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To the Editor: The article by Dr Kenagy and colleagues¹ disparages the quality of care at a particular medical center. The problems discussed in this article would never have occurred had the primary care physician and her office taken care of this patient in a reasonable and thoughtful fashion. The physician naively told the patient to schedule his own appointment for an intravenous pyelogram, a practice that I believe to be uncommon. Rather, the physician should have instructed her staff to make these arrangements. They could have scheduled the appointment for the patient and supplied him with detailed instructions and driving directions. Even though this patient was a physician, it was inexcusable for his physician to abandon her responsibility to him.

On the other hand, the patient should have thought to ask for directions to the center if they had not been given. Many patients might have thought to make . . . [Full Text of this Article]