The editorial "Controlling Doctor Bills" {Oct. 12} was off the mark. Don't blame the "greedy" doctor for the rising costs of Medicare. Despite no claims having been paid out by my malpractice insurance carrier on my behalf over the past 25 years, my premiums have quadrupled in two years from $8,000 to $36,000 annually. Where will it end? Who will pay? The patient (or the government in some cases).

There is no way I can quadruple my patient load or my fees for service. Look at the insurance industry for greed. Many of us are having to quit the practice of medicine because it is becoming more difficult to earn a respectable living for the responsibilities we bear. The insurance industry needs to be investigated for regulation to control the hemorrhage in medicine today.

JULIUS S. PIVER, M.D. Chevy Chase

The editorial on doctor bills seemed to put the blame completely and solely on "greedy" physicians for the continuing rise in Medicare expenditures. It is surprising that after so much thought on the subject, a very important variable was completely left out of the equation. The prophylaxis necessary in the prevention of malpractice suits probably accounts for a large portion of the increases in doctor billing the editorial described.

Doctors are prescribing more services because the failure of a physician to order a procedure could result in a charge of or conviction for malpractice -- even if the procedure has only a one in 100,000 chance of identifying disease. It's not that physicians must order tests with little sensitivity. Proper medico-legal practice now seems to require that physicians advise patients to have tests done, even if their better judgment tells them that the patient probably does not need to have a certain test performed to confirm a diagnosis.

Where previously a physician would have relied on his skill in the art of medicine to lead to a diagnosis, one is much safer now relying on the science of medicine to protect one's proverbial hide.

With this variable added to the equation, it seems unfair to blame physicians for "out-of-control" Medicare costs. I am a medical student, and I say it's the out-of-control malpractice situation in our country that needs fixing.

BRUCE KAHN Washington

Painstaking inquiry and assemblage of facts make for a difficult process of coming to a fair conclusion, so once again, though the facts are there for the asking, The Post has chosen the expedient of doctor bashing. The 38 percent increase in Part B premiums for Medicare beneficiaries is as alarming as it is complex, and the only thing really known about it is that not all of the increase is due to physicians' charging more or even seeing a greater number of patients.

Instead of setting small annual increments in the premium price, the government dug into reserves over the past two years and now has had to come up with this alarming increase all at once. About 9 percent of the total increase is caused by an increase in services provided by physicians, but even this piece of the pie is complicated by a shift of more services from the inpatient to the outpatient setting, by improvements in technology and by tests ordered by physicians for their patients. More claims were paid this year than before because of a legislative mandate to make payments quicker than the customary six weeks. And the population has grown, creating more demands for service.

Thus, more than 80 percent of the Part B premium increase appears to be the result of a variety of complex matters not under physicians' control.

CHARLES P. DUVALL, M.D. Washington