Call from Hell

[Adcadet]

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hey all -
just wondering what people thought about the different amount of call the various IM specialties have to take, and the different types of call. Of particular interest is the call of critical care docs. Are CCM docs frequently at-home on call, or is this one of those times when being at home is too far away to be of any use and thus there is no at-home call? And what about call schedules at private vs. teaching hospitals? How does call during residency compare to call during fellowship and practice?

Thanks!
Adcadet

 

[Kalel]

I think that most ICU's have to have at least one on call physician on the premises at all times. A pulmonologist was telling me that most states only require a CC trained physician to be in house for 8 hrs every 24, meaning that a regular internist can cover for the rest of the day. As with all specialties, the larger the group, and the less income you are willing to earn, the less your call will be. Your question regarding call with academic hospitals vs private hospitals is a complicated. In in private primary care and out-patient groups, private groups cover call for their patients, meaning that if none of their patients are admitted anywhere and need their assistance, they can occasionally have quiet overnight calls. In academic centers, call means the attendings team admits patients that night that show up in the ER or are transferred to their team. Some attendings at my school stay close by while the team is on call, while others just rely on the resident to relay info about new patients to them over the telephone. Call in residency is similar at most programs with the 80 hr work week rrc requirement, which generally means q4 call, usually with night float during most general medicine rotations. Call during fellowships is often q4 too, but it differs from specialty to specialty, school to school.