Age-related exemption to on-call

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trinityalumnus said:
Does anyone have a departmental policy, or personal thoughts, on when a provider should be exempt from mandatory overnight call based on reaching a certain age?
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Just personal thoughts. My father is 70 and sleeps about 5 hours a night. Is up til' about 1-2a, then up @ 6a x 7d/wk. He will catch a good 2 hour nappy poo about 3x/wk sometime in the pm.

Now, all he is doing is working in his shop, fishing, hunting or playing golf on a daily basis. But, he is active with a sharp mind.

I do not think he would have a problem with about Q6. Any shorter and he may run down pretty easy, but he has surprised me many times on the amount of endurance that ole' codger has.
 
trinityalumnus said:
Does anyone have a departmental policy, or personal thoughts, on when a provider should be exempt from mandatory overnight call based on reaching a certain age?
Click to expand...

Any such "policy" is bogus and unfair to the "junior" Anesthesiologists in the Group/department. In academia such a policy may be tolerated. In a Private Group it is the kiss of death as it leads to entitlements and privileges.

The best aproach is to PAY for such a privilege. This means a reduction in income or part-time status. 20 years ago it was fairly common for "senior" partners to use the age or seniority excuse to continue to earn full income while reducing/eliminating the night/call burden. However, that creates INEQUITY in the system and resentment.

If a Group decides to allow a "senior" member to go off night/weekend duty those members that actually do that work should be the ones determining the VALUE of it. Any Group which allows the individual receiving the benefit to determine its worth should be avoided at all cost.

Greed and Corruption are not just found on WallStreet; they can be endemic to certain Group practices.
 
Our department instituted a policy in which faculty older than 65 are strongly discouraged from taking call, and to say the least are not required to do so.
 
Current Policy: Everyone takes call. Except of course one guy who has been there forever and also has various leadership positions.

Another place I encountered: If you are going to retire, then the last 6mos may be call-free. Otherwise, get to work.

Thoughts? I feel like I'm 90years old when it's 3am. Therefore I should be exempt.
This conversation is reminiscent of the FAA mandatory retirement age for pilots. It was pretty early, (maybe 60?) but it was recently increased. Age degrades performance for some, but not all. The defensive coordinator for the Super Bowl Champions is in his 70's.
 
BLADEMDA said:
Any such "policy" is bogus and unfair to the "junior" Anesthesiologists in the Group/department. In academia such a policy may be tolerated. In a Private Group it is the kiss of death as it leads to entitlements and privileges.

The best aproach is to PAY for such a privilege. This means a reduction in income or part-time status. 20 years ago it was fairly common for "senior" partners to use the age or seniority excuse to continue to earn full income while reducing/eliminating the night/call burden. However, that creates INEQUITY in the system and resentment.

If a Group decides to allow a "senior" member to go off night/weekend duty those members that actually do that work should be the ones determining the VALUE of it. Any Group which allows the individual receiving the benefit to determine its worth should be avoided at all cost.

Greed and Corruption are not just found on WallStreet; they can be endemic to certain Group practices.
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Blade's perspective from the financial point-of-view is certainly correct. I was asking from the fatigue and patient safety point of view. I only get paid for going to work as I'm not a partner and I don't receive a flat monthly salary.

Twenty years ago I could work all night, remaining reasonably sharp throughout the wee hours of the morning, and still feel OK. Now in my 50s I really feel it at 0200 sitting on a drawn-out case, and I'm dead to the world when the sun comes up. Takes me two full nights of good sleep to feel truly recharged again.

I don't mind pulling my fair share of the load at work (and again, I don't get paid if I'm not there). I also don't want to zone out and cause a patient safety incident at 0200. And, after hours (1500-0700), we're totally alone --- no backup available.

So, at what age would it be considered reasonable for someone to request to be taken off the overnight call schedule, even if it meant pulling some 0700-1900 weekend on-call shifts in return?
 
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trinityalumnus said:
Blade's perspective from the financial point-of-view is certainly correct. I was asking from the fatigue and patient safety point of view. I only get paid for going to work as I'm not a partner and I don't receive a flat monthly salary.

Twenty years ago I could work all night, remaining reasonably sharp throughout the wee hours of the morning, and still feel OK. Now in my 50s I really feel it at 0200 sitting on a drawn-out case, and I'm dead to the world when the sun comes up. Takes me two full nights of good sleep to feel truly recharged again.

I don't mind pulling my fair share of the load at work (and again, I don't get paid if I'm not there). I also don't want to zone out and cause a patient safety incident at 0200. And, after hours (1500-0700), we're totally alone --- no backup available.

So, at what age would it be considered reasonable for someone to request to be taken off the overnight call schedule, even if it meant pulling some 0700-1900 weekend on-call shifts in return?
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Our docs can opt out of night call beginning at age 50 - in our group, those shifts are fairly lucrative relative to a day shift, so they do take a $ hit because of that. We are fortunate to have anesthetists that exclusively work nights, but those of us who take call are required to cover if they're on vacation. Fortunately, because of the extra days off that come with doing night shifts in my group, it's fairly easy to never work nights if you don't want to.

And speaking as another >50 guy, I can definitely tell a difference at this age. In my 20's I could stay out till 4am on Friday night and be at work at 7am on Saturday morning. No more - it would kill me.
 
These situations only work in the larger groups. Small groups need as many people in the call pool as they can get and would really frown on someone opting out.
 
I have an attending who is 82 years old, yes 82. He takes call about once a month. The guy is super sharp. In fact, he is one of the rare attendings who will show up when called for a late night code, extubation, epidural, etc. and heshows up in a jiffy.
 
Mofeen said:
I have an attending who is 82 years old, yes 82. He takes call about once a month. The guy is super sharp. In fact, he is one of the rare attendings who will show up when called for a late night code, extubation, epidural, etc. and heshows up in a jiffy.
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At 82 you better check if he is the CODE.
 
Mofeen said:
I have an attending who is 82 years old, yes 82. He takes call about once a month. The guy is super sharp. In fact, he is one of the rare attendings who will show up when called for a late night code, extubation, epidural, etc. and heshows up in a jiffy.
Click to expand...

Our former chair continued to take call until the stepped down, in his early 70s. He would work all day, be on call all night, then head back to this office after call and do admin work for a full day before going home.
 
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