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Reputation is a fragile and valuable commodity, as valuable to the clinician as his or her education or certification.
名誉既贵重又脆弱，对临床医生来说同教育和证书一样珍贵。
All health care professionals have a reputation, and it works either for or against them in achieving their patient care and professional goals.
所有医护工作者都有声誉，它既可以帮助医生治病救人，实现职业梦想，也可以让这一切毁于一旦。
Careful adherence to professional behavior in dress, speech, manners, and conflict resolution will create the most advantageous professional reputation for the surgeon.
在穿着，言谈举止，解决纠纷上恪守职业规范，这对于外科医生“扬名”极为有利。
With a positive reputation, the surgeon's behavior in ambiguous situations will be interpreted in a benevolent way.
由于有了好名声，当情况模糊不定时，人们对医生的所作所为也就有了更加积极的定义。
SYSTEMS-BASED PRACTICE
以系统为基础的实践
Systems-based practice is one of the core competencies defined by the ACGME as a necessary skill to be developed by graduate medical trainees.
美国毕业后医学教育认证委员会将“系统基础实践”定义为毕业生必须要掌握的核心技能。
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal care.
住院医生要有集体观念，对医院和整个医疗系统负责，善于运用系统资源为患者提供最佳的健康护理。
The process of teaching and learning systems-based practice has been in place for many years.
对于“系统基础实践”的讲授和学习已持续多年。
It is what might be considered the practical part of graduate medical training.
人们把它看成是毕业生实习的实践科目。
However, only fairly recently has it become a focus and metric for performance by training programs.
然而，直到最近实习项目才把它看成是衡量表现的重点。
As a part of training, then, residents must learn how different types of medical practice and health care delivery systems differ from one another, including methods for controlling health care costs and allocating resources.
作为培训的一部分，住院医必须要对各种医疗实践，医疗服务体系加以区分，包括控制医疗费用，分派资源等。
They must use this knowledge to practice cost-effective health care and resource allocation that limits the compromise of quality of care.
通过对知识的掌握，住院医需要执行成本划算的医疗服务，以及影响医疗质量的资源配置。
They must advocate for quality patient care and assist patients in dealing with complexities of the health care delivery system.
呼吁医院对病人提供优越的救治服务，因医疗服务体系过于庞杂，他们需要对病患提供帮助。
They must also understand how to work with health care managers and other collaborating health care providers to assess, coordinate, and improve health care for patients.
他们还需要懂得如何与医疗体系负责人，医疗协助人员进行合作，评估，改善医疗服务。
The role of the resident in identifying both the health care needs of the patient and the capability of the system to meet those needs is well established.
对于住院医来讲，在明确病患医疗需求，以及医疗系统是否能够满足需求上做得非常完善。
Surgery residents in their senior years are often important resources for hospital systems because they understand how to manipulate the system to meet the needs of the patient.
通常，高年级外科住院医总是医院系统的“顶梁柱”，因为他们知道如何为满足病患需求而对系统进行调配。
Medical students and surgical trainees must also recognize their role as a part of these complex systems.
不论是学院学生还是外科实习生，他们都应该认识到自己在庞杂系统中所发挥的作用。
译文属可可英语原创，未经允许，不得转载。
