More US hospitals andlarge medical groups arepaying on-call physicians,although those who do are stillin the minority. According to the 2003 PhysicianCompensation and Productivity Survey from Sullivan,Cotter & Associates, 40% of the organizations polledpay on-call physicians—up from 19% in 2001. Theamount of compensation is tied to whether the doctorstays on the premises or remains outside the facility,reporting there only when called. As expected, compensationfor doctors who stay on-site is higher thanthose who aren't required to stay on the premises.
The pay for an on-call doctor also varies by specialty.According to the survey, an on-call anesthesiologistaverages $80 an hour on-site and $32 an hour off-site,while doctors in most surgical specialties averageabout the same. Primary care physicians, on the otherhand, average $46 an hour on-site and $7 an hour offsite. The lack of pay, along with other problemssuch as care that hasn't been reimbursed, have causeda crisis in emergency rooms across the country, as somespecialists are opting out of on-call duty.
Required by federal law to have some specialties oncall at all times, hospitals sometimes pressure specialiststo be on call 24 hours a day, 365 days a year, tomaintain their hospital privileges. As a result, somedoctors began limiting their practice to a single hospitalto avoid onerous on-call rosters. This has resulted ina limited number of specialists on call and created aspecialist shortage in many hospital emergency rooms.
Last year, the Center for Medicare and MedicaidServices revised its regulations, allowing hospitalsmore flexibility in setting up on-call schedules. Ineffect, this means that some specialists might not beon hand at all times. Critics charge that emergencycases might not be able get the type of specialistcare they need under the new rules.