Beeper Call

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ms99

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It seems like most programs talk a lot about in-hospital call. I've recently realized that "beeper call"...or being available for your outpatients after hours...can vary a lot between residencies. I know that some programs have none of this, while others expect you to carry a pager 24/7. What's expected at most programs?
 
It seems like most programs talk a lot about in-hospital call. I've recently realized that "beeper call"...or being available for your outpatients after hours...can vary a lot between residencies. I know that some programs have none of this, while others expect you to carry a pager 24/7. What's expected at most programs?

Wow. Would not like this one bit. We take call from home (hospital only, no outpatients) after call in house and that 's bad enough. Call blows. Worst idea in medicine. Giving outpatients a number to possibly pester you after hours during the most valuable of things, that being your free time? Bad idea. Now giving them each other's number may be interesting. Just give them a number for a crisis-line or something. Best thing to do is to leave work at work.
 
My program does have an after hours emergency pager for outpatients to use if some kind of crisis occurs. We take turns covering it. I think that sort of model makes more sense than patients being able to page their personal doctor at all times.
I would definitely recommend trying to avoid programs that expect you to be available to patients 24/7.
Psychiatry - especially outpatient therapy IMO - is very emotionally taxing at times and I think it's important for your psychological well-being to have times when you truly are off from all responsibilities.
 
It seems like most programs talk a lot about in-hospital call. I've recently realized that "beeper call"...or being available for your outpatients after hours...can vary a lot between residencies. I know that some programs have none of this, while others expect you to carry a pager 24/7. What's expected at most programs?

I don't know of any programs where you are expected to provide your patients with your pager number. At my program we were not expected to do this.

That being said, it is probably not uncommon in private practice to provide patients with a pager or cell phone number. During my residency training I admitted countless patients who, when asked for their therapists' contact details, gave me a cell phone number. Personally, that would drive me batty. But then again, I am not in private practice nor am I getting paid the big bucks. Fine by me.
 
Beeper call usually means home call coming in only as necessary and possibly answering calls from outpatients in crisis whilst on call only. I am not aware of any (good) programs that require individuals to answer their pager 24/7. You should turn your pager off after 5pm unless on call!
 
Beeper call usually means home call coming in only as necessary and possibly answering calls from outpatients in crisis whilst on call only. I am not aware of any (good) programs that require individuals to answer their pager 24/7. You should turn your pager off after 5pm unless on call!

Agreed
 
We are expected to be "on pager" 24-7 x 4 years. We are supposed to have a pager buddy to whom we sign out one day of the week (we never do as PGY 1 or 2). It's most frustrating during 3rd year (so I hear). My husband already hates it. Got paged at 2 am yesterday by a family member of a patient I evaluated in the ER trying to ask me to do a personal favor for her (magically produce a bed in our full hospital). It's one point in the pro-fast track column.
 
We have call from home in our program. We have a call schedule for unit coverage and only go in for seclusion/restraints. We are always on call for our own outpatients though. Calls are pretty rare though.
 
For our program:

During 1st and 2nd year we do in house call. 2nd year and 3rd year we do back up call a few weeks a year which means if the resident on call ends up needing surgery for appendicitis or gets concussion or something we go in usually happens 1 or 2 times a year total between all residents. 3rd year we go in with the 1st years 6x to show them the ropes but we don't do any of the actual work. As 3rd year we are on phone back up if the 1st years have problems but 99% of the time they will call the attending because the attending gets paid and we can't sign off on discharge or commitments anyways. 4th years have no back up or buddy call.

Third year is all outpt for us. Two days a week pharm management (most of our pts) , 1 day lectures, 2 days high functioning college kids for therapy only (with a cap of 7 at any point in time). Most of us choose to have our ed notify us if one of our 7 private therapy pts shows up so we can deal with it personally. This usually happens to ~1 resident once during 3rd year. Other than that we don't have any sort of beeper call for our outpts and are not contacted after hours.
 
We have call from home in our program. We have a call schedule for unit coverage and only go in for seclusion/restraints. We are always on call for our own outpatients though. Calls are pretty rare though.

Would you by any chance be able to PM me which program you're at? And as far as always being on call for your own outpatients...isn't that stressful just trying to be ready to shift into "work zone" at any time? I feel like I might go crazy if I have to bring my pager w me if I ever want to go out to a restuarant, see a movie, have a glass of wine..(?).
 
Our 2nd years cover the night pager for the outpatient clinic while they're doing in-house call. 3rd year and on does no beeper call. Our 3rd years do wind up doing 1 weekend day shift in house every 5 weeks or so.
 
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