Having Call vs Shift Work -Which is Better?

[MadScientist95]

From my understanding, there are pros and cons to both. What do you guys think?

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[medhopeful82]

I'm going EM so I am obviously biased towards shift work. I don't like the idea of having to stay sober and close by the hospital on days/hours that I'm off just incase I get called in. Also, per hour the pay will always favor shift work >>> call.

On the other hand, as you age/become more senior in your practice call days will be fewer and much easier if you have midlevels and residents, but shift work always remains the same

Edited to add: for the sake of sounding like an alcoholic, it isn't just the drinking. my hobbies happen to include a lot of things that would be outside the city (hiking, fishing, climbing, camping, etc) so that would be difficult to participate in if on call often

 

[Matthew9Thirtyfive]

Depends on what you prioritize and what specialty you're going into. Personally, I don't find having to be sober once in a while to be a burden (I'm a teetotaler, so I don't drink anyway), as I can think of plenty of ways to enjoy myself without alcohol. Some people can't have fun unless they're drinking or at least free to drink, so that would be miserable to them. I don't particularly like rotating shifts, but taking OB call would be miserable too.

 

[libertyyne]

on call there is a potential of getting paid to sleep in the comfort of your own home. But there is also a risk of getting called into the hospital for a procedure and as soon as you are done you walk in and then have a full day of work ahead of you.
Rotating shifts sounds miserable and would probably cut years off my life.

 

[CharlieBillings]

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[Dr. Doctor MD]

Aren't there fields that have neither? Derm?

~Note: Not interested in derm

Derm absolutely has call as does almost every field in medicine, it's just some fields have much lighter call than others. There always needs to be a doctor on call even in derm/optho, and if you're a solo private practice, then it's 100% of the time. However most are in large single specialty groups where they can split call evenly to only have to take call one week every 2 or 3 months, and rarely do you need to go in, so it's almost always home call via phone. So to answer your question, yes derm (and similar specialties) do have call.

 

[CharlieBillings]

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[CherryRedDracul]

Depends on the type of call. Depends on the time of shift work.

Call can mean you're sitting in the luxury of your home and may get called into the hospital for something. How frequently you get called in depends on the type of specialty. An endocrinology fellow will be called into the hospital a lot less frequently than an interventional radiology fellow or resident.

Shift work often entails physicians working all sorts of weird hours. Young people can handle changing from nights to days and then back to nights a lot more easily than older folks.

I'd rather just do something with a regular schedule, either only days or only nights.

As far as radiology goes, you can get away with no call and no weekends depending on the type of practice.

 

[OnePunchBiopsy]

To each their own.

I’ve always preferred the idea of being called in to see patients who are post-op or new ones with a surgical issue.

I wouldn’t mind shift work if things were busy. It’s just a drag when it’s slow, having to count down the clock.

Also if my shift was done, I would absolutely hate staying longer. This can happen in EM if an unstable patient comes in at 10:50 and your shift ends at 11.

 

[MadScientist95]

 

[MadScientist95]

What about hospitalist shift work? From my understanding this is less random in that one can usually expect to work 7 on and 7 off, with usually working 7 AM to 7PM and doing a week of 7 PM to 7 AM every couple of months. I have heard this is easier to do since it is more consistent than EM where you have a lot of random shifts.

 

[Candidate2017]

Depends on you. The frequency, length and time of day you have to do shifts/call varies greatly between specialties and how well you negotiate. Some things for some specialties are generally not negotiable... doing day AND night shifts in EM, call for interventional stuff. Call varies as to the amount of pages and what is expected. Are you expected to come in vs handle pages via phone?

 

[Candidate2017]

Aren't there fields that have neither? Derm?

~Note: Not interested in derm

Psychiatry.

 

[Dr. Doctor MD]

Yeah but this is a "technically they have call because many of them do" or a "all of them have call" scenario? Do dermatologists ever sign contracts that have no call? Do hospitals even accept people ever accepting no call?

I remember shadowing a dermatologist in their 40s saying "I don't take call anymore" as well as learning that many IM subspecialitiy physicians "don't take call anymore" once they reach a certain age or seniority (as a scribe this was often an issue contacting people).

I feel like the better question is "What fields CANNOT get a job without taking call?".

It really depends but I don't think anyone in derm can escape call unless they were in a very large group and specifically stated in their contract that "Doctor X will not share in the call schedule" which if the group was okay with they would probably take a pay cut in order to have that. Although realistically, I doubt there are groups out there who would love the idea of hiring someone with that mindset. But I'm sure this can be found if you look hard enough. Let's say there is a Derm group with 10 MDs, then each doctor would take about 5 weeks of call to cover all patients at all the offices for that group. Basically your call is just making sure that the patients seen by your practice have access to a doctor in case of an emergency or situation directly arising from your care of that patient.

As far as hospital call, this is much less common in dermatology. Academic derm places will cover their hospital system, but I don't believe it is very common for private practices or single specialty groups to take derm call for a hospital, or at least I haven't seen it.

tldr; If you try hard enough you could probably arrange a contract where you don't share in the call pool, but you'd probably take a compensation hit and/or alienate some of the other doctors.

 

[Tenk]

Shift work with dedicated nocturnists > all.

 

[CharlieBillings]

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[Matthew9Thirtyfive]

Interestingly the dermatologist in question was a prior director of the department, but stepped down to focus on family life. They also mentioned a pay cut but that it was worth it!

What about fields like pathology, radiology, or some kind of cardiologist who only reads echos (I only hear this existing as a rumor).

Pathology has call. How busy it is depends on the service you’re on and where you are, I guess. Even in residency it is home call though (at least at my home program) and usually the calls can be answered from home. But sometimes there are issues that require you to go in.

But just like there are gas, rads, psych, etc. practices with no call, I’m sure there are path attendings out there not taking call.

 

[CherryRedDracul]

"tommorrow"

SMH. It's "tomorrow". Embarrassing.

 

[Neopolymath]

Post call days are awesome. If you told me I would work 6-5 5 days a week and a weekend every once in a while I would be pissed. I learned long ago that longer hours but less days is far better. It's why a lot of people hated getting q3 24 hour call changed to night float where you work 16 hours 6 days a week in residency a while back. The golden weekend is worth the longer shift. No brainer for me.

 

[CyrilFiggis]

Like everything, the only true answer is “it depends”. But it shouldn’t be the reason you choose a specialty. You’ll hate any time in the hospital/clinic if you despite your field.

 

[takeurmeds02]

Depends on what you prioritize and what specialty you're going into. Personally, I don't find having to be sober once in a while to be a burden (I'm a teetotaler, so I don't drink anyway), as I can think of plenty of ways to enjoy myself without alcohol. Some people can't have fun unless they're drinking or at least free to drink, so that would be miserable to them. I don't particularly like rotating shifts, but taking OB call would be miserable too.

that was so aggressive lol

 

[Matthew9Thirtyfive]

that was so aggressive lol

Ha. I didn’t mean it to be. Everyone is different. My partying days are over lol.

 

[cbrons]

From my understanding, there are pros and cons to both. What do you guys think?

Both are bad

 

[Splenda88]

A nurse just called me while I was drinking wine because a patient was having hiccups... There is your answer.


Calls seem cool when you are a med student, but you will hate that **** 6 months into residency.

 

[Angus Avagadro]

I have done both. I prefer call. Shift work was to hard on my system. After your body adjusts to nights, you're back on days. At least after a bad call you can get back on your sleep cycle.

 

[NickNaylor]

Psychiatry.

I had call as a resident and still have call as faculty. Granted, the likelihood of me needing to actually go to the hospital while on call is essentially zero, but I still have nights of getting paged in the middle of the night and being available for the resident on call if they have questions or concerns.