ЛЕКСИКА: utility bill - оплата коммунальных услуг catchment area - участок, прикреплённый к GP to ban charges referral letter non urgent (operation) make an appointment -записаться к врачу NHS walk-in-service - дежурная часть (24/7) Minor injuries unit - травмпункт NHS-111 - номер телефона 112 / 911 (offer free telephone support when you need medical help fast) 10) Major diseases - серьезные болезни 1) 2) 3) 4) 5) 6) 7) 8) 9) MEDICAL EXAMINATON ● blood pressure (take, check) ● blood / urine test ● (do, take, have ~ done / taken) ● diagnose the case / ~smb with smth ● go through / undergo / have a medical- пройти медицинское обследование ● (check-up / examination) ● heartbeat (check)- сердцебиение (проверить) ● make a diagnosis - поставить диагноз ● make an appointment with- записаться на прием ● make / write out a prescription for ● prescribe (medication for) ● pulse (feel, take, check) ● put smb / be on the sick-list - на больничном ● refer to a specialist- отправить к срециалисту ● temperature (take) ● listen to / sound the heart / lungs ● look at the tongue ● write a request for an X-ray / a test / a scan TREATMENT ● a cavity (fill, stop) ● a drip (set up, put on) - капельница (устанавливать, ставить) ● a medicine / an ointment / a pill for-лекарство / мазь / таблетка для ● the headache / the itch - головная боль / зуд ● a medicine / pill / tablet / lozenge / - лекарство / таблетка / таблетка / пастилка ● mixture (take, swallow) - микстура (принимать, глотать) ● a mixture (gargle- полоскание) ● a surgery (do, have) ● acupuncture / hypnosis - иглоукалывание / гипноз ● (have a session of) ● an injection (give, have) - инъекция (вводить, делать) ● an ointment ( rub on, apply to)- мазь (натирать, наносить на) ● an operation (perform, have) ● chemotherapy (give, do)- химиотерапия (проводить, делать) ● inhale medicine / steam - вдыхать лекарственные препараты / пар ● inoculate / vaccinate against - прививать / вакцинировать от ● keep to a diet - придерживаться диеты ● keep to bed - соблюдать постельный режим ● remove (a tooth, tonsils)- удалять (зуб, гланды) ● replace with an implant - замена на имплантат ● take a painkiller / a sedative / a tranquilizer / an antibiotic an ● anaesthetic (local / general, give, under) SYMPTOMS ● ache all over - боль во всём теле ● backache - боль в спине ● bring up (food, wind) ● constipation - запор ● develop symptoms ● diarrhea ● dizziness ● drowsiness ● earache ● eyes (watery, sore, itchy) ● fatigue - усталость ● fever ● have a cough (dry, wet, hawking) ● have a pain ● have a rash ● headache ● heartburn- изжога ● indigestion ● inflammation- воспаление ● insomnia (sleeplessness)- инсомния (бессонница) ● itch - зуд ● nausea - тошнота ● nose (blocked up, runny, stuffy) ● run a high temperature ● sneeze ● stomach ache ● suffer from ● throat (itchy, sore) ● throw up - блевать ● toothache ● twinge - судорога THE HUMAN BODY The human body is fantastic and it has many parts. There is a skeleton of 208 bones more than 600 muscles which make up 35-45% of the body's total weight, a blood system containing between 9 and 12 pints of blood operated by a heart which during a lifetime does enough work to have lifted a ton weight 150 miles up into the air; a nervous system dominated by a brain which makes the biggest computer look like a child's toy; a pair of lungs which handles 500 cubic feet of air a day; a cooling system to stop us from getting too hot which has between 2 and 3 million sweat glands; a feeding system which can handle about 50 tons of food in an average lifetime ( not to mention a 25-foot long alimentary canal); a reproductive system that has all too successfully populated today's world which is more than 4,000 million human beings; an excretory system with kidneys capable of filtering 45 gallons of fluid a day; and a 17-square feet of skin to cover everything, and, as one doctor puts it, " to keep the blood in and the rain out." This is the body, an extraordinary piece of machinery that we have taken to the depths of the ocean and up to the moon. It is the animal which has invented language, art, science, sports, architecture, politics, and religion. It has conquered the world and may yet destroy it. HEALTH CARE Most health care in Britain is provided by the National Health Service (NHS), which was introduced in 1948 to provide free medical treatment for all who need it. Most of the cost of the service is paid from the taxes the government collects, but a small percentage comes from direct charges and the National Insurance contributions paid by everybody in employment. The NНS provides а rаngе of services which include GP services, hospital services, еmеrgеnсу саrе (known as Accident & Еmеrgепсу оr А&Е), mental health, sехuаl health and social саrе, all of which are completely frее. People register as patients of a family doctor, called a general practitioner (GP), and when they are ill it is the GP who makes a diagnosis and decides on the treatment necessary or refers the patient to a specialist doctor in a hospital. GPs usually work in a group practice and see patients at a surgery or health centre. When medicine is needed, the doctor writes out a prescription which the patient then takes to a chemist’s (that is, a pharmacy, but this latter word is used only by medical professionals). There is a charge for each item prescribed, which is always the same regardless of its real cost. However, so many categories of people (e.g. pensioners, expectant and nursing mothers) are exempt that only around half of all the people who are prescribed medicine actually pay for it. The Secretary of State for Health, a Cabinet minister, is responsible for the NHS budget. The service is administered at the local level by District Health Authorities (DHA), which are in turn responsible to the Regional Health Authorities (RHA). Most doctors and dentists also have private patients, i.e. people who pay for their treatment. NHS hospitals have facilities for private patients and there are also private hospitals owned by health insurance companies. An increasing number of people pay for private health insurance, partly as a way of avoiding the National Health waiting lists for non-urgent operations. Many employers pay for private health insurance for their employees. Most people in Britain consider the establishment of the NHS, which turned 70 in 2018, to be the country’s greatest achievement. But it is a very different thing now compared with what it was in the past. It is not just the illnesses, facilities, technologies and demographics that are different, but the service’s very purpose. When the NHS was founded it was intended to keep the workforce healthy, reduce premature death and allow a dignified end for everyone. Now the NHS has a much broader scope with a focus on prolonging life almost irrespective of quality. The catch-22 (загвоздка) is that improving people’s health generally prolongs their lives, putting more pressure on the NHS – it costs five times more to look after an 80-year-old than a 30-year-old. Numbers of over-75s and over-85s are due to soar over the next decade, and pressures will only increase. NHS SYSTEM Health care in England is provided by the National Health Service, known as NHS and provides treatment for all residents through a wide range of health care services. Health care is provided by the British government and is paid for through taxes. As you will see later, most services are free but some are paid for in NHS rates. ● When you move to England you will qualify for NHS treatment from the day you arrive, as long as you intend and are entitled to live here permanently. As a rule of thumb, this typically means you will be here for at least six months and your passport allows you to stay here for at least one year without any restrictions. This also applies to family living with you permanently, such as your partner, children under 16 or children under 19 of studying full-time. ● Registering with the NHS is easy: ○ you will be given your NHS number when you register with a GP practice. ○ Simply visit a GP practice near your home and complete and submit their forms. You will need proof of identity, such as your passport and a proof of address, like a recent utility bill. ○ You will then receive your NHS medical card and number by post. ● You can change your GP practice at any time: ○ simply repeat the first two steps at the GP practice you would like to join and if you're accepted, ○ your medical records will automatically be transferred to your new practice. ★ In some cases, you may be unable to register with a GP practice. This may happen if you are not eligible to receive health care in England, the practice is not accepting new patients or you live outside the area covered by the practice. This is because most GPS are quite strict about their practice boundary. ● However, some GP practices now participate in a patient choice scheme which gives you the right to register somewhere more convenient for you. This means even though you live here some practices allow you to register somewhere near your workplace. ● When receiving care from the NHS, it's important to know that your first point of contact is a primary care provider. This means day to day providers, such as general practitioners, dentists and ophthalmic practitioners, are always your first point of contact for non-urgent health care. Primary care providers refer you to secondary care providers, who are made up of specialists. If you need to see a specialist, you will need to see your GP, dentist or ophthalmic practitioner first and only they will decide if you need to see a specialist in a particular field such as a surgeon, dermatologist, or cardiologist. A specialist will only see you with a referral letter. So your doctor will write a patient referral letter on your behalf which will include your medical history and background. In England you have the right to start treatment with a specialist within 18 weeks from when your GP dentist or other health care professional refers you. The right to treatment within 18 weeks from referral excludes maternity services and some mental health services. The NHS provides a range of services which include GP services, hospital services, emergency care, known as accident and emergency or A&E, mental health, sexual health and social care, all of which are completely free. The NHS also provides dental services, eye care and prescriptions and pharmacy which are paid for services, based on costs and ban charges set by the NHS. A number of people are entitled to free prescriptions, dental treatments and eye tests, depending on eligibility. You can find out if you qualify for free services on the NHS website. For urgent assistance the official emergency telephone number in the UK is 999 which is equivalent to 911 in some other countries. When you need urgent care, there are a number of NHS services you can use, other than hospitals and A&E departments. The first are NHS walk-in centres, which are convenient as they do not require an appointment and most are open every day of the year and outside office hours. They do not deal with long term or life-threatening emergencies. GP and dentist out-of-hours is available outside normal practice hours, normally from 6:30 p.m. to 8:00 a.m. on weekdays and all day on weekends and bank holidays. You will usually be directed to the out of hour service, when you call in. Minor injuries units offer assessment and treatment for minor injuries, such as sprains and strains. And lastly, NHS one-one-one offers free telephone support, when you need medical help fast, but it's not a 999 emergency. NHS one-one-one is available 24 hours a day 365 days a year. The Care Quality Commission are an independent regulator who inspect the level of safety and quality of all health and social care providers. You can find all of their inspection reports online you A DOCTOR’S VIEW (inequality of the system) I think patients are constantly being told, if they’re unhappy with the medical care that they’re receiving from their doctors that then they’re to vote with their feet and move on to a different practice. I think this is all right in theory, but 1 think it’s quite difficult in a small valley environment or in a rural environment. In the inner cities, where there are lots of practices to choose from, it might be easier to choose a different doctor if you’re unhappy with the service that’s being delivered. In London obviously there are plenty of hospitals. Waiting lists are short. Any patient with a problem can be quickly referred by the General Practitioner. And the General Practitioner also has a choice of places to which he can refer a patient. If he’s aware that one hospital offers a better service than another for a certain condition, then obviously the patient can be referred there and generally speaking the waiting lists are short. But of course out of London, away from the larger cities, this isn’t the case and patients may end up waiting a year or two years for a hospital appointment and then may not still be guaranteed the quality of service that they would have received at one of the larger hospitals. If a patient has no alternative other than to rely on the National Health Service, he or she may be referred to a hospital clinic and have to wait at least a year to be seen at an outpatient clinic. She cannot ask to be seen by a specific doctor and after waiting maybe two or three hours in a crowded waiting room, will be seen by maybe a junior member of staff. I think it’s sad that undoubtedly there are certain places, certain hospitals that are going to be more attractive places for doctors to work. In certain places in South Wales they’re desperately short of medical staff. And however much money is pumped into the NHS, these places are not going to become any more attractive. So there’ll always be this inequality of service. I think for some, there’ll always be a second-class medical service, unfortunately. But if you do pay for your medicine, then you also have to travel for your medicine. I think one of the advantages in paying for your medicine is that you can actually pay for the consultant, you choose your doctor, you choose the time of your consultation, and I think you, because you’re paying, I think it’s a quirk (причуда) really of human nature, because you pay for something, you feel you’re getting the best and psychologically I think you feel better as the result of a private consultation. Although maybe the service that you ultimately receive is no better than the service you might have received as an NHS patient. But there’s some satisfaction in that you’ve made the choice, you’ve gone along and you’ve paid your money. At the end of the day you may well, or generally do, feel better for it. But often you have to travel for your private medicine. Private medicine is not on the doorstep. And that's another strange thing, I think. Patients are prepared to travel for private medicine, and don't moan and groan about that. But already I think we're hearing moans about patients at the prospect of patients having to travel for NHS medicine. When you are ill in Britain, you normally go to your GP in a small practice near your home. You are registered with that practice, or team of doctors, and they keep your medical history / record. Each GP has about 2,000 people on the books. If you suffer from a lot of illness (or are a hypochondriac) your own doctor will know you personally. If you need medical care from, for example, a dermatologist, an ophthalmologist or an obstetrician, the GP will refer you to a hospital. All specialists work in hospitals, and you cannot see them without a referral (letter) from your GP. The advantage of this arrangement is that the specialist’s time is not wasted by inappropriate inquiries, as the GP acts as a sort of gatekeeper. Also the patient does not have to make difficult decisions about which specialist to go to. GPs are able to deal with the great majority of problems themselves; if you have a cold, you do not need an ear-nose-and-throat specialist to tell you to go home and keep warm. And GPs are more likely to take a holistic (целостный, во всей красе) approach, having knowledge of the patient’s character and lifestyle. HUMAN BODY SYSTEM The human body is fantastic and it has many parts; there is a skeleton of 208 bones; more than 600 muscles which make up 35–45 per cent of the body’s total weight; a blood system containing between 9 and 12 pints (4,25-5,67 литров) of blood, operated by a heart which during a lifetime does enough work to have lifted a ton weight 150 miles (241 км) up into the air; a nervous system dominated by a brain which makes the biggest computer look like a child’s toy, a pair of lungs which handle 500 cubic feet (14 м3) of air a day; a cooling system to stop us getting too hot which has between two and three million sweat glands; a feeding system which can handle about 50 tons of food in an average lifetime (not to mention a 25-foot-long (7,62 м) alimentary canal); a reproductive system that has all too successfully populated today’s world with more than 4,000 million human beings; an excretory system with kidneys capable of filtering 45 gallons of fluid a day; and 17 square feet (1,57 м2) of skin to cover everything and, as one doctor put it, “to keep the blood in and the rain out.” This is the body, an extraordinary piece of machinery that we have taken to the depths of the ocean and up to the moon. It is the animal which has invented language, art, science, sport, architecture, politics and religion. It has conquered the world and may yet destroy it. 1. Integumentary System (Покровная система) a. dermatitis - дерматит /ˌdɜː.məˈtaɪ.təs/ b. eczema - экзема /ˈek.sɪ.mə/ 2. Skeletal System (Скелет человека) a. osteoporosis - остеопороз /ˌɒs.ti.əʊ.pəˈrəʊ.sɪs/ b. scoliosis - сколиоз /ˌskɒl.iˈəʊ.sɪs/ 3. Muscular System (Мышечная система) a. arthritis - артрит /ɑːˈθraɪ.tɪs/ 4. Nervous System (Нервная система) a. schizophrenia - шизофрения /ˌskɪt.səˈfriː.ni.ə/ b. depression - депрессия /dɪˈpreʃ.ən/ 5. Endocrine System (Эндокринная система) a. obesity - ожирение /əʊˈbiː.sə.ti/ b. diabetes - диабет /ˌdaɪ.əˈbiː.tiːz/ 6. Cardiovascular System (Циркуляторная/ Кровеносная система) a. obesity - ожирение /əʊˈbiː.sə.ti/ b. angina - стенокардия /ænˈdʒaɪ.nə/ c. leukaemia - лейкемия /luːˈkiː.mi.ə/ d. anaemia - анемия /əˈniː.mi.ə/ e. haemorrhage - кровотечение /ˈhem.ər.ɪdʒ/ 7. Lymphatic System (Лимфатическая система) a. 8. Respiratory System (Дыхательная система) a. bronchitis - бронхит /brɒŋˈkaɪ.tɪs/ b. pneumonia - пневмония /njuːˈməʊ.ni.ə/ 9. Digestive System (Пищеварительная система) a. indigestion - несварение желудка /ˌɪn.dɪˈdʒes.tʃən/ b. gastritis - гастрит /ɡæsˈtraɪ.tɪs/ c. dysentery - дизентерия /ˈdɪs.ən.tər.i/ 10. Urinary (excretory) System (Мочевыделительная система) a. pyelonephritis - пиелонефрит 11. Reproductive System (Репродуктивная система) a. infertility - бесплодие /ˌɪn.fəˈtɪl.ə.ti/ b. haemorrhage - кровотечение /ˈhem.ər.ɪdʒ/ US HEALTH SYSTEM ● Unlike the UK, the US does not have a national healthcare service. Medicine in America is basically all private. It means that you must foot the whole bill and choose your own doctor — a general practitioner. ● A private doctor, or a family doctor, gives his patients regular examinations and inoculations.In case professional care is needed, the family doctor arranges for the patient to see a specialist or to go to a hospital. The family doctor receives pay directly from the patient. They make use of the hospital’s facilities whenever necessary. A family doctor either has his own private office or works with several other doctors in a so-called group practice. ● Children are usually taken to paediatricians. ● When you have to pay for medical care out of your own pocket the psychology of the patient is different. First of all, this effects Americans’ attitude towards their health: ○ it’s better to eat right and exercise to stay healthy than to pay a doctor. And if you get sick you tend to try to cure yourself if possible before going to a doctor. ○ Most Americans do not go to a doctor for a cold. ○ And even if you get a temperature you try just to bring it down with aspirin. ○ Only when it’s evident something is seriously wrong you do see a doctor. ● The doctors often complain that if the patients had come to them sooner it wouldn’t have been so expensive to cure them. Now there are HMOs (Health Maintenance Organizations) where you pay a set fee every year and can go to the doctor as many times as you want, and it is thought that they may help cope with this situation. ● Many Americans have no family doctor and they come directly to the hospital for all their medical needs. The hospital provides health care to the sick and injured. There are government-financed and private hospitals. ● The patients are admitted to hospitals or clinics staffed by consulting physicians, residents, interns and highly skilled nurses. ● Most hospitals have at least the following major departments or units: surgery, obstetrics and gynaecology, pediatrics and general medicine. They may also have trauma and intensive care units, neurosurgical and renal care units, and a psychiatric unit. ● The Emergency Room (unit) is a very special area in the hospital. The emergency patients receive immediate attention. ● Two thirds of the population have private health insurance. The great cost of medical care in the country and the great number of people who could not pay for it forced the federal government to develop two health insurance programs – Medicaid and Medicare. ○ Medicaid, provides free medical care for low-income people, the aged, the blind and for dependent children (иждевенцы). ○ Medicare is a federal program providing free medical care for aged Americans over 65, for those who in the past had the greatest medical expenses. ● Still there are a lot of Americans who cannot afford insurance but are not poor enough to qualify for government support. In 2010 the Affordable Care Act (ACA), also known as Obamacare, was signed into law to help such people. SUMMARY Just as high education is not free in America, neither is medical care. This makes a big difference in the way the doctor treats the patients and the patient’s attitude toward their health. No one wants to get sick and Americans try very hard to stay healthy. Sometimes, though, they do get sick and need medical care. They have to take sick leave (больничный) and, if it’s something serious, go to a doctor. The doctor must cure patients or they won’t return. Because this is a big demand and doctors have to go through a lot of training, they charge a lot. So Americans try to take care of themselves by eating right and exercising rather than having to pay a big doctor’s bill. Even when you get sick in America you probably won’t go to a doctor right away. As a result you sometimes get very sick and the doctor’s bill may be so high you can’t pay it. That’s why it’s a good idea to take out health insurance with an insurance company. INSURANCE 1. If you want to see a doctor in America, you have to make an appointment. 2. So you choose one doctor and keep going to him when you get ill and for check-ups. 3. When you go to see a doctor he may take some tests, like a blood test, and prescribe some medicine. 4. Before leaving the office you must pay the bill for seeing the doctor. 5. The laboratory sends you the bill for the test. 6. You pay for the medicine at the drugstore when you get the prescription filled. 7. Since most Americans worry about how they will pay if they get really sick they take out insurance. 8. Insurance only covers some of the hospital bills / treatment, it does not cover visits to the doctor. 9. It doesn’t usually cover the cost of medicine or tests either. 10. If you want to know exactly what the insurance you have covers you must read your policy. 11. The insurance policies (полис мед страхования) differ depending on what company it is and how much you pay for it. ● ● ● ● ● PAIN TYPES I feel faint (упаду в обморок), sore, weak, giddy (кружится голова), nauseous (тошнит) I've got a blinding (окулярная мигрень), pounding (пульсирующая), thumping (сильная пульсирующая) headache. My leg feels numb (онемела), itchy (чешется), stiff (болит, когда двигаешь), sore (болит). My sight is blurry (размыто), double (двоится), unclear (размыто). I've got an itchy (першит), sore (болит) throat. ● He's got a tickly (щекочущий), chesty (вызванный легочной инфекцией), weak, hacking (сильный, неприятный на слух) cough. 1. The England football captain has pain his ankle, and won’t be playing in next week’s international against Belgium. 2. The soldier had a bullet injured in his thigh. 3 I have a terrible pain in my chest. When I cough, it really hurts. 4. Two people died and ten were injured in a train crash yesterday. 5. I played tennis for the first time this year yesterday. Today my whole body aches. 6. Two football fans were seriously wounded in a knife attack by rival fans earlier today. Three men are helping police with their inquiries. 7. Please don’t touch my ankle. It’s too painful / sore to move. 8. Doctor: I want to feel your bones. If it hurts, tell me and I’ll stop. 9. My feet are sore with all that walking. ПОХОД КО ВРАЧУ I have felt far from well lately. I only reached the age of 20, and right after I started feeling worse. From time to time various terrible pains started occurring to me, moreover, I banged my head by accident so I felt dizzy for some time. I was shivering constantly. I decided to turn to a qualified specialist for help rather than do any kind of self-treatment. I had already been registered as a patient at the local GP-practice in my hometown so I just had to make an appointment with a General Practitioner. I queued up for two hours and finally entered his surgery. During this time I felt nauseous and weak. I had a pounding headache and at one point my sight was blurry. The doctor gave me a look and figured out that my condition was beyond bad. He asked me whether I felt unwell. I started telling him about the wide variety of aches and sores I went through over the past weeks. I had terrible backache and felt sharp pain in the chest which expressed itself through sudden pangs. There was not a single limb that wasn't sore and it was a tough challenge to move at all. But it was not the end of the list. Sometimes I would feel nauseous and at the same time I would have an attack of diarrhea. It was unpredictable, you could never prevent it. No stomachache would preceed it. I tried swallowing different medicine throughout the day before and after the food, after the waking and before going to sleep but nothing helped. I never mentioned it but it was difficult to miss that I was coughing constantly. It was a hacking cough and obviously a chesty one. The recent head injury was a cherry on the cake. The first symptoms of my terrible condition started showing up when I was riding a bicycle. At a certain moment I felt giddy, my eyesight became double and blurry and I fell off the bike, then banged my head on the ground. Since then I've had occasional pounding headaches. I made a conclusion: I simply ache all over. I felt more dead than alive. Then the doctor felt my pulse, took temperature, measured my blood pressure, listened to my lungs and checked my throat. At least my glands were not swollen, for that I was thankful. It was definitely too early to make any conclusion, and my case demanded a holistic approach. But the doctor stated right away that the site of my disease was located in the lungs. As for my headaches, it was simply a concussion. The doctor supposed that it was lung cancer or tuberculosis, and the second one was more likely. The metastases had spread over the neighbouring organs which caused the problems with my digestive system. We were short on time so he did not refer me to the other specialists. The only way was to send me to a hospital treatment right away. There I had to go through a medical check-up which included taking different tests like blood and urine tests, X-Rays and much more. The doctor also wrote out prescription painkillers to soften my overall ache. ДОКТОРА И ИХ ОБЯЗАННОСТИ ● Paediatrician - a doctor who has special training in medical care for children ● Gynaecologist - a doctor skilled in the treatment of women's diseases, especially those of the reproductive organs ● Psychiatrist - a doctor who is also trained in psychiatry (mental health) ● Neurologist - a doctor who studies and treats diseases of the nerves ● Allergist - treats allergies. asthma and people who are allergic to smth ● Physiotherapist - someone who treats people using physiotherapy ● Homeopath - an alternative medicine based on the theory of treating 'like with like' with natural ingredients and plants (organic) ● Acupuncturist - a person who is trained to do acupuncture (= a treatment for pain or illness using thin needles put into the skin in particular places around the body): ● Anaesthetist - a doctor who gives anaesthetic to people in hospital ● Urologist - a doctor who specializes in treating diseases of the parts of the body that produce and carry urine ● Speech therapist - someone whose job is to treat people who have difficulty speaking: ● Chiropractor - a person who treats diseases by pressing a person's joints (= places where two bones are connected), especially those in the back ● Psychoanalyst - a person who examines or treats people using psychoanalysis (= a mental health treatment that works by trying to examine the unconscious mind): ● Occupational therapist - someone whose job is to treat physical or mental illness (caused by occupation) by giving patients activities and helping them do things they want or need to do ● Traumatologist - orthopedic surgeon who specializes in the treatment of both simple and complex fractures, as well as wounds and injuries caused by accidents or sudden violence.