PBS高端访谈:询问病人什么问题最合适

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AMNA NAWAZ: And tonight's Brief But Spectacular features pediatrician Lucy Marcil, who integrates free tax and financial services into her care for patients and their families as a way to help improve their overall health.

阿姆娜·纳瓦兹：今晚做客《简短而精彩》的是儿科医生露西·马西尔，她将免费的税收和金融服务融入到她对病人及其家属的护理中，以此来帮助改善他们的整体健康状况。

DR. LUCY MARCIL, Pediatrician: People trust their doctor. We ask them really intimate questions all the time. We ask them about sex, about mental health, about alcohol use. But I bet, if you think about your own experiences, you have probably never had your doctor ask you how much money you make. If you have less money, you have worse health outcomes in almost any disease you can think of. Poor children in the U.S. die at higher rates. They are one-and-a-half more likely to die. They're twice as likely to be hospitalized. So, it really is a health issue, and it's negligence¹ on our part not to be asking about it. I had a mom in clinic last week who is trying her best to raise two lovely kids, but she's been homeless. She's been in several abusive relationships. She's encountered mental health problems. And, as a result, it's been hard for her to keep steady jobs. With her, for instance, I asked her, Have you filed your taxes? She said: I'm not going to. I only made $3,000 last year. And I was able to explain to her how, if she did file, the U.S. government would give her $1,200, which would be a third of her annual income. So that's just a small example of the way in which we try to prescribe tax preparation as a health intervention² in pediatric clinics.

露西·马尔西尔医生，儿科医生：人们信任他们的医生。我们总是问他们非常亲密的问题。我们问他们关于性，心理健康，酗酒的问题。但我敢打赌，如果你想想你自己的经历，你可能从来没有让你的医生问过你赚了多少钱。如果你的钱不多，你可以想到的任何一种疾病都可能带来严重健康问题。美国贫困儿童的死亡率更高。他们死亡的可能性要大一点半。他们住院的可能性是以前的两倍。所以，这真的是一个健康问题，不去询问是我们的疏忽。上周有个妈妈在我的诊所里，她正尽力抚养两个可爱的孩子，但她一直无家可归。她的几次恋爱中都存在虐待问题，她遇到了心理健康问题。因此，她很难有稳定工作，比如，我问她，你交过税了吗？她说：没交过，我去年只赚了3000美元。我可以向她解释，如果她真的提交文件，美国政府将给她1200美元，这将是她年收入的三分之一。所以这只是一个很小的例子，我们试图在儿科诊所里把税收筹划作为一种健康干预。

We found that 60 percent of the families we serve have never heard of the Earned Income Tax Credit. It's not just about getting the money back that's been withheld³ from your paycheck. The government is going to give you extra money. And, often, it's thousands of dollars. For people who do know about it and are filing their taxes, they might not know that free tax preparation exists in the community. So it's a huge relief to them often when I say, we can do this right here in the office for you. And they say, you're not going to charge me? We have done, over the last three years, about 2,000 tax returns and returned over $4,000,000 to families. The very first family that we served was a great-grandmother who had custody⁴ of a 2-year-old. And after we got her back several thousand dollars, she said to me: I was able to buy luxuries. I bought a winter coat and fresh vegetables. And we live in the United States of America. A winter coat and vegetables should not be luxuries when you're trying to raise a child. So, the patients that I have that have used StreetCred, I feel I have a deeper, more trusting relationship with. You know, I think they recognize that I'm someone they can tell anything to, that I'm interested in their problems, not just interested in telling them about how their kids should drink less juice, which they should. No one should be drinking juice. Unless we show that we really care for people, they won't trust us and let us help them. My name is Dr. Lucy Marcil, and this is my Brief But Spectacular take on reimagining what a doctor's visit looks like.

我们发现，我们服务的60%的家庭从未听说过所得税抵免。这不仅仅是要拿回从你的薪水里扣下来的钱，政府还会给你额外的钱。而且，通常是几千美元。对于那些知道这一点并正在申报纳税的人来说，他们可能不知道社区里存在免费纳税筹划。所以，当我说，我们可以在办公室为你做这件事时，他们常常感到非常欣慰。他们说，你不会起诉我吗？在过去三年里，我们已完成约2000份报税表，并向家庭退还逾400万美元。 我们服务的第一个家庭是一个有2岁孩子监护权的曾祖母。在我们帮她找回数千美金后，她对我说：我可以买奢侈品。我买了一件冬衣和新鲜蔬菜。我们住在美利坚合众国。当你想抚养孩子时，一件冬衣和蔬菜不应该是奢侈品。所以，我的病人使用了“StreetCred”，我觉得我和他们之间的关系更深，更信任。你知道，我想他们知道我是一个可以告诉任何事情的人，我对他们的问题很感兴趣，不仅仅是想告诉他们孩子们少喝些果汁，而是他们应该如何做。没人应该喝果汁，除非我们表现出我们真的关心别人，否则他们不会信任我们，让我们帮助他们。我的名字是露西·马尔西尔博士，我在《简短而精彩》观点是重新设想医生来访。