絕密★啟用前

上海普通高等招生統(tǒng)一考試

英語試卷

（滿分150分，考試時間120分鐘）

考生注意：

答題前，務必在答題紙上填寫準考證號和姓名，并將核對后的條形碼貼在指定的位置上，在答

題紙反面清楚地填寫自己的姓名。

1.ListeningComprehension

Directions:InSectionA,youwillheartenshortconversationsbetweentwospeaks.Attheendof

eachconversation,aquestionwillbeaskedaboutwhatwassaid.Theconversationsandthe

questionswillbespokenonlyonce.Afteryouhearaconversationandaquestionaboutit,readthe

fourpossibleanswersonyourpaper,anddecidewhichoneisthebestanswertothequestionyou

haveheard.

1.A.Herworkingalldaylong.B.Thefamilyreunion.

C.Theannoyinghousework.D.Theintenseschedule.

2.A.Thekidswerefrightenedbythemovie.B.Thekidsenjoyedthemovie.

C.Themovieisnotsuitableforkidstosee.D.Themovieisquiteboring.

3.A.Sheisdrinkingteaatatable.B.Sheisinterestedinreadingmagazines.

C.Shelikesthepicturesinthemagazines.D.Shedoesn'tknowanyChinese.

4.A.Supermarket.B.Drugstore.

C.Barbershop.D.Shoppingcenter.

5.A.Helikescookingfoodhimself.B.Hethinksfrozenfoodishealthier.

C.Heacceptsthewoman'sinvitation.D.Hepreferstobuyfrozenfood.

6.A.Afull-timestudent.B.Anexchangestudent.

C.Avisitingscholar.D.Apart-timestudent.

7.A.Sheisbossy.B.Sheisshy.

C.Sheisarrogant（傲慢的）.D.Sheistrustworthy.

8.A.He'sateacher.B.He'sawriter.

C.He*sabusinessman.D.He'sajournalist.

9.A.1hour.B.2hours.C.3hours.D.4hours.

10.A.Thebadweatherstoppedhim.B.Hisshoeswerewornout.

C.Hedidn'tlikethebikingtrip.D.He'stootiredtocontinue.

SectionB

Directions:InSectionB,youwillheartwoshortpassagesandonelongerconversation.After

eachpassageorconversation,youwillbeaskedseveralquestion.Thepassagesandconversation

willbereadtwice,butthequestionwillbespokenonlyonce.Whenyouhearaquestion,readthe

fourpossibleanswersonyourpaperanddecidewhichoneisthebestanswertothequestionyou

haveheard.

Question11through13arebasedonthefollowingpassage.

11.A.Theybecamemoreactiveinwater.B.Symptomsofdepressiondisappeared.

C.Theirdigestiondeveloped.D.Theysufferedfromdepression.

12.A.Neonlights.B.Kindlescreens.

C.Overweight.D.Closedwindowcurtains.

13.A.Turnoffalltheelectronicdevices.B.Readabookanddrinksomewater.

C.Takesomesleeppills.D.Goonadietandlosesomeweight.

Questions14through16arebasedonthefollowingpassage.

14.A.71%ofthepoorliveadaywithlessthantendollars.

B.Thepopulationofpeopleliveinpovertyhasdecreasedinthepastdecade.

C.Economicgrowthhasmadeglobalpovertyworsethanbefore.

D.Themiddleclassarenowonestepawayfrompoverty.

15.A.Themiddleclasshasexpandedinthe111countries.

B.Thenumberofmiddleclasshasincreasedbutitisnotaglobalphenomenon.

C.Greatprogresshasbeenmadeforthepeopleinpovertywithimpressiveresults.

D.Oncegettingoutofpoverty,thosepeoplewillliveabetterlife.

16.A.Themiddleclasswouldnotallowthosepoortomakeabetterliving.

B.Whateverprogressismade,nothingwillbechanged.

C.Goodchangesaretootinytomakethosepoorliveatotallydifferentlife.

D.Developedcountriessufferfromthequestionfrombothpovertyandthemiddleclass.

Questions17through20arebasedonthefollowingconversation.

17.A.Athunderstormaccident.B.Acableemergency.

C.AnappointmentonSaturday.D.Acomputersystembreakdown.

18.A.Lightning.B.Powerfailure.

C.Cablecut.D.Systemfailure.

19.A.PlugtheTVoff.B.Keepthecableconnected.

C.Stayathome.D.Callthecablecenterforsure.

20.A.OnSaturdaymorning.B.OnSaturdayafternoon.

C.OnTuesdaymorning.D.OnTuesdayafternoon.

II.GrammarandVocabulary

SectionA

Directions:Afterreadingthepassagesbelow,fillintheblankstomake.thepassagescoherent

andgrammaticallycorrect.Fortheblankswithagivenword,fillineachblankwiththeproper

formofthegivenword;fortheotherblanks,useonewordthatbestfitseachblank.

MyKid-FreeLife

Ihadexpectedtohavemorefreetimeaftermysons,EvanandAlex,eachleftforcollegeand

Ido.Thekitchencalendarlooksspare.Rarely(21)Ineedtopreparefamilydinner

everyday.Thereisalot(22)(little)laundry.

Whentheboyswereinfants,IwonderedhowI(23)(spend)allthehoursbefore

theywerebom.(24)Ihavethosehoursback,Icanfocusonmyownneeds.

Ihadalsoexpectedtoworryaboutthemwhentheywereaway.AndIdo.Didtheygettheir

flushots(流感疫苗注射)？Willtheyrememberthetalksabout€4goodchoices"?Ontheother

hand,theworryismixedwithrelief.Ihaveseen(25)vigorouslytheygrowwithoutme.

DoImissthem?Yes.BothmoreandlessthanFdguessed.DoIfeelunitedforhavinglost

myprimaryroleinlife?No,becauseovertheyear,Itookgreatpride(26)thefactthat

myidentitywasnotdependentontheirs.But,surprisingly,yes.(27)(be)adifferent

kindofmotherdefinesmenow.

Themissingcomesatunexpectedmoments:seeingtheschoolbusdriveby,startingtoputtoo

manyplatesonthetable...Whentheyhavedoubtsaboutfriendshipsorjobprospects,Icanonly

say,"Tmsureyouwillfigureitout.”

Andyet,thespaces(28)(empty)bylossaremorethanfilledbywhatI'vefound.I

nowhavethechance(29)(see)themasthewholeworlddoesbutalsolikenooneelse

everwill.AsadultsIhappenedtohelpcreate.

Therooms(30)theboysusedtolivelookvacant.Ifeelsadnessbutalsojoy.I

knewtheywouldleave,buttheywillfindtheirwayback.

Myhomeisempty.Butoverflowing.

SectionB

Directions:Fillineachblankwithaproperwordchosenfromthebox.Eachwordcanbeused

onlyonce.Notethatthereisonewordmorethanyouneed.

A.AddressB.fascinationC.governedD.imposingE.offensive

F.originallyG.overlookingH.rebellionI.reminderJ.randomlyK.swept

Palacesareknownfortheirbeautyandsplendor,buttheyofferlittleprotectionagainst

attacks.Itiseasytodefendafortress(堡壘),butfortressesarenotdesignedwiththecomfortof

kingorqueeninmind.Whenitcomestostructuresthatareboth(31)andwell-fortified

theclassicEuropeancastleisthepinnacle(小尖頂)ofdesign.Acrosstheagescastleschanged,

developed,andeventuallyfelloutofuse,buttheystillcommandthe(32)ofourculture.

Castleswere(33)builtinEnglandbyNormaninvadersin1066.AsWilliamthe

Conqueror(34)throughEngland,hefortifiedkeypositionstosecurethelandhehad

taken.ThecastleshebuiltallowedtheNormanlordstoretreattosafetywhenthreatenedby

English(35).Castlesalsoservedasbasesofoperationforoffensiveattacks.Troops

weresummonedto,organizedaround,anddeployedfromcastles.Inthiswaycastlesservedboth

(36)anddefensiverolesinmilitaryoperations.

Notlimitedtomilitarypurposes,castlesalsoservedasofficesfromWhichthelordwould

administercontroloverhisfiefdom(領(lǐng)地).Thatistosay,thelordofthelandwouldholdcourtin

hiscastle.Thosethatweresociallybeneaththelordwouldcometoreporttheaffairsofthelands

thatthey(37)andpaidtributetothelord.Theywould(38)disputes,handle

business,feast,andenjoyfestivities.Inthiswaycastlesservedasimportantsocialcentersin

medievalEngland.Castlesalsoservedassymbolsofpower.Builtonprominentsites(39)

thesurroundingareas,castlesconstantlyloomedinthebackgroundofmanypeasants5

livesandservedasadaily(40)ofthelord'sstrength.

III.ReadingComprehension

SectionA

Directions:ForeachblankinthefollowingpassagestherearefourwordsorphrasesmarkedA,B,

CandD.Fillineachblankwiththewordorphrasethatbestfitsthecontext.

Humanshatemarkedlytogiveworkersmorethantheydeserve;andindeedmanywillsettle

forlesstocompensateworkequitably.Butisthisimpulse(41)?Perhapsnot,says

psychologicalscientistMarieSchaferinGermany.AccordingtoSchafer,nobodyhaseverlooked

athowyoungchildrenfromdifferent(42)thinkaboutmeritwhensharingrewards.

ThereisreasontosuspectthatmeritocracymaybemoreofaWesternconceptandvalue,soshe

andseveralcolleaguesdecidedtoputthistothetest,studyingthe(43)ofchildren,four

to11yearsold,inthreedifferentcultures.

Theideawastotesthowmuchthechildrenvaluedmerit.Soeachchildwasgivenanumber

ofsweetsequaltothetotalnumberoffishinthecatch,andwastoldtodistributethesweetsany

wayheorshewanted-withoutadultsintheroomtoinfluencethem.Iftheyvaluedmerit,

childrenshould(44)thesweetsaccordingtosharesofthecatch.Thatis,iftheyhad

landedthesamenumberoffish,theywouldchoosetorewardeachone(45),butifone

faredmuchbetteratfishing,rewardswouldalsobedisproportionate.Inthecasewheretheywere

simplygiventhefish,rewardsshouldbeunrelatedtocatchsize-sincenoeffortwasinvolved.

(46)matters.Thafsthemainfindingamongmanyfromthestudy,asdescribedin

aforthcomingissueofthejournalPsychologicalScience.TheGermanchildrendistributedthe

spoilsofthedaypreciselyinproportionto(47),evenwhenthismeantavery

unbalanceddistributionofrewards.Bycontrast,childrenfromthetworuralAfricanforager(狩獵)

societiesbarelytookmeritintoconsiderationatall.Thesefindingssuggestthatthebasicnotionof

meritanddistributivejusticeisfarfromuniversalinourspecies,andthat(48)is

culturallydefined.

Butwhy?Thescientistsoffersome(49)onthis.Itcouldbethatinlarge-scale

societieslikeGermany,ameritocracyis(50)forregulatingtransactionsbetweenpeople

whodon'tknoweachotherandmaynotinteractagain.Thefocusisonequitableinteractions,

becausethingswon'tbe"evenedout“inthefuture.Insmallscalesocieties,(51),most

exchangestakeplacebetweenpeoplewhoare(52)withoneanother.Itmaybemore

importantinsuchsocietiestobuildlong-termrelationshipsbasedonequity-ratherthantoinsist

onequityinasingletransaction.Inegalitarianforagersocieties,suchastheHaillom,(53)

isanimportantlevelingmechanism,(54)asymmetriesinwealthandincreasing

harmony.Childrenmayinternalizethesesocialvaluesearlyon,andapplythemevenwhenthe

fishingtripis(55).

41.A.unblockedB.universalC.unconsciousD.unique

42.A.culturesB.casesC.companiesD.aspects

43.A.moodB.behaviorC.emotionD.habit

44.A.collectB.loadC.stressD.distribute

45.A.reallyB.deliberatelyC.equallyD.happily

46.A.SceneB.ObjectC.CultureD.Trend

47.A.productivityB.benefitC.interestD.survey

48.A.tirednessB.businessC.thicknessD.fairness

49.A.feelingsB.thoughtsC.livesD.emotions

50.A.usefulB.majorC.smallD.important

51.A.inawordB.inadditionC.bycontrastD.whafsmore

52.A.familiarB.delightedC.satisfiedD.same

53.A.cooperatingB.smilingC.equalingD.sharing

54.A.forcingB.judgingC.balancingD.experiencing

55.A.creativeB.imaginaryC.innovativeD.logic

SectionB

Directions:Readthefollowingthreepassages.Eachpassageisfollowedbyseveralquestions

orunfinishedstatements.ForeachofthemtherearefourchoicesmarkedA,B,CandD.Choose

theonethatfitsbestaccordingtotheinformationgiveninthepassageyouhavejustread.

(A)

WeHaveaPaintertoThankforYellowstone

BeforeartistThomasMoransetfootinthepark,itwasseenasunhappyplace.After,itwas

marketedasawonderland.

BeforeThomasMoranarrived,Yellowstoneinthepopularimaginationwasaharsh,wild

placepockedwithhellishgeysers.Afterthepainter'sworkwasfinished,Yellowstonewas

establishedasanationalparkandmarketedasawonderland.

In1871MoranandphotographerWilliamHenryJacksonhadjoinedthefirstU.S.

governmentsurveyoftheregion.FortwoweeksMoranfilledasketchbookwiththelandscape's

moststunningsights.Thesurveyresults,Jackson'sphotos,andMoran'swatercolors-thefirst

colorrenderingsofthearea—werepresentedtoCongressthatfall.cuThephotographswereproof

thatwhattheartistwasshowingreallyexisted,saysEleanorHarvey,seniorcuratoratthe

SmithsonianAmericanArtMuseum.

InMarch1872lawmakersofficiallymadeYellowstoneanationalpark,theworld'sfirst.By

April,Moranhadtransformedsomeofhissketchesintoa7-by-12-footpainting.Thegold-

splatteredvalleyandbillowingLowerFallsof“TheGrandCanyonoftheYellowstone^^attracted

thepublic.ccItistoograndandwonderfulforwords,“declaredtheLadies"RepositorythatAugust,

“andnonecaneverjudgeofitswondersfromanyengravingorphotographinmereblackand

white.

ThoughMoranlaterpaintedLakeSuperior,theGrandCanyon,andtheRockies,his

reputationwassointertwinedwithYellowstonethathetooktosigninghispaintings"TYM,"for

Thomas"Yellowstone"Moran.

56.WhatcanweknowaboutYellowstoneaccordingtothepassage?

A.ItwasapopularparkwithgeysersbeforeThomasMoranfinishedtransformation.

B.Itwasanimaginationofaharshandwildplace.

C.ItbecameanationalparkwiththeeffortsofMoranandJackson.

D.Itisanattractivegrandvalley.

57.Whatdoesthe"pocked“meaninthefirstsentence(paragraph2)?

A.Packed.

B.Dotted.

C.Blocked.

D.Stuck.

58.WhatarethecharacteristicsofThomasMoran'spaintingsaboutYellowstonePark?

A.Payingattentiontocolorrenderingofpaintings.

B.Hismagnificentandwonderfulpaintings.

C.HisreputationcloselylinkedtoYellowstonePark.

D.Hispaintingswithnothingspecial.

59.Whatdoesthepassagemainlytalkabout?

A.TheSignificanceofThomasMoran?spaintingstoYellowstonePark.

B.HowYellowstoneParkisestablishedasaNationalPark.

C.TheGreatPainter-ThomasMoran.

D.TheprocessofYellowstoneParkbeinglabelledasafairyland.

(B)

WhyUPSTrucks,(Almost)NeverTurnLeft

Byfavoringright-handturnsatalltimes—unlessaleftisunavoidable-thecarriersaves

millionsofgallonsoffueleachyear,andavoidsemissionsequivalenttoover20,000passenger

cars.

Thepracticestarteddecadesago,beforecomputersandGPS,andisnowmanagedbya

softwarethatconjuresthemostefficientrouteforeachtruck.

Whafswrongwithturningleft?

Left-handturnsaregenerallyconsideredunsafeandwastefulonright-handdrivingroads,

suchasthoseintheU.S.

“Left-turningtraffictypicallyhastoturnagainstaflowofoncomingvehicles,9,explainsTom

Vanderbilt,authorofthebook”Traffic:WhyWedrivethewaywedo.”

“Thiscannotonlybedangerous,butmakestrafficbuildup,unlessyouinstalladedicated

left-turn'phase',whichisfinebutbasicallyadds30or45secondstoeveryoneelse'ssingle

hesaid.

Astudyoncrashfactorsinintersection-relatedaccidentsfromtheU.S.NationalHighway

TrafficSafetyAssociationshowsthatturningleftisoneoftheleading"'criticalpre-crashevents^^

(aneventthatmadeacollisioninevitable),occurringin22.2percentofcrashes,asopposedto1.2

percentforrightturns.About61percentofcrashesthatoccurwhileturningorcrossingan

intersectioninvolveleftturns,asopposedtojust3.1percentinvolvingrightturns.

Leftturnsarealsothreetimesmorelikelytokillpedestriansthanrightones,accordingto

datacollectedbyNewYorkCity'stransportationplanners.

Therightwaytosavefuel

“Aleft-handturnisalsolessfuelefficient,9,saidJackLevis,UPSSeniorDirectorofProcess

Management,"becauseyourcar'sidling(未熄火)longer,whichisalsonotgoodforyour

vehicle.

Byavoidingleftturns

wheneverpossible,

UPSestimatestosave:

■

廣金0二m即i。lHul”ion丁事田SO"；

i程軟Ria輯旨以盤副同仁空罌空雪翼

UPSdoesnotbanleftturnsoutright,saysLevis:"Wewillmakelefthandturns,butnotones

thatareunnecessary.Wedon'tneedtogoincirclesalldaylongbymakingonlyrighthandturns.

Wehavetoolsanalyzethenumberoflefthandturnforeachroute,andwecanworkoutwhich

onesareavoidable.^^

Theprocedureinnowincorporatedinmostcountriesaroundtheworld.

Tothisend,thecarriercreateditsownmaps,whichitsaysaremoreaccuratethat

commerciallyavailableones:"Wecandifferentiatemoreimportantleft-handturnsfrom

unimportantones.GoogleMapshasnoconceptofnotmakingaleft-handturn,itjustshowsthe

mostdirectwaytoreachyourdestination.Wehavetheabilitytopenalizesomeofthose.9,Levis

toldCNN.

Thesystemknowsaboutparkinglots,privatedriveways,variablespeedlimitsandroadsthat

areinaccessibleforatruck.

Thesoftwarecangiveanundesirableleftturnapenaltythatadds20secondstotheestimated

routelime.Inthatcase,goingaroundtheblockandturningalwaysrightmightoffsetthat

20-sccondpenalty:"Wewereabletoturnofflefthandturns,“saidLevis.

Takingalongerroutewhilestillsavingtimeandfuelmightsoundconfusing,eventoUPS

drivers,accordingtoVanderbilt:'TveactuallybeentoUPS'slogisticscenteranddiscussedthis

withtheirleadengineers.hesaid.

“Alotofindividualdriversfeltthenewroutingsoftwarewasmakingtheirtripslonger,but

theywerelaterprovenwrong.Thisisthethingabouttraffic,ifssuchacomplexsystemthatoften

theindividualcannotgetasenseoftheoverallefficiencyofthesystem,andoptimizeaccordingly.

It'salsooneofthecounterintuitive,4slower-is-faster9effectsyouoftenseeintraffic.9,

Therule,saysLevis,canalsobeappliedtoleft-handdrivingcountries,suchasAustraliaand

theUK,whereitdiscouragesright-handturns.

60.HowmuchresourcescanUPStruckssavebyavoidingturningleft?

A.UPStruckswillconsumemillionsofgallonsoffuel.

B.TheemissionofUPStrucksisequivalenttothatofover2000passengercars.

C.UPStrucksestimatetosave100,000metrictonsofCO2emissionayear.

D.UPStrucksestimateanincreaseof6to8milesperroute.

61.InTomVanderbilt'sView,howtoDealwiththeLeftTurnProblemintheUnitedStates?

A.Installadedicatedleftturnphase.

B.Trafficplannersmanageroadconditionso

C.Operatorsmaketheirowntrafficmaps.

D.Nationalpolicyencouragesleftturnofvehicles.

62.WhichofthefollowingoptionsisNOTTRUEaccordingtothepassage?

A.It'sunsafetoturnleftonright-handdrivingroads.

B.Turningleftisresource-efficientonright-handdrivingroads.

C.Leftturningislikelytocausetrafficaccidents.

D.Left-turnisdiscouragedinallcountries.

(C)

“Isdatathenewoil?askedproponentsofbigdatabackin2012inForbesmagazine.By

2016,andtheriseofbigdata'sturbo-poweredcousindeeplearning,wehadbecomemorecertain:

“Dataisthenewoil,^^statedFortune.

Amazon'sNeilLawrencehasaslightlydifferentanalogy:Data,hesays,iscoal.Notcoal

today,though,butcoalintheearlydaysofthe18thcentury,whenThomasNewcomeninvented

thesteamengine.ADevonianironmonger,Newcomenbuilthisdevicetopumpwateroutofthe

southwesfsprolifictinmines.

TheProblem,asLawrencetoldtheRe-WorkconferenceonDeepLearninginLondon.was

thatthepumpwasrathermoreusefultothosewhohadalotofcoalthanthosewhodidn't:itwas

good,butnotgoodenoughtobuycoalintorunit.ThatwassotruethatthefirstofNewcomen's

steamengineswasn'tbuiltinatinmine,butincoalworksnearDudley.

Sowhyisdatacoal?Theproblemissimilar:therearealotofNewcomensintheworldof

deeplearning.StartupslikeLondon'sMagicPonyandSwiftKeyarecomingupwithrevolutionary

newwaystotrainmachinestodoimpressivefeatsofcognition,fromreconstructingfacialdata

fromgrainyimagestolearningthewritingstyleofanindividualusertobetterpredictwhichword

theyaregoingtotypeinasentence.

Andyet,likeNewcomen,theirinnovationsaresomuchmoreusefultothepeoplewho

actuallyhavecopious（豐富的）amountsofrawmaterialtoworkfrom.AndsoMagicPonyis

acquiredbyTwitter,SwiftKeyisacquiredbyMicrosoftandLawrencehimselfgetshiredby

AmazonfromtheUniversityofSheffield,wherehewasbaseduntilthreeweeksago.

Butthereisacodatothestory:69yearslater,JamesWattmadeanicetweaktothe

Newcomensteamengine,addingacondensertothedesign.Thatchange,Lawrencesaid,“made

thesteamenginemuchmoreefficient,andthafswhattriggertheindustrialrevolution.

Whetherdataisoilorcoal,then,there9sanotherwaytheanalogyholdsup.alotofworkis

goingintotryingtomakesurewecandomore,withless.Ifsnotasimpressiveasteachinga

computertoplayGoorPac-Manbetterthananyhumanalive,but"dataefficiency^^isacrucial

stepifdeeplearningisgoingtomoveawayfromsimplygobblingupoodlesofdataandspitting

outthebestcorrelationspossible.

“Ifyoulookatalltheareaswheredeeplearningissuccessful,they'reallareaswherethere9s

lotsofdata,“pointsoutLawrence.Thafsgreatifyouwanttocategorizeimagesofcats,butless

helpfulifyouwanttousedeeplearningtodiagnoserareillnesses."It'sgenerallyconsidered

unethicaltoforcepeopletobecomesickinordertoacquiredata.

63.Accordingtothepassage,whydataisseenasthenewcoal?

A.Itcandrivethesteamenginetopumpwater.

B.Itcanhelppeoplemakemorecoals.

C.Itcanhelptheareasofdeeplearning.

D.Itcanhelpcurediagnoserareillnesses.

64.AccordingtoLawrence,whybigdataislesshelpfultodiagnoserareillnesses?

A.Becausethereisnosuchdemand.

B.Becauseitcanonlyusetocategorizeimagesofcats.

C.Becauseit'sunethicaltoacquiredatabyforcingpeopletobecomesick.

D.Becauseitneedstoomuchdata.

65.Whichareasaremostlikelytobesuccessfulinin-depthlearning?

A.Somesmallstart-ups.

B.Areaswithlargeamountsofdata.

C.CoalandPetroleumDevelopmentField.

D.Areasfortacklingrarediseases.

66.Accordingtothecontentofthearticle,whichisNOTTRUEaboutthebigdata?

A.Westillhavealotofworktostudythebigdata.

B.Itrequirescountlessdatatobecollected.

C.Thepurposeofstudyingbigdataistosaveparents9costs.

D.”Dataefficiency^^isacriticalsteptoexploremoredata.

SectionC

Directions:Readthefollowingpassage.Fillineachblankwithapropersentencegiveninthe

box.Eachsentencecanbeusedonlyonce.Notethattherearetwomoresentencesthanyouneed.

A.Weweighbenefitsofmedicationsversusthecomplexityofaddingonemoredrugtoher

crowdedpillbox.

B.Ifyouansweredno,you'renotalone.

C.Whenyouropinionsareshared,youwillfindmorepotentialaboutyou.

D.Yourvaluesandneedsmayalsovaryfromoneappointmenttothenext.

E.Thetruedifferencereliesonwhatyouunderstandinsteadofwhatyousee.

F.Ayearfromnowaftergraduation,we'llrevisittheconversation,ashisgoalsandneedsmaybe

different.

TheMostImportantThingYou'reNotDiscussingwithYourDoctor

Shareddecisionmakingrequiresyoutobeanactiveparticipant.Politiciansandpolicymakers

arediscussingwhatpartsoftheAffordableCareActtochangeandwhattokeep.Whilemostofus

havelittlecontroloverthosediscussions,thereisonehealthcaretopicthatwecancontrol;what

wetalkaboutwithourdoctor.

TheInstituteofMedicine(IOM)releasedthelandmarkpublicationCrossingtheQuality

Chasm15yearsago.ThereportproposedsixaimsforimprovementintheU.S.healthsystem,

identifyingthathealthcareshouldbepatient-centered,safe,effective,timely,efficientand

equitable.

Theideathathealthcareshouldbepatient-centeredsoundsobvious,butwhatdoesthatmean?

TheIOMdefinesitascarethatis"respectfulofandresponsivetoindividualpatientpreferences,

needs,andvalues“andthatensures“patientvaluesguideallclinicaldecisions.^^

Forthistotrulyhappen,doctors5appointmentsneedtocovermoretopicsthanhowoneis

feelingandwhatcanbedone.Doesyourdoctorknowyourvalues?66Fewerthanhalf

ofpeoplereportthattheirphysicianorotherhealthcareprovideraskabouttheirgoalsand

concernsfortheirhealthandhealthcare.Yourdoctorcandiscussmedicaltestsandtreatments

withoutknowingyourlifegoals,butsharingyourvaluesandneedswithyourdoctormakes

discussionsanddecisionsmorepersonalizedandmayleadtobetterhealth.

Howd