Private Practice Call

[DrRobert]

Another busy call night. These 24 hour in-house calls can be brutal.

Any of the private practice guys want to share what call is like in the real world?

24 hour (7AM-7AM) vs. 16 hour (3PM-7AM)
In-house vs. Beeper
Post-call day off vs. Not
q4 vs. q7, etc.
Weekend call vs. Weekday call

I really hope it gets better than this.

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[UTSouthwestern]

Another busy call night. These 24 hour in-house calls can be brutal.

Any of the private practice guys want to share what call is like in the real world?

24 hour (7AM-7AM) vs. 16 hour (3PM-7AM)
In-house vs. Beeper
Post-call day off vs. Not
q4 vs. q7, etc.
Weekend call vs. Weekday call

I really hope it gets better than this.

Can be any way you can imagine. Some groups have only pager calls some have traditional in house overnight call. One in seven days call, one weekend in 7 weekends on call is the average I hear around here.

 

[DrRobert]

Can be any way you can imagine. Some groups have only pager calls some have traditional in house overnight call. One in seven days call, one weekend in 7 weekends on call is the average I hear around here.

What's it like for your group?

I think if some private practice attendings can shed some light on how their group does it, that would give us residents a general idea of what to expect.

 

[pd4emergence]

We come in at 3 p.m. on weekdays and usually leave by 7 or 8 the next day. Weekends are split up one Fri/Sun person and Saturday is split between two people with the morning person leaving at one or so and the evening person staying sunday until 8 am. Sunday calls are the only one where we are there for close to 24 hrs. All our call is in house. Some nights are good some are not so good. OR schedule and afternoon addons usually done by 9 or 10 pm. Most nights there are a few cases after and usually 3-4 epidurals on OB. Usually about 1 call in 4 are miserable and 1 call in 4 we don't really do much. The other 2 are sort of medium with some sleep in between cases or epidurals that trickle in. I usually have about 4-5 calls a month. 1 or 2 of which are on weekends (either Fri/Sun or Sat) so usually just one weekend a month.

 

[deleted126335]

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[Laurel123]

What's it like for your group?

I think if some private practice attendings can shed some light on how their group does it, that would give us residents a general idea of what to expect.

OB call: about twice a month. 24 hours. Post call off. Hospital gives stipend and then we eat what we kill during we stiff. So unlike residency when you hope for a quiet call, I hope for a really busy call. I feel like as long as I am in house, I want to get killed - and then make great money.

OR call:about once or twice a month. Starts at 4pm to 7am. Stipend. Usually not that busy with cases until about midnight and then after midnight if there is trauma. post call off. Again, I would rather work all night long

Pager calls - 2nd or 3rd calls. about two to three times a month. Go home after cases are done but have to have a 20 minute response time to get back for traumas. 60-70% of the time, after we leave, we don't get called back. I sort of hate waiting at home feeling. No stipend.

Unlike residency, when call is hideous, call in private practice is money. So every month there are at least two people in the group that are asking to take your call because they need more income.

 

[coprolalia]

I like the "eat what you kill" incentive in your OB call, Laurel. I agree that this makes call much more palatable. If you reward people for hard work beyond what they're already getting, it makes getting out of bed at 3:30 AM to a complaining laboring woman much less irritating.

Also, I think the P4P initiative has it all wrong. It's not really set-up to reward people, but to punish them. But, I recognize that may be a topic to start on a different thread.

-copro

 

[johankriek]

We come in at 3 p.m. on weekdays and usually leave by 7 or 8 the next day. Weekends are split up one Fri/Sun person and Saturday is split between two people with the morning person leaving at one or so and the evening person staying sunday until 8 am. Sunday calls are the only one where we are there for close to 24 hrs. All our call is in house. Some nights are good some are not so good. OR schedule and afternoon addons usually done by 9 or 10 pm. Most nights there are a few cases after and usually 3-4 epidurals on OB. Usually about 1 call in 4 are miserable and 1 call in 4 we don't really do much. The other 2 are sort of medium with some sleep in between cases or epidurals that trickle in. I usually have about 4-5 calls a month. 1 or 2 of which are on weekends (either Fri/Sun or Sat) so usually just one weekend a month.

I hope you are getting paid a lot of money.

 

[pd4emergence]

I hope you are getting paid a lot of money.

I look at it as my private practice fellowship. Good experience. Good partners (even though we all work hard). Decent pay. The length of my fellowship will be determined by how quickly I get my loans and most of my house paid off. It also has something to do with getting valuable real world experience. Then it is back to academia where I will never ever ever ever put a stat c section to sleep even if it means the kid will be a vegetable (just kidding).

 

[johankriek]

I look at it as my private practice fellowship. Good experience. Good partners (even though we all work hard). Decent pay. The length of my fellowship will be determined by how quickly I get my loans and most of my house paid off. It also has something to do with getting valuable real world experience. Then it is back to academia where I will never ever ever ever put a stat c section to sleep even if it means the kid will be a vegetable (just kidding).

i hear ya.. what you described is 500 material..... easy... staying in house? 5 times a month? thats 50 times a year you are sleeping in the hospital.. its all good as long as they show you the money cuba gooding jr style.

 

[objdoc]

i hear ya.. what you described is 500 material..... easy... staying in house? 5 times a month? thats 50 times a year you are sleeping in the hospital.. its all good as long as they show you the money cuba gooding jr style.

?? sounds like about 65 hrs/wk FTE to me...

 

[kmurp]

2 smallish hospitals with a first call at each (beeper) and one second call person taking beeper call covering both places. 13 guys in the group so that is 365*2= 56 1st calls and 14 second calls per year.
Actually, it's a bit more complicated as we have a night float on beeper at each place from Sun-Thursday and he replaces the "1st call" at 10PM. The first call person then works the next day. Sometimes we also need the night float guys during the day. Most work is done by 9-10PM. One hospital often has 2 rooms in the evening though.
Weekends we do 24 hr call on Fridays and Saturdays. Sunday is till 10PM with the night float week guy taking over at that time. On weekends we do only one 1st call day. For example, I am on this Friday and will be off at 8 AM Sat. If I were 1st call Sat, I would be off 1st call on Sun, BUT, I would then be on second or backup call on Sunday.
God even I don't understand our system-hope it makes some sense to you. They way we do it minimizes the chance of being up 36 hrs in a row by splitting the weekend call into parts; this is good especially after one reaches a certain age...it is cumbersome because you have more people on for more partial weekends and therefore are free and clear less often.