Here's how to get the doctor on the phone when it's really important:

Strongly say "It's an emergency" or "It's really important" or "I'm in pain" if that is the case. Don't exaggerate, however, if you want prompt attention in the future.

Accept the fact that the doctor can't handle every call, that you have to accept some information or help from the staff. But you have a right to expect skill and courtesy from the staff as well as the doctor.

When you call, stick to the point. Everyone's time is important. Get ready for your phone call. Note down your exact symptoms. Take your temperature. Know what medicines you've been taking or have on hand.

If you're not going to be home when the doctor might call, phone again and leave a message on where and when you can be reached.

Don't call the doctor at 11 p.m. to get a nonurgent prescription refilled. If something bothers you on Friday or in late afternoon, don't wait -- call then rather than at 2 a.m. or on Sunday morning. But don't hesitate to phone any time if there is real worry. It may save your life.

Don't use phone calls to avoid making appointments, whether to save time, money or trouble. Unless a doctor sees you from time to time, you're a physiological stranger when you call. Doctors are understandably irritated by patients who can afford care, yet habitually try to get telephone advice without making a visit.

Washington internist Dr. Raymond Scalettar adds one more piece of advice: "If you've been trying to reach your doctor and you don't get a callback and you think it's really an emergency, don't wait -- go to the nearest hospital emergency room. I may be caught in traffic on the Beltway, and my beeper goes off but I have no way of reaching you. Or, as happened one night, the electricity in our building went off and there was no way for our answering service to pick up our calls.

"If you think your symptoms are a bit extraordinary and you get no prompt response from your doctor, go to a hospital."