I've just never heard of a physician in private practice who didn't have some sort of after hours mechanism for patients to get taken care of. However, that said, I will say that docs get frustrated by patients calling with very minor issues at 11pm at night (like they knew 2 weeks ago that they were going to run out of a prescription, but didnt call anyone until 11pm at night on a weekend, or they have minor itching or something and call up someone at 2am). Also, some cardiology patients will call in the middle of the night and say they have chest pain - the answer/response is going to be call 9-11 or go to the ER, since we can't tell by talking to somebody over the phone whether something bad is going on. Still, I don't see how these docs can get away with not having anybody on call at night...it generally comes with the job and I think it's definitely a liability risk. At my fellowship program we (fellows) take all the phone calls at night and on weekends, so the attending doctors never have to take patient phone calls at night. So usually the way one gets out of taking patient phone calls is to be an academic attending doctor...LOL.
