Since there are two sides to every story, and I've seen how hard and
long my ophthalmologist works in the office after doing early morning surgeries, rounds, etc., I looked around to see what is said about being on-call for the hospital.
This article linked below and others talk about this "national problem" for drs.
in community hospitals that do not have residents in training on call.
It didn't take long to find out that on-call specialists are
most likely going to go unpaid when being awakened from sleep and having to go to the hospital in the middle of the night to work on an unknown patient and then travel home to try to grab a couple more hours of sleep so they can do their best for their patients in surgery and office consults the next day.
Personally, I would not want my airline captain being awakened at 1 a.m. and told to go to the airport to work on a plane of unknown origin for 1-2 hours and then drive back home/hotel to bed at 3:00 a.m., when he has to get up and be at his best to fly 200 passengers at 6:00 a.m.
The same goes for my eye surgeon.
Then, to add insult to injury, articles and readers report that the dr. specialist on call is more likely to be sued by random patients they don't know but have to treat in the night, so they have to do lots of legal documentation CYA with call patients who don't show up for followup and are non-compliant with their treatment.
The reader comments from drs. are especially revealing. These two said it well:
I am still on call for assigned outpatients from ER call. At least 80% of them are self pay or Medicaid. The rest are noncompliant insured patients. Many of them fail to show up for the follow up visit and about 5-10% of them have abnormal labs that need follow up. I then have to look up their demographics at the hospital, attempt to call the person and send a certified letter with the abnormal information. I have to recommend that they follow up with a physician somewhere, just to lower my liability risks. It gets old dealing with abnormal glucose, STDs, + drug screens, abnormal CTs or CXRs. It actually costs me money and time to deal with these free follow up patients.
Greg • 3 years ago
Good post highlighting a problem that most of the public has no idea exists.
Part of the problem for specialists taking call is that providing pro-bono care isn't free. Even if a specialist is willing to give up his/her sleep night after night, and is willing to work without pay (already a combination most non-doctor workers in America would refuse outright), he/she is still liable for any litigation which results from their services. So even if they spend a sleepless night working for free, they may still lose their shirt if sued for malpractice. It's difficult to be altruistic to those who may harm you; it's possible, but takes a Dalai Lama-esqe sense of compassion to pull off, and is therefore pretty rare. As a result, even altruistic specialists are turned off from night call, and the problem only gets worse.
imdoc Greg • 3 years ago
And, of course, if an untoward event does occur after many hours of work doing your duty to cover the ER, the plaintiff attorney will use it against you to imply that fatigue undermined your abilities at the time.
Smart Doc imdoc • 3 years ago
Yup, the lawyers will 100% attack you on that basis.
No liabilty for ER slave duty. Emergent care must be made exempt from liabilty charges.
See Article:
Fewer physicians are taking call in rural emergency rooms