переведите текст, пожалуйста. The National health service USA.

Whereas in Britain the doctor of first contact is regularly a general practitioner, in the US the nature of fint - contact care s les conistent. General practice in the US has been in a state of decline in the second half of the 20 century, especially in hetropolitan areas. The general practitioner, however, is being to go directly to physicians with narruwer specialties, including replaced to some degree by the growing field of family practice 1969 family practice was recognizod as a medical specialty ahe the American Academy of General Practice (now the Americae Academy of Family Physicians) and the American Medicat Association creted the American Board of General (now Familys Practice Since that time the field has become one of the larger medical specialties in the US. The family physicians were the firt group of medical specialists in the US for whom recertification was required. There is no National Health Service, as such, in the Most physicians in the country have traditionally been in some form of private practice, whether seeing patients in their own offices, elinies, medical centers, or another type of facility and regardless the pationts'income. Doctors are usualy compensated by such state and federally supported agencies as Medicaid (for treating the poor) and Medicare (for treating the clderly), not all doctors, however, accept poor patients. There are also some state-supported elinies and bospitals where the poor and elderly may receive free or low-cost treatment, and some doctors devote a small percentage of their time to treatment of the indigent Veterans may recerve free weatment at Veterans Administration hospitals, and the federal govermment through its Indian Health Service provides medical services to American Indians and Alaskan natives, sometimes asing trainod auxiliaries for first- contact care. In the rural US fint-contact care is likely to come from a generalist. The middle-and upper-income groups living in urban arcas, however, have access to a larger mumber of primary medical care options Children are often taken to pediatricians ho may evenee the child's health needs until adulthood. Adults otuently make their initial contact with an internist, whose field mainly that of rmedical (n opposed to surgical) illinesses; the temist often hecomes the family physician. Other adults choose n eo directly to physicians with namwer specialties, including Wtologists. llergista pnecologists, orthopedista and ophthalmologists.Putients in the US may also choose to be treated by doctur of gopathy. These doctors are fully qualified, but they make up y a small pencentage of the oountry's physicians. They may o branch of into specialties, but general practice is much more common in their group than among MD's It used to be more common in the United States for physicians providing primary care to work independently. providing thcir own equipment and paying their own ncillary staff. In smaller cities they mostly had full hospital privileges, but in larger cities these privileges were more likely to be restricted. Physicians, often sharing the same specialties, are increasingly entering into group associations, where the expenses of office space, staff, and equipment may be shared: such associations may work out of suites of offices, clinics, or medical centers. The increasing competition and risks of private practice have caused muny physicians to join Health Maintenance Organizations (HMOS), which provide comprehensive medical care and hospital care on a prepaid basis. The most savings to patients are considerable, but they must use only the HMO doctors and facilities. HMOS stress preventive medicine and out-patient treatment as opposed to hospitalization as a means of reducing costs, a policy that has caused an increased number of empty hospital beds in the US. While the number of doctors per 100,000 population in the US has been steadily increasing, there has been a trend among physicians toward the use of trained medical personnel to handle some of the basic services normally performed by the doctor. So-called physician extender services are commonly divided into nurse practitioners and physician's assistants, both of whom provide similar ancillary services Tor the general practitioner or specialists. Such personnel do not replace the doctor. Almost all American physicians lave systems for taking each other's calls when they become unavailable. House calls in the US, as in Britain, have become exceedingly rare.​