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Dear Ann Landers: Your recent column, concerning the "moron" in the doctor's office who sent a bill with a smiley face to a patient who died, prompts this letter. Obviously, you have no idea how medical billing is done, nor do you comprehend the present status of what used to be a respected profession.

Doctors who see patients in hospitals keep a list of those patients, and record the services performed with numerical codes. This is required for billing to insurance companies. These lists are then given to the billing clerk. The requirements for billing are so complex that it is virtually impossible without computerization. The billing clerk sees only the patient's name and a numerical code. If the doctor has failed to note that the patient has died, the clerk will not know about it.

If the doctor belongs to a group, the clerks enter billing data for hundreds of patients a day. It is unfortunate that a smiley-face bill went to a family that had lost someone, but this doesn't mean the billing clerk was a moron, which is what you called her. My husband is a physician. I work in his office, and I am not a moron.

The American medical establishment is the best and most innovative in the world. It is being destroyed by government meddling and insurance companies that interfere with clinical determinations and discourage physicians from even touching patients. Nobody does this solely out of altruism, and no industry gets the best and the brightest without paying for it. No one bats an eye when sports figures, whose drug and sexual exploits are common knowledge, sign contracts for millions of dollars, yet people complain about the cost of medical care from doctors who spend more than a decade in training.

More people like my husband will decide that a medical career is not worth the sacrifice, and bright students coming up will send their applications to business schools instead.

-- Nameless in Maine
Dear Nameless: In my opinion, no smiley face should appear on any bill. Nevertheless, you've written a fine letter about the medical profession. If anyone wishes to make a strong backup statement or a rebuttal, I will print it.

A spoiled child

Dear Ann Landers: I have a young daughter who is the joy of my life. My parents spoil "Lexie" by giving her too many toys and fancy outfits. I am not complaining. I love the attention she gets, and am happy that she has such adoring grandparents, but there's a problem.

My parents continually purchase toys to keep at their house for the times when Lexie visits. When Lexie outgrows the toys, my mother expects me to keep them in our house. Ann, our basement is full enough without having to take toys we didn't buy and don't want.

Tell me, Ann, is it our obligation to find storage space for these toys? If not, how can I get my mother to stop pushing them on us?

-- T.H. in Ohio
Dear T.H.: Please don't attempt to discourage your generous parents from buying toys for your daughter. It obviously gives them a great deal of pleasure. When Lexie outgrows the toys or clothes, tell your mother you would be happy to take them to a nearby children's hospital, the Salvation Army or a shelter for homeless or battered women and children, where such items would be greatly appreciated. I'm sure your parents will buy plenty more for the next child.

Problems? Dump on Ann. Write her at The Buffalo News, P.O. Box 100, Buffalo, N.Y. 14240.

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