Questioning New Lab Rules

On the matter of new regulations for doctors' office labs {Policy, Sept. 18}, these proposed rules ignore the technological advances of the past few decades. Just as personal computers brought computer power to the desktop, new technologies are giving physicians the ability to perform desktop chemistry and hematology right in their offices. It has also made possible public health screenings for cholesterol and other tests and has given people with diabetes the ability to test their blood glucose levels at home. Other technology is bringing testing directly to the patient's bedside.

If the proposed rules are approved, many physician office labs would close and public health screenings would be nearly impossible. This would severely restrict access to health care. Particularly in rural areas, only the most basic testing would be done. Patients who needed other tests would have to travel long distances or wait days or even weeks for diagnoses. In some cases, delayed diagnoses could lessen the chances for successful treatment. In other cases, people simply won't get the tests they need and diseases will progress undiagnosed.

While regulation of laboratories is necessary to assure public health, the regulations should be as up-to-date as the technologies they regulate. The rules under consideration do not meet this simple test. Instead, they would add to health care costs while harming, rather than helping, public health. Richard G. Flaherty Vice President Health Industry Manufacturers Association Washington The Role of Antidepressants

In response to comments that antidepressant drugs are to be used only as a last resort {Letters, Sept. 18}, then discontinued as soon as a non-drug support system is in place, I feel that such a statement is misinformed. If one is talking about tranquilizers, such as Valium, that is correct; these do give temporary relief from some mental illnesses and can be reduced or discontinued at the proper time.

However, these drugs are not the same as tranquilizers; they affect the electrochemical processes of the brain's synapses, or gaps between brain cells, that control nerve impulses within the brain. One does not get a "buzz" or mellow feeling. Normally, four to six weeks pass before a depressed person begins to feel better. If depression were a purely psychological illness, then medications would have no effect, but since it is really a physical disease, many depressed patients feel better while taking antidepressants without "talk therapy." I hope this letter helps someone who is depressed and is hesitant about taking antidepressants. One last point: taking antidepressants is not the same as popping a Valium when one feels anxious. J. Mark Harl Germantown Hearing Loss: An Invisible Disability

Hearing loss is the most common but one of the least understood physical disabilities in this country. As a barrier to communication, it cuts people off from other people, and that is very serious, especially for children. That is why hearing impairment should have been mentioned in the article on mainstreaming children with disabilities in regular classrooms {How & Why, Sept. 25}.

A hearing-impaired child may be able to enter a classroom or a playground but may find it very difficult to take part in what is going on there. Deaf children cannot watch television unless the show has captions (and most do not) or call their friends on a telephone unless it has special equipment. Movies are not much fun when you can't hear the sound (no dramatic movies, only foreign films, are captioned). Our pain may be as invisible as our hearing loss, but it is still very real. Joan M. Cassidy President Self-Help for Hard of Hearing People Sterling