I wrote in one column last year that many hospital patients, confronted by ever shifting arrays of doctors, residents, interns, technicians and nurses, at last ask in frustration:

"Who's responsible for my care? Who's in charge?"

A partly retired surgeon-friend of mine writes: "Your doctor should be."

And he asks: "Who's yours?"

In other words, he is saying, one key to good medical and hospital care is to find a caring, attentive physician who maintains an interest in you through hell or high water. If you find one, hang on.

And my surgeon-friend objects to my explaining "how to use your doctor when you're hospitalized." "I object to the word 'using,' " he says. "One uses a tool, a slave or a prostitute."

He has a point. One key to keeping and getting the best out of a good doctor is mutual understanding and respect.

He worries about various ratings of hospitals as "good," "very good" or "outstanding" because: "They sound like the Michelin Guide or AAA ratings for motels. Where is the heart?"

Yes, he says, high-tech procedures can only be done in the big, "excellent" centers. But "not everyone has special problems like heart transplants. The bulk of care can and in some places is done in other than the finest," and hospitals of any size can be " 'good' to 'excellent.' " "A few cases get bum care in small as well as big hospitals, and more folks get 'lost' in the large ones than in the small, and the second time around refuse the 'big' ones over the small if given the choice."

How did he make sure his patients didn't get "lost"?

"I sat and talked and talked and talked to them and their relatives, and also the nurses and aides and technicians," this because he knew all could forget or make mistakes sometimes. Then he often "phoned ahead to grease the skids" to make sure everything was ready before he operated, "and I often was there to see to it that mistakes didn't happen after I left. Efficient and proper care? It can only be done this way. It won't be done otherwise."

As to nurses, he adds: "If a nurse is spotted doing these things properly, she is often hired away by a staff man who makes her part of his team." This may be selfish, he allows, "but, by God, his patients know he is not forgetful."