Thanks for the answer 👍! This thread cleared up all of my questions, but there is one more thing; there's only one person covering on call emergencies for any given night? For example, if there are seven partners working at the same practice, than each partner would only take calls once a week? Again, I know that it works whichever way you set it up, but is that likely to happen? What if there are two orthopedic emergencies that need to be performed on immediately? Would one of the other six partners decide among themselves who would go and handle it?
We take call a week at a time. I'm on next week and then not until November. Because our practice is breast surgical oncology, there are very few emergencies. I cannot recall the last time I had to go in after hours to see a patient.
Let's talk about the difference between emergent, urgent and elective surgery.
Most surgeries are elective. Elective does not mean the patient doesn't need a procedure. For example, cancer surgeries are typically elective and scheduled in advance.
Urgent surgeries are typically done when the patient is medically stable, a surgeon or OR is available, and delay does not result in harm to the patient. Most patients who present to the ED and need surgery fall into this category: appendectomies, trauma/orthopedic injuries, incarcerated hernias, etc.
Emergent surgeries are those which need to be done ASAP or the patient will either die or suffer serious morbidity. These are least common and would include things like ruptured/impending rupture AAA, brain herniation, patients needing a surgical airway.
Using your example of "two orthopedic emergencies" that need to be operated on right away, that is unlikely to happen. Most orthopedic and other surgical presentations are not emergent but rather urgent. For example, a dislocated fracture can be reduced or have an ex-fix placed, and definitive surgery delayed until the schedule allows. The patient with acute cholecystitis will be admitted for pain control and put on the OR schedule as the surgeon's schedule allows. When you have multiple consults at the same time, the surgeon would triage and decide what order the patients need to go in, depending on the resources available. It is rare that you would two equally emergent cases. But if you truly had multiple emergencies most practices have a "first call guy, second call guy, third call.." or the surgeon on call would call one of his partners and explain the situation and ask for help. My ex-SO is a trauma surgeon and they have the first/second/third call schedule but they always call each other in if it gets crazy or they have a difficult case and need an extra set of trained hands.
Remember, there are many surgical subspecialties where emergencies are unusual, which generally results in a better lifestyle.
You can...stay in the hospital, right? You don't have to go into private practice?
Of course. You can be employed by a hospital if you prefer.
