PULSE HOUSE CALLS ARE THEIR BAG.

Byline: Mariko Thompson Staff Writer

You're sick, it's the middle of the night, and you can't wait until morning to go to the doctor. Do you gut it out or go to the emergency room?

Next time this happens, SOS Medlink is banking you'll pay to bring the doctor to you. The new house-call service was launched in December in West Los Angeles. Founder Veronique Mastey says the company plans to expand to the San Fernando Valley next.

``We're in business when the doctors aren't,'' Mastey said. ``Going to the emergency room is a minimum four- to six-hour wait unless you have a heart attack or a gunshot wound. Our service will allow the ERs to handle the emergencies rather than the nonemergencies.''

House calls in various forms have made a comeback in recent years. Some, like SOS Medlink, offer their services to the general public. Others target a particular niche, such as Medicare patients or travelers.

Doctors who work for house-call services say they're drawn by the promise of reduced daily case loads and the ability to practice a more personal brand of medicine. For consumers, the allure is time and convenience. According to the Centers for Disease Control and Prevention, Americans made 108 million visits to the emergency room in 2000, a 14 percent increase over 1997. Patients with nonurgent medical needs waited 68 minutes to see the doctor in 2000, compared to 51 minutes in 1997.

``It's a return to how medicine used to be practiced before there was so much technology involved and before highways got so congested,'' said Paul Ginsburg, an economist and president of the Center for Studying Health System Change in Washington, D.C. ``There's a fertile field to pursue, offering people who can pay better services than have been available in the past.''

Though insurance companies have billing codes for house calls, consumers would be wise to check with their health plans first, said Walter Zelman, president of California Association of Health Plans. The average consumer is better off going to an urgent care center that has agreements with most health insurance plans, he said.

``This is an upscale, limousine way of delivering health care,'' Zelman said. ``Your insurance company may reimburse some or none of it.''

At SOS Medlink, Dr. Louis Fishman, an internist, and Dr. Peter Waldstein, a pediatrician, serve as the clinical directors. Calls are answered by a registered nurse who assesses the symptoms and dispatches the physician. The service promises to have a doctor at the patient's door within an hour.

A doctor's visit costs $225 on weeknights and $250 on weekends and holidays, excluding diagnostic costs or pharmacy services. Patients are expected to pay for the service and then submit the bill to their health insurance carrier.

``When I went into private practice, I was trained from the old school to do house calls, which I still do to this day,'' Waldstein said. ``I thought (SOS Medlink) was a fabulous thing, especially with the county emergency rooms having problems.''

--For more information, visit www.sosmedlink.com.

LEND ME A HAND: Swollen and/or aching hands from autoimmune diseases such as arthritis, fibromyalgia or lupus can make cooking, gardening and even dressing more than just a chore. Sometimes it's too painful to get a grip on the tools or buttons. A number of companies are now addressing the growing health problem.

To learn more about all the new adaptive tools for your home and office, check out certified hand therapist Martha Patterson's program at 6:30 p.m. March 4. The event is sponsored by the Conejo Valley Lupus Support Group and will be held at 4415 S. Lakeview Canyon Road in the former Westlake Village Hospital. Admission is free. For more information, call [phone] or Lupus International at [phone].

Among the newest hand-friendly products you'll find at garden centers is the Easi-Grip collection of garden tools from Great Britain. The hand tools designed by Lionel Crockett with the help of orthopedists and physical therapists have anatomically friendly shapes and handles to reduce stress. They're $10.95 each and can be purchased in standard or long-reach versions for gardeners who have difficulty bending. Look for them at garden supply stores or online at www.peta-uk.com.

Igo Home Products already has a reputation for soft-handled kitchen utensils, but the company recently added a lightweight cordless drill that's easy to hold and operate. You can find it for $9.99 at Albertson's, RadioShack, Rite Aid and other major retailers.

For those women who have difficulty fastening a bra, there's the Easy-to- Fasten Bra collection that is endorsed by the American Occupational Therapy Association. The collection utilizes larger hooks and Velcro and can be found at JC Penney and specialty shops or at www.leadinglady.com.

- Barbara De Witt