“钱那点事”
1.Doctors cut, burn, and torture the sick, and then demand of them an undeserved fee for such services.
—— Heraclitus, ?——513 BC
【译文】医生又是切，又是烙地折磨患者，还让患者为这种服务支付冤枉费用。
2.As long as men are liable to die and are desirous to live, a physician will be made fun of, but he will be well paid.
—— Jean de La Bruyère, 1645——1696
【译文】只要有人可能会死，并且还有活下去的意愿，医生就会被取笑。但医生还是能得到不错的报酬。
【点评】没办法，这就是医疗这个行业的特殊性。
3.Every man desires to acquire wealth in order that he may give it to the doctors, therefore they ought to be rich.
—— Leonardo da Vinci, 1452——1519
【译文】每个人都渴望获得财富，但是最后把它都交给了医生，因此，医生不可能差钱。
4.Know just this, a remuneration worthy of your labours, that is to say, a very good fee, makes for the authority of the physician and increases the confidence which the patient has in him, even if the physician be of great ignorance.
—— William of Salicet, 1210——1277
【译文】即使一个极其无知的医生，也应知道，只有与劳动付出相匹配的薪酬才是一份好的薪酬，才能造就医生的权威，增加患者对你的信心。
5.Surgical services have no fixed cost; they are without value in that they are invaluable.
—— Augustus Charles Bernays, 1854——1907
【译文】 外科服务没有固定标价，无价，因其价值无法估量。
6.Negative wallet biopsy is equal to operating on the non-insured.
【译文】所谓“钱包活检阴性”就是说给没有医疗保险的患者做手术。
7.Sometimes give your services for nothing … and if there be an opportunity of serving one who is a stranger in financial straits, give full assistance to all such.For where there is love of man, there is also love of the surgical art.
—— Hippocrates, 460——377 BC
【译文】有时你的服务是免费的……如果有机会为经济拮据的陌生人服务，请你全力相助。因为哪里有对人的爱，哪里就有外科艺术的爱。
8.Private patients, if they do not like me, can go elsewhere; but the poor devils in the hospital I am bound to take care of.
—— John Abernethy, 1764——1831
【译文】私人患者，如果他们不喜欢我，可以去别的地方；但医院里的那些可怜的患者我一定要照顾好。
9.The best patients are the poor because the Lord has taken it upon himself to pay me for them.
—— Herman Boerhaave, 1668——1738
【译文】最好的患者是穷人，因为上帝已经亲自为他们付给了我工钱。
10.He should give advice to the poor for sake of God, he should make the rich pay well if he can.
—— Henri de Mondeville, 1260——1320
【译文】看在上帝的份上，你应多帮助穷人，也应该让负担得起的富人多付一点。
11.He should help the poor according to whatever they are able to pay but should ask good reward from the rich.
—— Hieronymus Brunschwig, 1450——1512
【译文】你要依据穷人的支付能力为其提供帮助，但可向富人索取更丰厚的报酬。
【点评】可惜，现代医疗支付体系中，既不能多收一分，也不能少收一分。
12.Most medical men are amateurs at finance, and what is learned comes through bitter experience.
—— Harold Gillies, 1882——1960, & Ralph D.Millard, Jr.
【译文】大多数医务人员不懂财务，所学到的那一点东西全来自痛苦的经历。
13.A fashionable surgeon, like a pelican, can be recognized by the size of his bill.
—— J.Chalmers Da Costa, 1863——1933
【译文】账单的大小是识别外科医生是否风光的标志，就像可以通过嘴巴大小识别鹈鹕鸟一样。
【点评】账单大的外科医生一定风光，但风光的不一定富有。
14.You can be a very rich surgeon or a very good surgeon but rarely both.
【译文】你可以是一个很富有的外科医生，也可以是一个很优秀的外科医生，但很少能两者兼得。
【点评】现实不应该如此矛盾，如果现实果真如此，那一定是社会的错。
15.Mucho trabajo, poko dinero——much trouble, little money.
—— N.B.Pai, 1937——1999
【译文】操心多，报酬少。
【点评】这句话原文为西班牙语，看来西班牙医生和中国大陆医生有着相同的抱怨。
16.It is asking more than human perfection to assume that a surgeon's judgment may not be influenced unconsciously by pressing financial need.
—— Edwin P.Lehman, 1888——1954(https://www.daowen.com)
【译文】要求一名外科医生保持其判断力不会在无意识中受到其自身囊中羞涩的左右，这已超过了人类的完美。
【点评】按理这应该是一个成熟社会应提供给每一名外科医生的经济保障的底线。
17.Economic considerations sometimes motivate the physicians to accept that part of the scientific evidence that best supports the method that gives him the most money.
—— George Crile, Jr.1907——1992
【译文】 经济因素有时会促使医生选择性接受科学证据中最有利于他赚钱多的那一种方法。
【点评】为避免这种情形的发生，除了强化医生的职业操守之外，社会或政府也应保证给予医务人员合理的薪酬待遇。
18.Training, practice, and economic pressures can push the surgeons' thinking in the direction of more frequent, more radical, and more remunerative surgery.It is not that surgeons consciously decide to do an operation for economic reasons.The decision is more subtle, and is based on training and on habits of practice which through the years have been influenced by economic pressures, always in the same direction.If there is a question between operating or not operating, it is economically sound to operate.If it is a question of a big operation or a little one, it is better economically to do the big one.If it is a question of surgery versus radiation, it is surgery that gives the advantage to the surgeon.Finally, if it is a question of doing the operation oneself or referring the patient to a better-qualified specialist, it is obvious that there is little profit to be derived from referral.
—— George Crile, Jr, 1907——1992
【译文】培训、实践和经济压力可以促使外科医生的思维偏向于更频繁、更激进、更有利可图的外科手术。但也并非出于经济原因有意这样决定。这个决定比较微妙，而且是基于多年来受到经济压力影响所形成的一种训练和实践习惯，从未曾改变方向。当纠结于做与不做手术时，从经济上讲应该做；在选择做大手术还是小手术时，大手术在经济上更好；是采用手术抑或放射治疗时，那么手术更有利于外科医生。最后，在决定是自己做这手术还是将患者交给更合格的专科医生做时，显然，转诊的利润实在太少了。
【点评】文字虽有点长，却深刻描绘出了当下国内外外科医生的一种有意无意之中、或多或少的被商业利益所侵染的现状。
19.I am sure that one of the reasons why salaried physicians and surgeons are apt to be the first to adopt simplified methods of treatment is that unlike those in private practice, their income is not directly affected when the treatment is less costly.
—— George Crile, Jr, 1907——1992
【译文】我敢肯定，拿固定薪酬的内外科医生不会像私人医生那样，他们会倾向于优先采用简单疗法，理由是其收入不会受到少收费的直接影响。
20.Filled with idealism, students nowadays are plunged into a gaudy and greedy commercial world of corporate profit and personal wealth.They see the huge earnings of insurance companies, hospitals (even the "nonprofits"),administration and doctors.They are not blind to the million-dollar incomes of many physicians and surgeons today, shocking though they may be to us oldtimers.Everyone wants to make a buck out of the medical monster.That is why it costs so much to keep it alive.
—— Francis D.Moore, 1913——2001
【译文】如今，充满理想主义的学生们陷入了（追逐）企业利润和个人财富的浮华、贪婪的商业世界。眼中所见，尽是保险公司、医院（即使是“非营利的”）、政府管理部门和医生的巨额收入。他们目睹了如今许多内外科医生百万美元的收入，虽然这让我们这些过来人也深感震惊。每个人都想从这个医学怪兽身上赚一把，这就是为什么维持这个体系的正常运转要花那么多钱的症结之所在。
21.In using the term "success" I do not regard it synonymous with wealth.Some men are so busy making money that they have no time to study, to observe,or to think.A rich man who has not brought honor to his profession is not a real success.
—— J.Chalmers Da Costa, 1863——1933
【译文】说到“成功”这个词时，我并不认为它等同于财富。有些忙着挣钱的人，连学习、观察或思考的时间都没有。一个没有给自己职业生涯带来荣誉的富豪不是真正的成功者。
22.He shall also not for the sake of money, undertake the impossible that may do him harm or give him a poor reputation.
—— Hans von Gersdorff, 1480——1540
【译文】医生不得为了金钱去做可能伤害自身或给自身带来污名的事。
【点评】君子爱财，取之有道。
23.Commercialism in medicine never leads to true satisfaction, and to maintain our self-respect is more precious than gold.
—— William J.Mayo, 1861——1939
【译文】医学的商业化从来不会带来真正的满足感。保持自尊比黄金更珍贵。
24.Commercialism and professionalism are parallel streams in our society that can coexist in peace.When they start to get mixed with each other, beware.
—— Francis D.Moore, 1913——2001
【译文】我们的社会中，商业化和专业精神泾渭分流，当两者开始互相混淆时，要当心。
【点评】当今医疗领域里许多恶行的根源就在于两者的含糊不清。
25.Don't let cost-containment become care-containment
—— Leo A.Gordon
【译文】不要让成本控制变为关爱控制。
【点评】在当下医疗费用总体控制的大背景下，应警惕这一情形的发生。
26.The hospital is like a shopping mall.
—— P.O.Nystrom
【译文】（当今）医院就像一个大商场。
27.Great hospitals do two things.They look after patients, and they teach young doctors.We look after clients, and we teach young advertising people.
—— David Ogilvy
【译文】（现在的）大医院只做两件事。他们照顾患者，培养年轻医生。我们照顾客户，培养年轻的广告人。
28.We are known to the world as a nation of dollar chasers where nearly everything that should control the right of living is sacrificed to the Moloch of money.
—— C.W.Oviatt
【译文】众所周知，这是一个追逐金钱的国度，几乎一切控制生存权的东西都牺牲在金钱这个魔掌中。
【点评】面对生死，如何跳出金钱这个魔掌，是全世界各国都在为之努力的目标。
29.De dinero y bondad, siempre la mitad （西班牙语）—— of money and goodness, always in the middle.
—— Eric Oliverd
【译文】金钱和善良，我们始终在两者之间。
【点评】这就是医疗服务业所独有的双重性。作为一个经济实体，它需要钱维持日常运作和发展进步；而面对以解除痛苦、恢复健康为目的而来的患者，最好是分文不取、普救众生。因此，身处第一线的每一位医疗工作者总在金钱与善良之间徘徊。