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by Abigail Van Buren

DEAR ABBY: Your response to "Lucky in Connecticut," whose doctor failed to notify her of abnormal pap smears (for three years!) was inappropriate. You told her that in these days of managed care, doctors are seeing many more patients than they used to, and many of them expect their patients to be more sophisticated and responsible for their health than a generation ago. You further advised her to take the initiative and call the doctor for test results instead of waiting for notification.

Abby, it IS the physician's responsibility to notify the patient about an abnormal test result. I know some MDs who tell their patients to call for results, but I (and most other physicians) disagree. I tell my patients I'll call them about an ABNORMAL pap. If it's a normal report, they'll receive a card by mail -- and if they haven't heard anything by three weeks, they're to call me to find out why. You should not have made "Lucky" feel guilty that she didn't call for her report. She did not fail in her responsibility as a patient.

Thank you for letting me have my say. Your column is great! -- ANDREW JAMIESON, M.D., BUTTE, MONT.

DEAR DR. JAMIESON: My response to "Lucky" was meant to encourage women to take responsibility for calling their doctors if they had not received test results in a reasonable amount of time. I agree that when a doctor performs tests, it is the doctor's responsibility to inform the patient of the results -- and an irresponsible doctor should be held accountable. However, in today's chaotic health-care environment, we all need to be more aware of our personal medical needs and insist on good care. Read on:

DEAR ABBY: I have a bit of advice I'd like to give to "Lucky in Connecticut." KEEP YOUR OWN HEALTH FILE. After every visit to the doctor for a complete physical, pap smear, mammogram, ultrasound, MRI, etc., ask -- no, TELL your doctor that you want a copy of the results. It is your right! You'll probably have to sign a waiver, that's all. Then compare your test results from visit to visit. It is amazing what you can learn from your blood panel results.

Abby, you were right when you said there is an overwhelming ratio of patients to doctors. Patients must ask questions. That is also their right. Of course, all of us want our doctors to treat us as though we are their one and only patient. Unfortunately, we must lower the pedestal we once had them on to a more realistic level. We cannot put all our faith in them -- we must help them out.

Oh, by the way, patients should make sure the names on the test result forms are THEIRS. Here's a little incident that happened to me: Last February, I was admitted for major surgery (a complete hysterectomy). I was next on the list, and a young woman called my last name. We sat at her desk and she said, "Have you ever been here before for this surgery?" "No," I replied, "if I had, I wouldn't be here now." She said, "Oh, you'd be surprised. Some people come back three or four times." I said, "You're kidding!" She said, "No."

We both looked at each other with that quizzical look and I said, "What's the first name on that form?" The first names were different, of course. The person whose file was in her hands was going to have FOOT surgery! Could you imagine? My middle name was about to become "Ooops!"

I have kept my own file now for about 15 years and only wish I had started sooner. I guess my middle name back then was "Naive." -- INFORMED NOW IN WEST BLOOMFIELD HILLS, MICH.

DEAR INFORMED: That's a valuable suggestion, and all that's required is taking the initiative.

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