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There's no real choice of doctors

July 16, 2007

Jan Greene's article ["The Good Doctor," July 9] is somewhat misleading. Green misses a major point, namely that in this country's HMO-driven health system, the (insured) patients' "choice" of their practitioners is severely circumscribed in the first place.

Having grown up in a European country with a different health system, I was shocked to learn about such limitations when I became a U.S. resident. I find the claim that an HMO-insured patent in the US could choose her doctor rather absurd.

The HMOs' bureaucrats basically dictate which doctors are available. So far, I have not felt free to choose my doctors.

ANNETTE SCHLICHTER

Laguna Beach

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I had to laugh at some of the advice in your essentially helpful article. Helpful in some other country, perhaps. In my HMO, I have very few choices. I like my primary care physician, who has been my PCP for more than 10 years, but the penalty is that I'm stuck with specialists in the same medical group.

I have multiple sclerosis, and I saw an excellent doctor for eight years until he informed me he was dropping all his MS patients because he didn't think the HMO was reimbursing him sufficiently for their care. This left three available neurologists who see MS patients from whom to choose. In this situation, using The Times' suggestions for choosing a doctor is an unattainable luxury.

Also, while I can see the benefit of a computerized doctor's office, there are ways patients can use their home computers to keep all their doctors appropriately informed. I keep a list of all my current medications: the ones I take daily, the ones I take as needed, and vitamins and supplements. I update this list every time I have a doctor's appointment. This way, each physician is aware of ALL the medications a patient is taking.

Doctors' staffs, in my experience, are always delighted when you tell them they can keep the list and put it directly in your chart, as you have it on the computer at home. Whether a doctor's office is computerized or not, patients should also take responsibility for keeping their own basic "medical records."

ATARA STEIN

Chino

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