On Call

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Do doc's get paid while doing On Call?

 

[Bartelby]

I don't think so, although if you are salaried I guess it kind of comes with the territory.

 

[njbmd]

Do doc's get paid while doing On Call?

Residents get their salary-below minimum wage; attendings get paid for any cases/referrals that they perform/accept.

 

[michaelrack]

It depends on who a doctor is on call for (his own practice, or for a hospital ER). Some hospitals pay docs to take call. Most of the time docs don't make much for taking call.

 

[Law2Doc]

Do doc's get paid while doing On Call?

If you are talking "overtime", or some special payment for the nights they work overnight, the answer is no. Most physicians (or professionals in general for that matter) have a flat salary, which contemplates having X on call days per year; there is no extra pay for working longer than normal business hours. For a resident, that may be every 3rd or 4th night for good chunks of their residency. They don't get any extra -- they still get their regular paycheck. There are some hospitals which are short staffed and hire licensed physicians from elsewhere to moonlight, and moonlighters tend to earn a decent amount for their time, but usually have to maintain their own license and insurance. And residents who moonlight still have to fit that into the 80 hour work week limitation, so some residencies may forbid it.

Only 9 to 5 types get paid extra for overtime -- this is not a notion that translates to professionals, who are expected to work longer hours sometimes, as the job requires.

 

[Ashers]

There are some hospitals that pay the doctors a flat fee for just carrying the pager, and they get their procedure/billing stuff if they have to come in and do stuff.

 

[Catalystik]

An attending in private practice who takes call and sees their patients after office hours will bill more, and eventually be rewarded with more income. If they take call, refer everyone to the ER, then have a hospitalist manage their inpatients, there would be no financial reward for time spent on the phone arranging things. So it depends.

 

[MSKalltheway]

There are some hospitals that pay the doctors a flat fee for just carrying the pager, and they get their procedure/billing stuff if they have to come in and do stuff.

I was told by a neurosurg chief that some places pay attendings 1K each night they're on call just to hold the pager...not even to come in!

 

[Ashers]

I was told by a neurosurg chief that some places pay attendings 1K each night they're on call just to hold the pager...not even to come in!

Quotes I've heard are usually around $1000. My dad's company gets paid $1000 every night he's on call (he gets comp time if he has to go in). When my dad was doing research to present to his hospital for people to get paid while on call, he found that the pay to carry the pager ranged from $500-$3000/night, with their additional fees if they came in and did stuff. He did this research before I started med school, and I was surprised at the time that people got paid to go on call, but apparently among a lot of the orthos he knows, it's the norm.

 

[Trismegistus4]

Can we have some accuracy around here, please?

Residents get their salary-below minimum wage; attendings get paid for any cases/referrals that they perform/accept.

Residents are not paid a salary, they are paid a stipend, and they are not paid below minimum wage while on call or at any other time, because they are not paid a wage, which would imply getting paid by the hour, which most physicians, and certainly residents, are not.

If you are talking "overtime", or some special payment for the nights they work overnight, the answer is no. Most physicians (or professionals in general for that matter) have a flat salary,

No, they don't. Most physicians are in private practice and earn income by charging a fee to the payor each time they provide a service. Even many of the ones who are not in private practice are compensated for their clinical work based on productivity, i.e., how many units of work they perform.

Only 9 to 5 types get paid extra for overtime -- this is not a notion that translates to professionals, who are expected to work longer hours sometimes, as the job requires.

No, only a certain subset of those who could be considered 9 to 5 types get paid for overtime, usually those who are contractors. A typical 9-to-5er, like an engineer, software developer, accountant, or person working any other of a myriad of white-collar mid-level office positions, is on salary and does not get paid for overtime.

 

[IHeartNerds]

Can we have some accuracy around here, please?
.... A typical 9-to-5er, like an engineer, software developer, accountant, or person working any other of a myriad of white-collar mid-level office positions, is on salary and does not get paid for overtime.

If you're being anal for accuracy, you might want to rethink stating that the average programmer work 9 to 5. The schedule I see a lot more often in my friends from UG that went on into software is about noon to midnight. After all, that Google cafeteria is open all hours...

also, who pissed in your cornflakes? chill. i'm pretty sure l2d just meant doctors aren't paid hourly, i doubt s/he forgot that most MDs live and die by procedural billing. And if you counted up the hours that residents work....However, at 80 hours * 50 weeks / yr = 4000 hours, with a salary of 40k, 10 dollars an hour is pretty bad for eight years of post-high school education.

 

[DrJosephKim]

Lots of people moonlight as "house docs" and earn some nice extra cash.

 

[Law2Doc]

No, they don't. Most physicians are in private practice and earn income by charging a fee to the payor each time they provide a service. Even many of the ones who are not in private practice are compensated for their clinical work based on productivity, i.e., how many units of work they perform.

Actually most people in private practice are employees, not partners or shareholders. Particularly so in organizations large enough that "taking call" occurs. The partnership bills by fee/reimbursements but its employee doctors still get paid flat. There is a pyramidal hierarchy with company ownership at the top and employees at the bottom. True in almost every professional field.

But in your fairly regular effort to contradict certain members of SDN, you seem to be focusing in on things unrelated to the OP's question. Nothing you've said suggests that the typical doctor gets paid more for doing call nights required of his/her residency, practice or department. It doesn't work that way. Moonlighters get paid by the hour. The typical doctor for whom call is part of his company's requirements doesn't get a lick extra.

 

[Trismegistus4]

If you're being anal for accuracy, you might want to rethink stating that the average programmer work 9 to 5. The schedule I see a lot more often in my friends from UG that went on into software is about noon to midnight. After all, that Google cafeteria is open all hours...

That's true if you're talking about a software company; I was thinking of the IT staff of a non-tech company, which is where my own experience is. Regardless, the point is that most white-collar employees, programmers included, do not work a fixed hourly schedule and are not paid by the hour.

And if you counted up the hours that residents work....However, at 80 hours * 50 weeks / yr = 4000 hours, with a salary of 40k, 10 dollars an hour is pretty bad for eight years of post-high school education.

Yes, but the point I'm always trying to make is that it's meaningless to do so, because residents are neither scheduled to work a fixed number of hours nor paid by the hour. It would have been equally meaningless for me, when I was a systems analyst at a pharmaceutical company, to divide my annual salary by 40*52 and claim that I earned that many dollars per hour. I didn't, since I was paid by the month, not by the hour.

Actually most people in private practice are employees, not partners or shareholders. Particularly so in organizations large enough that "taking call" occurs. The partnership bills by fee/reimbursements but its employee doctors still get paid flat. There is a pyramidal hierarchy with company ownership at the top and employees at the bottom. True in almost every professional field.

Do you have a cite that most doctors in private practice are employees? If that is true, it is certainly a very recent trend, since the standard for quite a while in private practice has been the small group practice in which a new doc starts as an employee and is offered the opportunity to buy in as a partner after a couple of years. I couldn't find any statistics in about 10 minutes of Googling.

But in your fairly regular effort to contradict certain members of SDN,

That's rich coming from you. Virtually all your posts are aimed at shooting somebody down.

 

[ZonaRidicularis]

z

 

[SoCuteMD]

One place I know of doesn't pay the plastic surgeons on call, but since a plastics facial lac closure pays 3K, they go in to sew up the insured patients with facial lacs. Very few complaints, as you can imagine.

 

[Law2Doc]

Just can't sleep at night knowing that others may have different opinions that don't fall withing the "majority opinion". Majority is not always right, especially when it comes to ideas... sometimes there is no right or wrong as well.

Actually my threads rarely represent the majority opinion, and I sometimes take unpopular (cold hard reality) views which is why I take a lot of flack.
But certain posters seek out other posters specifically to contradict them, which is a violation of TOS.

 

[Law2Doc]

since the standard for quite a while in private practice has been the small group practice in which a new doc starts as an employee and is offered the opportunity to buy in as a partner after a couple of years.

This is exactly what I was talking about, not contradictory to it. In any private practice, you need a pyramidal structure where the folks who have been in longer earn more, and do less call. They do this by having more employees than bosses. It exists in all professional fields. Every time they make an employee a boss, they hire a couple more employees to fill his slot and keep the pyramid going. If you add it up, it equals more salaried people than nonsalaried. And the number of employees actually has increased of late because more and more people are seeking part time options.

 

[Trismegistus4]

This is exactly what I was talking about, not contradictory to it. In any private practice, you need a pyramidal structure where the folks who have been in longer earn more, and do less call.

No, the norm that I'm talking about is the small group practice of 3-6 physicians where the goal is to become a partner and stay there. They only bring a new person on when they need to replace a partner who retired or decided for some other reason to leave, or if they feel they need to expand, which happens slowly, not exponentially as you suggest. At any given time there is 1 employee at most, the rest partners, and the employee is made a partner in 1-2 years. The partners share call responsibility equally. Again, if you have some evidence that the norm for private practice is now a large group where most docs are employees, I'd like to see it.

PS: If you believe I've violated TOS, go ahead and report me.

 

[Law2Doc]

No, the norm that I'm talking about is the small group practice of 3-6 physicians where the goal is to become a partner and stay there. They only bring a new person on when they need to replace a partner who retired or decided for some other reason to leave, or if they feel they need to expand, which happens slowly, not exponentially as you suggest. At any given time there is 1 employee at most, the rest partners, and the employee is made a partner in 1-2 years. The partners share call responsibility equally.

There are a ton of larger practices out there and employees tend to outnumber the 3 man shops you describe (which also exist). The pyramidal structure of businesses is alive and well in medicine. In a brief google search, I don't see anyplace where numbers of physicians are broken down by practice size, so I don't have a citation to give you, though I stand by my assertion. If you have support for your own assertion you want to cite, please feel free to post it. But saying "cite your proof" while not offering any for your own, equally speculative, position is not particularly persuasive.

 

[Tired]

There are a ton of larger practices out there and employees tend to outnumber the 3 man shops you describe (which also exist). The pyramidal structure of businesses is alive and well in medicine. In a brief google search, I don't see anyplace where numbers of physicians are broken down by practice size, so I don't have a citation to give you, though I stand by my assertion. If you have support for your own assertion you want to cite, please feel free to post it. But saying "cite your proof" while not offering any for your own, equally speculative, position is not particularly persuasive.

From what I've seen, even in the smaller groups, the more junior you are, the more call you take. It's pretty much a given. I have yet to see a private practice group where call was distributed evenly.