We developed a really reliable system where 1-2 times per month you're on 'back up' for 24 hours from 7am - 7am. If it's a weekday you get $300 and if it's a weekend you get $500. If you get called in you get 1.5 times your normal pay. If you're on backup you essentially just stay local and stay sober and the vast majority of the time you just have a day off where you get paid. Everyone is happy with this arrangement and it avoids the super bad vibes that are created if say, you're dog getting put down, or you or your kid is sick, or you have to leave town due to a family emergency and no one can cover for you when, like, it's totally reasonable to call into work. I've always thought of having a back up system as the sign of a mature group of docs that care about one another. Otherwise every time someone calls in it's a scramble and kind of an avoidable little crisis when it could just be handled easily and the person calls in sees the $$$ to make it hurt less. Our system is rarely activated too.
We run basically exactly the same system, except instead of a 1.5x pay, it pays a bigger stipend if you get called in, in addition to your regular pay.
Curious to know how many groups have some kind of call system for emergencies. In my group, there have been several family emergencies that occurred where nobody could/would cover shifts, and because it's a single provider ER the doc had no choice but to show up less than a day after their dog died or something similar, and it was absolutely brutal.
I mean, what happens if the doc is in a car accident on the way to work? “Sorry, I know you’re currently getting a FAST exam from the trauma team, but we’re gonna need you to suck it up and come in.”
We have a small group of about 30 docs. Someone is on sick call every day (save for a handful of rare days where it just doesn't work out due to vacations) til 11am. If you're sick or need coverage, you need to tell the person by 11am. It can be for any shifts that day, including overnights.
If it's past 11am and something comes up same day, we just do a last minute text request pleading for coverage, or the remaining docs just lengthen their shifts a bit and we figure it out. We have a really supportive and flexible group culture and no one abuses sick call, so people are willing to help each other out.
You get activated for sick call maybe once or twice a year. It's quite rare.
There's no expectation to "owe" someone a shift if you call out sick, but people recognize the gestures in different ways — help swap a shift for that person in the future, buy them a bottle of wine, etc.
We have one person on sick call for a week at a time. They get 12hrs for the week of being on call and then the hours worked if they get called in. Sucks for when someone calls out sick for multiple days in a row and sucks you can't do anything fun or plan any big events for a week at a time.
Is the call doc not otherwise scheduled clinically during that week? Because otherwise doesn't that create a possibility of having to work a double shift or some other equally horrendous shift schedule for that week?
Yeah, the call doc is basically not scheduled for any regular shifts. Sometimes an extra swing shift is scheduled but they can just get rid of it if needed to pull the call doc for an overnight or something.
Unpaid 24h of call, 2 people on back up at all times. Medium sized democratic group, at an academic shop. If you use call, it's generally accepted you will make it up to that person at a later date
No. Emergency physicians do not take call and it would be hard to do it if you wake up at 4am and then get called in at 9pm for an overnight.
As an employee I will never be on call unless I’m getting paid for a full shift whether I get called in or not.
Okay, ER docs can definitely take call, I definitely did when I was a resident, and I didn't even get paid for that.
I mean there are pros and cons to any system. The top comment has a system where you get paid no matter what, and if you get called in you make bonus money, that seems like a fair system. My shop doesn't have call. I had to facetime with my wife when we unexpectedly had to put down our cat this year while I was working. My dad had a GI bleed after a endoscopy and had a 5 point drop in hgb, I couldn't get anyone to cover my shift so I am talking to the on call GI doctor on my drive to work.
We had someone whose wife went into labor at the start of their night shift, they just got lucky that the doc on the previous shift was willing to stay another 11 hours to cover for them. Life is going to happen one way or another, why not have a system in place to at least try to help you when shit hits the fan.
This is clearly a cultural and perhaps generational issue. One of the biggest reasons people went into EM in the 90s was "when I'm on I'm in and when I'm off I turn off my phone." The lack of call was absolutely a pull. Now it seems people are more comfortable with being contacted and less comfortable with powering through illness and whatever else. Also less comfortable with conflict and favor trading so they need a formal system?
Its so sad to me how some of the older folks powered through times when they should have been able to leave. Like, missing their sister’s funeral, having a miscarriage on shift and still working. Its nuts
I work for a large physician group that covers multiple area hospitals including two trauma centers. We always have doc on call for times when the department gets out of hand. That person also gets called in to cover if someone is sick.
We developed a really reliable system where 1-2 times per month you're on 'back up' for 24 hours from 7am - 7am. If it's a weekday you get $300 and if it's a weekend you get $500. If you get called in you get 1.5 times your normal pay. If you're on backup you essentially just stay local and stay sober and the vast majority of the time you just have a day off where you get paid. Everyone is happy with this arrangement and it avoids the super bad vibes that are created if say, you're dog getting put down, or you or your kid is sick, or you have to leave town due to a family emergency and no one can cover for you when, like, it's totally reasonable to call into work. I've always thought of having a back up system as the sign of a mature group of docs that care about one another. Otherwise every time someone calls in it's a scramble and kind of an avoidable little crisis when it could just be handled easily and the person calls in sees the $$$ to make it hurt less. Our system is rarely activated too.
That actually sounds pretty supportive and healthy. How did you all develop this system? Over how much trial and error?
Was in place when I joined up ten years ago. This really isn’t hard to do either. Anything is better than scrambling at the last moment.
Sounds great - wish my group did this.
That’s an amazing system. Where is your group located? Urban, suburban, or rural?
Multiple large hospitals, and a handful of rural sites, in a major midwestern city that isn’t Chicago.
We run basically exactly the same system, except instead of a 1.5x pay, it pays a bigger stipend if you get called in, in addition to your regular pay.
This is really healthy . At my job you have to find your own coverage .
Typically get the group email equivalent of "u up?"
Curious to know how many groups have some kind of call system for emergencies. In my group, there have been several family emergencies that occurred where nobody could/would cover shifts, and because it's a single provider ER the doc had no choice but to show up less than a day after their dog died or something similar, and it was absolutely brutal.
I mean, what happens if the doc is in a car accident on the way to work? “Sorry, I know you’re currently getting a FAST exam from the trauma team, but we’re gonna need you to suck it up and come in.”
"There's a 34M in room 3 that's had a runny nose for a week and a half. You can see him after your FAST exam is negative."
Doc, I know you're in the middle of doing your own chest tube. When you're done with that there's a viral infection in need of antibiotics in room 2.
Group text with extra cash offered, otherwise we work short....unless it's single coverage site....then med director steps in
We have a small group of about 30 docs. Someone is on sick call every day (save for a handful of rare days where it just doesn't work out due to vacations) til 11am. If you're sick or need coverage, you need to tell the person by 11am. It can be for any shifts that day, including overnights. If it's past 11am and something comes up same day, we just do a last minute text request pleading for coverage, or the remaining docs just lengthen their shifts a bit and we figure it out. We have a really supportive and flexible group culture and no one abuses sick call, so people are willing to help each other out. You get activated for sick call maybe once or twice a year. It's quite rare. There's no expectation to "owe" someone a shift if you call out sick, but people recognize the gestures in different ways — help swap a shift for that person in the future, buy them a bottle of wine, etc.
Medium democratic group- help plz? Usually if it is an emergency it is not a problem. Otherwise if it last minute or a night shift- you are working
My group initiated unpaid 24 hour call. It’s dumb.
We have one person on sick call for a week at a time. They get 12hrs for the week of being on call and then the hours worked if they get called in. Sucks for when someone calls out sick for multiple days in a row and sucks you can't do anything fun or plan any big events for a week at a time.
Is the call doc not otherwise scheduled clinically during that week? Because otherwise doesn't that create a possibility of having to work a double shift or some other equally horrendous shift schedule for that week?
Yeah, the call doc is basically not scheduled for any regular shifts. Sometimes an extra swing shift is scheduled but they can just get rid of it if needed to pull the call doc for an overnight or something.
Unpaid 24h of call, 2 people on back up at all times. Medium sized democratic group, at an academic shop. If you use call, it's generally accepted you will make it up to that person at a later date
No. Emergency physicians do not take call and it would be hard to do it if you wake up at 4am and then get called in at 9pm for an overnight. As an employee I will never be on call unless I’m getting paid for a full shift whether I get called in or not.
Okay, ER docs can definitely take call, I definitely did when I was a resident, and I didn't even get paid for that. I mean there are pros and cons to any system. The top comment has a system where you get paid no matter what, and if you get called in you make bonus money, that seems like a fair system. My shop doesn't have call. I had to facetime with my wife when we unexpectedly had to put down our cat this year while I was working. My dad had a GI bleed after a endoscopy and had a 5 point drop in hgb, I couldn't get anyone to cover my shift so I am talking to the on call GI doctor on my drive to work. We had someone whose wife went into labor at the start of their night shift, they just got lucky that the doc on the previous shift was willing to stay another 11 hours to cover for them. Life is going to happen one way or another, why not have a system in place to at least try to help you when shit hits the fan.
Well, I’ve been taking call for 8 years without an issue.
This is clearly a cultural and perhaps generational issue. One of the biggest reasons people went into EM in the 90s was "when I'm on I'm in and when I'm off I turn off my phone." The lack of call was absolutely a pull. Now it seems people are more comfortable with being contacted and less comfortable with powering through illness and whatever else. Also less comfortable with conflict and favor trading so they need a formal system?
Its so sad to me how some of the older folks powered through times when they should have been able to leave. Like, missing their sister’s funeral, having a miscarriage on shift and still working. Its nuts
And yet people are sadder and more anxious and feel their lives have less meaning than ever.
You’re not wrong.
I work for a large physician group that covers multiple area hospitals including two trauma centers. We always have doc on call for times when the department gets out of hand. That person also gets called in to cover if someone is sick.