"Is There a Doctor in the House? It Just Might Be You."

Eleven years ago, a sharp Washington Post editor wrote that headline over a story I had done about an unusual new book called "Take Care of Yourself: The Consumer's Guide to Medical Care" by Drs. Donald Vickery and James Fries.

"When should you call a doctor?" I wrote. "Should you phone -- or even seek immediate care -- for your sore throat, headache, sprain, chest pain or burn? What could prove to be the best way yet to answer that question has

been published in the form of 68, mainly simple flow charts that quickly give anyone who can read a 'yes' or 'no' answer."

Today, nearly 4 million copies later, the third, much enlarged edition of this book

has been published (Addison-Wesley, $14.95). There are now 99 flow charts and a good deal more information on taking care of yourself. But consulting this book, in my opinion, is still the best way for a family or individual to answer the questions: "Must I call the doctor or even go to an emergency room? Or can I take care of this?"

The flow charts are the key. I had read much the same information before in paragraph form in a score of books. But it is somehow hard to absorb this kind of advice from a complicated printed paragraph. It is easy to absorb it from a chart -- like one on headache -- that first asks "Is the headache associated with fever and stiff neck?" Yes? "See physician now." Then come more questions, and often the flow chart concludes: "Apply home treatment," which the book also explains.

The charts alone do not and cannot give you complete guidance. Each is accompanied by a text with further explanation. Vickery and Fries say: "Our advice is as sound as we can make it but, like advice from your doctor or nurse, it will not always prove successful . . . If a problem persists, see a doctor . . . If you're under a doctor's care and get contrary advice, follow it."

Just the same, they believe, "You can do more for your health than your doctor can . . . 'Take care of yourself' means responding decisively to new medical problems . . . Most often, your response should be self-care, and you can be your own doctor . . . Over 80 percent of new problems are treated at home, and an even larger number could be." ::

Donald Vickery met James Fries in 1969, when he was a medical resident getting his advanced training at Stanford University. He worked with Fries on computer programs to help doctors decide, step by step, on a patient's diagnosis and treatment.

Working at Stanford later, Fries made what he believed to be the first flow chart for medical diagnosis. Vickery soon found such charts could be even more useful to people who are medically less sophisticated. In 1971, he became an Army doctor and spent two years developing such charts to train physicians' assistants, nurses and Red Cross volunteers at Fort Belvoir, Va., clinics.

As Vickery and Fries once put it, "We started to develop computer programs for diagnosis. To program the computer, we had to develop flow charts. Then, we realized that the greatest contribution we coud make was the charts. They are really the standard medical advice put down simply." ::

An Armco Steel vice president once started scanning the Vickery-Fries book to help decide whether to buy it as part of an employe health education program. He carried it with him on a business trip. On the way to the airport, he began to feel chest plain.

He took the book out of his briefcase, consulted it, then got himself to a hospital, instead of the airport. In the hospital emergency room, he suffered cardiac arrest and was successfuly resuscitated. Had he continued on his trip, he would probably have died.

The Vickery-Fries book and associated materials are now used by scores of companies like Lockheed, Stauffer, Johnson & Johnson, Black & Decker and Giant Foods as part of employe health programs. To develop and sell these, Vickery now heads the Center for Corporate Health Promotion, a Reston-based subsidiary of Travelers Insurance Co.

With Dr. Robert Pantell, Vickery and Fries have also written "Taking Care of Your Child: A Parents' Guide to Medical Care," now in a third edition (Addison-Wesley, $12.95). Vickery hopes to produce future guidance for three growing groups, the chronically ill, the aging and the family members and others who help care for them. ::

The Vickery-Fries books have new, high-quality competition. The American Medical Association has produced its latest "American Medical Association Family Medical Guide" (Random House, $29.95) and three smaller guides, "The American Medical Association MEN {or WOMEN or CHILDREN}: How to Understand Your {or Their} Symptoms" (Random House, $9.95 each). These books also use flow charts to help you decide what to do. They are much more complicated, mainly because they include more advice, information and possible diagnoses of the sort Vickery and Fries cover in accompanying texts.

I'd recommend buying the Vickery-Fries book first, then, if you can, adding one or more of the AMA books for additional understanding.

Next Week: When you really need a doctor.