DOCTOR'S DILEMMA

Your article on weeding out incompetent doctors (MEDICINE, May 26) makes the error of assuming that state medical boards can act autonomously in controlling dangerous physicians. The chain of effective discipline starts . with reporting the offense, followed by investigation and then the prosecution, none of which are in the hands of a medical board. A physician thought to be incompetent must be accorded full protection of the law and can be punished only after a fair hearing, to which can be added the right of appeal. This is as it should be, but it takes time. Rather than direct criticism toward what is perceived as a protective-guild mentality among doctors, turn the attack on those who are in control of the investigation. At the present time, the medical profession occupies the uncomfortable seat of being held responsible for all medical discipline without authority over the process. The state giveth the license, and only the state can taketh it away. Robert C. Coe, M.D., Chairman Medical Disciplinary Board State of Washington Seattle Though the medical profession may have been derelict in its housekeeping duties, the inevitable improvement should not come through governmentally related professional-review organizations. The change for the better is already occurring from inside the profession with the appearance of a new generation of doctors who approve of using the system of peer review. This younger breed of physicians is devoted to ensuring the supremacy of U.S. medicine and patient care and does not want the Government to do our housecleaning for us. Alan Hollingsworth, M.D. Marina del Rey, Calif.