Comprehension
Read the passage and answer the following question.
History has shaped academic medical centers (AMCs) to perform 3 functions: patient care,research, and teaching. These 3 missions are now fraught with problems because the attempt to combine them has led to such inefficiencies as duplication of activities and personnel, inpatient procedures that could and should have been out-patient procedures, and unwieldy administrative bureaucracies.
One source of inefficiency derives from mixed lines of authority. Clinical chiefs and prac- titioners in AMCs are typically responsible to the hospital for practice issues but to the med- ical school for promotion, marketing, membership in a faculty practice plan, and educational accreditation. Community physicians with privileges at a university hospital add more com- plications. They have no official affiliation with the AMC’s medical school connected, but their cooperation with faculty members is essential for proper patient treatment. The frag- mented accountability is heightened by the fact that 3 different groups often vie for the loy- alty of physicians who receive research. The medical school may wish to capitalize on the research for its educational value to students; the hospital may desire the state-of-the-art treat- ment methods resulting from the research; and the grant administrators may focus on the re- searchers’ humanitarian motives. Communication among these groups is rarely coordinated, and the physicians may serve whichever group promises the best perks and ignore the rest — which inevitably strains relationships.
Another source of inefficiency is the fact that physicians have obligations to many different illnesses cost, and of how other institutions treat patient conditions, they would be better practitioners, and the educational and clinical care missions of AMCs would both be better served. groups: patients, students, faculty members, referring physicians, third-party payers, and staff members, all of whom have varied expectations. Satisfying the interests of one group may alienate others. Patient care provides a common example. For the benefit of medical students, physicians may order too many tests, prolong patient visits, or encourage experimental studies of a patient. If AMC faculty physicians were more aware of how much treatments of specific.
A bias toward specialization adds yet more inefficiency. AMCs are viewed as institutions serving the gravest cases in need of the most advanced treatments. The high number of spe- cialty residents and the presence of burn units, blood banks, and transplant centers validate this belief. Also present at AMCs, though less conspicuous, are facilities for ordinary pri- mary care patients. In fact, many patients choose to visit an AMC for primary care because they realize that any necessary follow-up can occur almost instantaneously. While AMCs have emphasized cutting-edge specialty medicine, their more routine medical services need development and enhancement.
A final contribution to inefficiency is organizational complacency. Until recently, most academic medical centers drew the public merely by existing. The rising presence, however, of tertiary hospitals with patient care as their only goal has immersed AMCs in a very com- petitive market. It is only in the past several years that AMCs have started to recognize and develop strategies to address competition.
Question: 1

The author's attitude toward the inefficiencies at academic medical centers is one of:

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When asked about tone or attitude, focus on whether the author’s criticism is emotional, neutral, or balanced. Look for language that reveals intent without exaggeration.
Updated On: Jul 29, 2025
  • reluctant acquiescence
  • strident opposition
  • agonized indecision
  • reasoned criticism
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The Correct Option is D

Solution and Explanation

Throughout the passage, the author presents a balanced and detailed account of the inefficiencies in academic medical centers (AMCs), citing specific causes such as duplication of effort, administrative bureaucracy, and multiple lines of authority. The tone is analytical, supported by examples, and aims to highlight problems without using overly emotional or one-sided language. This aligns with a \emph{reasoned criticism} — pointing out flaws, explaining their origins, and suggesting the need for strategic changes. The author is neither passive (ruling out A), nor aggressive (ruling out B), nor indecisive (ruling out C).
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Question: 2

The author of the passage would most likely agree with which of the following statements about primary care at AMCs?

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When matching an author’s likely agreement, look for statements that align with the problem-solution framework given in the passage.
Updated On: Jul 29, 2025
  • AMCs would make more money if they focused mainly on primary care.
  • Burn and transplant patients need specialty care more than primary care.
  • AMCs offer the best primary care for most patients.
  • Inefficiencies at AMCs would be reduced if better primary care were offered.
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The Correct Option is D

Solution and Explanation

The passage notes that AMCs have traditionally emphasized cutting-edge specialty medicine, while primary care facilities at AMCs are less conspicuous and sometimes inadequate. The author argues that if AMCs provided more effective primary care — including quick follow-up visits and treatment of ordinary ailments — patients could be served more efficiently, reducing delays and excessive use of specialty services. This aligns directly with (D). The author does not focus on profitability (A), merely notes the need for specialty care without comparing priorities (B), and never claims AMCs offer the \emph{best} primary care (C).
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Question: 3

The author's primary purpose in this passage is to:

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Look for contrasts or comparisons between entities — if the author repeatedly juxtaposes two types of organizations, the primary purpose is often comparative.
Updated On: Jul 29, 2025
  • discuss the rise and fall of academic medical centers
  • list the main failings of academic medical centers
  • explain that multiple lines of authority in a medical centre create inefficiencies
  • examine the differences between academic and other health care entities
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The Correct Option is D

Solution and Explanation

The passage discusses academic medical centers (AMCs) in the context of their structure, roles, and functions, contrasting these with non-academic or community health care entities. While inefficiencies and operational issues are mentioned, they serve to highlight how AMCs differ from other health care organizations in responsibilities, governance, and challenges. This comparative framing makes (D) the best answer — the author’s primary goal is to examine the differences rather than merely listing shortcomings (B) or focusing solely on authority structure (C), and it is not a historical account (A).
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Question: 4

The author implies which of the following about faculty physicians at AMCs?

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In RC inference questions, identify trade-offs the author mentions — here, the trade-off is between teaching duties and patient care.
Updated On: Jul 29, 2025
  • Most of them lack good business sense.
  • They put patients’ physical health above their hospitals’ monetary concerns.
  • They sometimes focus on education at the expense of patient care.
  • They lack official affiliation with the medical schools connected to AMCs.
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The Correct Option is C

Solution and Explanation

The passage describes how faculty physicians at AMCs divide their time among patient care, teaching, and research. It notes that the emphasis on training new doctors and fulfilling academic duties can sometimes reduce the time and attention available for patient care. This implies that in some situations, educational responsibilities can take precedence over direct patient treatment, making (C) the best choice. The passage does not explicitly say they lack business sense (A), consistently prioritize patient health over finances (B), or lack affiliation with the medical school (D).
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