Call Coverage and the Specialist Physician

By Tricia Shackelford

A universal truth about physicians… they all agree that call coverage is one of the worst parts of the job.  When a physician is accepted to membership in a hospital’s medical staff, the physician usually commits to being a part of the on-call pool as a condition of being part of the facility’s active medical staff.  After practicing for multiple decades, seasoned physicians are often ready to slow down and pass the baton on to younger, more energetic doctors. However, what happens when an elder physician’s requests to be removed from the call rotation is denied?  Luckily, there may be options – other than retirement.

On-call coverage is governed by a hospital’s Bylaws.  The Bylaw provisions for on-call coverage may differentiate between specialties.  For specialties such as – general practice and internal medicine, there may be many young physicians on the medical staff to provide coverage, which allows the hospital to permit senior physician staff members to be relieved of their call obligations.  For other specialties with fewer members on staff – for example, a hand or wrist surgeon or pediatric surgeon – senior physicians may not have the option of not taking call because there are fewer specialists on staff.  

A hospital may not, however, require a physician to be on-call twenty-four hours a day, seven days a week, three hundred sixty-five days a year.  In situations where a hospital does not have enough physicians on its medical staff in a given specialty to provide reasonable coverage, use of locum tenens services is often a good solution.  Another option may be for the physician to convert medical staff membership status from active to that of a courtesy or honorary staff member as these categories of membership do not generally require call coverage.  This is a good solution if the physician does not frequently admit patients to the facility or treat hospital in-patients.

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