Doctors House Calls Make a Comeback | NY Times- House Calls | By FRANKLIN WHITEHOUSE

NEW ROCHELLE— DOCTORS who make house calls, contrary to a prevailing notion, have not vanished like the 5-cent cigar. They are alive, well and treating patients in the county at night and on weekends.

Most of them are young residents in New York City hospitals who have been recruited by commercial referral services to cover off-duty hours of private physicians and to respond to calls from the public.

They charge patients about $245 a visit to treat conditions ranging from sniffles to sprained ankles but, like Dr. Patrick H. Griffin, they call on ambulances and hospital emergency rooms when it comes to ”life threatening” heart attacks and other ailments.

”I didn’t know what it would be like to take care of patients without 60 million tests and lots of people to back you up,” said Dr. Griffin the other night as he set out in his down vest at the wheel of his wife’s car, heading for Mount Vernon. ”I thought it would be the right thing to do.”

Dr. Griffin is a 27-year-old third-year resident in internal medicine at Columbia Presbyterian Medical Center in Manhattan. One or two nights a week he puts his stethoscope into his ”black bag,” which is actually a white athletic equipment carrier, and goes to work for Medical HouseCalls.

Medical HouseCalls is a six-month-old referral service that Robin Sorelle and Charlotte Spencer operate out of a basement room in Miss Spencer’s home here. A similar service, Cornerstone House Calls, is operated by two gastroenterologists in the Riverdale section of the Bronx, Dr. Robert A. Sable and Dr. Isadore Gutwein.

Both services cover the North Bronx and the southern half of Westchester. Cornerstone began in 1976, covering calls that go to the off-hours answering services of private physicians, Dr. Sable said last week. A new offshoot, called Home Calls, has recently been set up by the two physicians to take direct calls from patients. Cornerstone and Home Calls employ nearly a dozen medical residents trained at the Montefiore Hospital and Medical Center in the Bronx, Dr. Sable said.

Dr. Griffin, like most of the other field physicians, works a shift for Medical HouseCalls that starts at 6 P.M. and ends 12 hours later. A recent night began in Miss Spencer’s basement office over sandwiches and the first knish the Tulsa-born doctor had ever tasted. Dr. Griffin, a graduate of Columbia College and Columbia University’s College of Physicians and Surgeons, has been in New York for 12 years.

”We have about 15 doctors, and we’re recruiting,” said Miss Spencer, who lives on the floors above with her husband, Dr. Harvey Seigerman, a pediatrician with a private New Rochelle practice.

Dr. Seigerman is medical adviser to the business and helps check medical references of the physicians that Miss Spencer and Miss Sorelle enlist at such hopitals as Montefiore, Columbia Presbyterian, Einstein and Lenox Hill.

The Medical HouseCalls brochure shows a fee schedule starting at $45 for a call before 10 P.M., Monday through Friday, and rising to $60 for calls on Sundays and holidays. ”Payment is made directly to the visiting physician at the time of treatment,” the copy says.

The physician keeps $130 of the $245, with the balance going to the service, said Miss Spencer. Medicare will pay up to 80 percent of the costs, Dr. Seigerman said.

When Dr. Griffin arrived one recent week night, Miss Sorelle told him the evening would start with three calls for help already received by the firm’s answering service. The first turned out to be in Mount Vernon.

An 84-year-old woman, the assignment sheet said, was suffering from a ”belly pain.” At 7:20 P.M., Dr. Griffin found her dozing in front of a television set attended by a paid female helper, who said the patient had had a good dinner. Dr. Griffin helped put her to bed.

At the end of a 35-minute examination, Dr. Griffin determined that the patient had bronchitis and possibly ”early pneumonia.” He prescribed an antibiotic called Erythromycin and told her son, who arrived during the examination, to see that his mother received a chest X-ray if she developed a high fever.

”She was a good kind of case for this service,” Dr. Griffin said later. ”She’s old and doesn’t want to go out, but she has to be seen and treated because of possible complications. Her stomach didn’t turn out to be anything at all.”

Dr. Griffin said that the Medical HouseCalls service filled a need for medical treatment among patients not sick enough to be rushed to an emergency room, where a visit can cost $70, yet who need to be seen earlier than their own doctors can schedule.

”It’s unlikely that the doctors we cover would have 30- or 40-minute openings that day or the next,” Dr. Griffin said. The service passes Dr. Griffin’s medical report along to the patient’s regular physician.

From Mount Vernon, Dr. Griffin drove across the city line to the Woodlawn section of the Bronx. He found a 68-year-old man whose son said his father ”had never been sick a day in his life.” But Dr. Griffin found symptoms of pernicious anemia or, perhaps, cancer.

It was one of the cases that Dr. Griffin defined as lifethreatening, and he recommended that family members drive the patient immediately to Lawrence Hospital in Bronxville. Dr. Griffin called the hospital from the house to alert the staff. The time was 8:55.

The last of the night’s calls took Dr. Griffin to the New Rochelle home of Elise Rothberg, 13 year old. Examination showed the girl to have swollen lymph glands and to be ”in the right age group for mononucleosis.”

”Flu or mono,” said Elise’s mother, Lois. ”That’s why she’s been so run-down.” ”That’s why she has no spark,” said her father, Evan, a certified public accountant. Mrs. Rothberg had saved a Medical HouseCalls pamphlet she had picked up in a local pharmacy and called the number.

Dr. Griffin took a blood sample and a throat culture. Then he drove to Dr. Seigerman’s house. ”I’ll do the culture myself,” said the pediatrician. The blood for testing was placed in a metal container resembling a milk box outside Dr. Seigerman’s front door for pickup by a commercial laboratory.

By 10 P.M., Dr. Griffin had put 43 miles on the odometer of his wife’s car, an expense which he said he must write off against the estimated $300 to $400 a month he makes working for the service.

Miss Sorelle said that in addition to internists, the service provides a psychiatrist and a dentist who is willing to open his New Rochelle office at night and on weekends.

She said she had accompanied the psychiatrist to Larchmont on an all-night call early in January to see a patient nearing a breakdown. ”I really think he prevented him from committing suicide,” she said.