intern [专八]
美[ ˈɪntɜːrn] | 英[ˈɪntɜːn]
n. 实习生；拘留犯 vt. 扣留 vi. 作实习生
consolidation [考研]
美[kənˌsɑlɪˈdeʃən] | 英[kənˌsɒlɪ'deɪʃən]
n. 巩固；加强；统一；合并；联合
pharmacy [考研]
美[ˈfɑːrməsi] | 英[ˈfɑːməsi]
n. 药房；药剂学
frontline [雅思]
美[ˈfrʌntˌlaɪn] | 英[ˈfrʌntlaɪn]
n. 前线；头等
重点讲解
For years, many doctors and pharmacists believed they stood largely outside the traditional management-labor hierarchy. Now, they feel smothered by it.
多年来，许多医生和药剂师认为，他们在很大程度上不受传统的劳资等级制度约束。现在，他们感觉要被这一制度窒息了。
hierarchy n. 等级制度
【例】social hierarchy/hierarchy of needs 社会等级/需求等级
She's quite high up in the management hierarchy.
她位居管理层要职。
【近义词】pecking order 等级排序
smother v.
1. 使窒息；使透不过气
【例】The skier was almost smothered to death by the snow slide.
滑雪运动员差点被雪崩闷死。
2. 使压抑；抑制
【例】The voices of the opposition were effectively smothered.
反对党的声音被有效地压制了下去。
【近义词】stifle/suffocate v. 使窒息；压抑
【辨析】smooth adj. 光滑的
The result is a growing worker consciousness among people who haven't always exhibited one -- a sense that they are subordinates constantly at odds with their overseers.
其结果是，这些并不常常表现出工人意识的人，现在愈加意识到自己是工人，即他们感觉自己是下属，且总是与上级有矛盾。
subordinate n. & adj.
1. 作名词：下级；下属
【例】the relationship between subordinates and superiors 上下级关系
【反义词】overseer/supervisor n. 监督者
2. 作形容词：次要的；隶属的
【例】All other issues are subordinate to this one.
所有其他问题都没有这一问题重要。
【近义词】secondary adj. 次要的；从属的
at odds with
1. （与某人）有矛盾；有分歧
【例】He's always at odds with his father over politics.
他在政治上总是与他父亲的意见相左。
2. （与某事）不相符；有差异
【例】These findings are at odds with the reality.
这些研究结果与实际情况并不相符。
"I realized at end of the day that all of us are workers, no matter how elite we're perceived to be," said Dr. Alia Sharif, a colleague of Dr. Wust's at Allina who was heavily involved in the union campaign.
"我最终意识到，我们所有人都是工人，尽管外界以为我们是精英。"艾莉亚·谢里夫医生说，她是伍斯特医生在阿尼娜的同事，也深度参与了工会活动。
perceive v. 注意到；察觉到
【例】She perceived that he was tired.
她注意到他累了。
【辨析】conceive v. 构想；设想
【搭配】be perceived to be/as 被看作……
"We're seen as cogs in the wheel. You can be a physician or a factory worker, and you're treated exactly the same way by these large corporations."
"我们被当作轮子上的一个齿轮。你是医生还是工厂工人都没有区别，这些大公司会以同样的方式对待你。"
perceive v. 注意到；察觉到
【例】She perceived that he was tired.
她注意到他累了。
【辨析】conceive v. 构想；设想
【搭配】be perceived to be/as 被看作……
As a pharmacy intern and pharmacist at CVS in Massachusetts beginning in the late 1990s, Dr. Ed Smith found the stores consistently well staffed. He said pharmacists had time to develop relationships with patients.
从20世纪90年代末开始，埃德·史密斯医生就在马萨诸塞州CVS担任药房实习生和药剂师，当时他发现药店的工作人员配备一直很齐全。他说，当时药剂师还有时间与患者建立关系。
staff n. & v.
1. 作名词：（集合名词）全体职工
【例】a staff of ten 共十名职工
2. 作动词：配备人员
【例】The advice center is staffed entirely by volunteers.
在咨询中心工作的全部是志愿者。
【拓展】fully-staffed/over-staffed/short-staffed/understaffed adj.
人员配备齐全的/人浮于事的/人手不足的/人员不足的
well staffed and well equipped 兵强马壮的
Around 2004, he became a district manager in the Boston area, overseeing roughly 20 locations for the company. Dr. Smith said CVS executives were attentive to input from pharmacists -- raising pay for technicians if there was a shortage, or upgrading clunky software.
2004年左右，他成为波士顿地区的地区经理，负责公司大约20个地方的业务。史密斯说，CVS的高管很重视药剂师的意见，如果出现人员短缺，就会提高技术人员的工资，或者升级不灵敏的软件。
attentive adj. 专心的；认真的
【例】an attentive audience/worker 聚精会神的听众(或观众)/专心工作的人
【反义词】inattentive adj. 漫不经心的；注意力不集中的
rise v. & n.
1. 作动词：上升；增加
【例】The sun/price rises. 太阳升起。/价格上涨
【辨析】raise v. 使增加；提高
【例】to raise the price 提高价格
2. 作名词：崛起；兴起
【例】the rise and fall of the British Empire 大英帝国的兴衰
【辨析】rising/uprising n. 起义；叛乱
"Every decision was based on something that we said we needed," he recalled. Over time, however, consolidation and the rise of ever-larger health care corporations left workers with less influence.
"每一个决定都是基于我们的需求。"他回忆道。然而，渐渐地，企业开始合并，规模越来越大的医疗保健公司开始崛起，让工人的影响力变得越来越小。
attentive adj. 专心的；认真的
【例】an attentive audience/worker 聚精会神的听众(或观众)/专心工作的人
【反义词】inattentive adj. 漫不经心的；注意力不集中的
rise v. & n.
1. 作动词：上升；增加
【例】The sun/price rises. 太阳升起。/价格上涨
【辨析】raise v. 使增加；提高
【例】to raise the price 提高价格
2. 作名词：崛起；兴起
【例】the rise and fall of the British Empire 大英帝国的兴衰
【辨析】rising/uprising n. 起义；叛乱
As so-called pharmacy benefit managers, which negotiate discounts with pharmacies on behalf of insurers and employers, bought up rivals, retail giants like Walgreens and CVS made acquisitions as well, to avoid losing market power.
随着药房福利经理（代表保险公司和雇主与药房谈折扣）收购了许多竞争对手药房，沃尔格林和CVS等零售巨头也进行了收购，以避免失去市场支配力。
acquisition n.
1. 收购
【例】mergers and acquisitions 企业合并与收购
2. （知识、技能等的）获得，习得
【例】Education is not merely about the acquisition of knowledge.
教育不仅仅是习得知识。
【拓展】acquire v. 收购；获得
rein sth in/back 严格控制
【例】We need to rein back public spending.
我们需要严格控制公共开销。
【拓展】give sb free rein 给某人自由；对……不加约束
【例】The designer was given free rein.
设计者可以自由发挥。
The chains closed many of their newly owned locations, driving more customers to existing stores. They sought to cut costs, especially labor costs, as the benefit managers reined in drug prices.
这些连锁店关闭了许多新收购的药房，驱使更多顾客来到它们的现有门店。福利经理要控制药品价格，于是这些药房就努力削减成本，特别是劳动力成本。
acquisition n.
1. 收购
【例】mergers and acquisitions 企业合并与收购
2. （知识、技能等的）获得，习得
【例】Education is not merely about the acquisition of knowledge.
教育不仅仅是习得知识。
【拓展】acquire v. 收购；获得
rein sth in/back 严格控制
【例】We need to rein back public spending.
我们需要严格控制公共开销。
【拓展】give sb free rein 给某人自由；对……不加约束
【例】The designer was given free rein.
设计者可以自由发挥。
Around 2015, Dr. Smith stepped down from his role as a district manager and became a frontline pharmacist again, reluctant to supervise co-workers under conditions he considered subpar.
2015年左右，史密斯卸任地区经理的职务，再次成为一线药剂师，他不愿在他认为不合理的条件下去管理同事。
subpar adj. 平均标准以下的；不够标准的
【例】a subpar performance/subpar service in the hotel
表现不佳/酒店的服务不达标
【近义词】under par 达不到标准
【反义词】up to par 达到应有标准
Among his frustrations, he said, was the need to strictly limit the number of workers each pharmacy could schedule. "Every week that you're over your labor budget, you get a call, regardless of prescription volume, from your district manager," Dr. Smith said.
他说，让他失望的事情之一是他需要严格限制每家药店可以安排的工作人员数量。"只要你的劳动力预算超支，你每周就会接到地区经理打来的电话，不管我们那周开了多少药。"史密斯说。
subpar adj. 平均标准以下的；不够标准的
【例】a subpar performance/subpar service in the hotel
表现不佳/酒店的服务不达标
【近义词】under par 达不到标准
【反义词】up to par 达到应有标准
The pharmacists also described being held to increasingly strict performance metrics, such as how quickly they answered the phone, the portion of prescriptions that are filled for 90 days rather than 30 or 60 days (longer prescriptions mean more money up front) and calls made urging people to fill or pick up prescriptions.
史密斯还说他们被要求遵守越来越严格的绩效指标，比如接电话的速度、90天处方而非30天或60天处方的占比(疗程更长的处方意味着有更多的预付款)，以及为了催促人们完成疗程或取药而打了多少电话。
hold sb to sth 使某人受……约束
【例】hold him to his promise/contract
让他遵守诺言/让他履行合约
【拓展】hold sb prisoner/silent/responsible
监禁某人/让某人安静/让某人负责
metrics n. 指标（用于量化某过程或活动）
【例】metrics on the rate of usage for the service 服务使用率的指标
【辨析】index/scale/measure n. 指数/量表；等级/衡量单位
课后练习
Dr. Alia Sharif is troubled by ____.
A. the pressure of getting promoted
B. the complaints from subordinates
C. the disadvantaged position of medical workers
D. the repetition of meaningless tasks
According to Dr. Smith, CVS used to ____.
A. invest heavily in staff training
B. focus on providing quality service
C. allow pharmacists to make decisions
D. offer adequate support to pharmacists
The consolidation of pharmacies led to ____.
A. a pay rise for pharmacists
B. an increase of job opportunities
C. a loss of customers
D. a tighter labor budget
Dr. Smith is frustrated with ____.
A. the inflexible work schedule
B. the rigid management
C. the long working days
D. the declining profit