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Would you do extra easy call for money?

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  • Would you do extra easy call for money?

    I am an employed subspecialty surgeon at a small community hospital. I am the only surgeon in my speciality. I am obligated by contract to do 10 ER calls a month at a rate of $600/day. The hospital CMO encourages me to take additional calls at the same rate. His reasoning was that I would likely get called anyways even I am not listed as on call, so I might as well get paid for it. My calls has been very light. In fact, I didn't get any calls from ER last week. The chance of actually having to get up at the middle of night and come to see a patient in the hospital is quite small.

    I am a little conflicted about taking on additional calls. I guess I can take on additional weekday calls. I am a non-drinker so taking calls does not really impact too much on my lifestyle.

    What would you do?

  • #2
    If you can pick the days you’re on call and don’t mind it, why not. Also can’t hurt to ask for more money. Going rate can go up to $1-1.5k.

    I took some extra weekend call at a sister hospital 50 minutes away. Super small. I got a total of 4 consults over 3 separate weekends. Did an egd and a central line. Got paid $1k a day for it and reimbursed “gas mileage”.

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    • #3
      If you were called anyway on a day youre not the call person, what would happen? Lets say you were drinking so certainly cant come in- Do they wait until the next day (not sure how urgent your subspecialty is) or will a gen surg on call person take the pt?

      How are your days after call? Filled with clinic patients so if you did happen to get called at 3 am the night before it would make your life/next day horrible? Or not so it wouldnt make a dent in your happiness or productivity? It ultimately comes down to a personal decision, but generally if the hospital is approaching you it's for their best business interest, not yours.

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      • #4
        I don’t know your age, but I worked a lot and did extra call in my younger years.

        My older self (age 57) who doesn’t have to work anymore unless I want to, profusely thanks my younger self! In view of the current dangers of covid, I especially thank my younger self. A dear 70 year old co-worker is currently in ICU with covid. He did not have the financial option of cutting back shifts when covid became prevalent.

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        • #5
          I doubt I can get the hospital to raise the rate.

          I will not do weekend call for $600 a day. In my specialty, most consults can wait until the next day. So if I am not on call, the patient will be admitted to the hospitalist who will call me the next day. General surgeons can't take care them. If a patient can't wait until the next day, the patient will be transferred to another hospital in town.

          Hypothetically speaking, if the chance of having to come into the hospital after hours while one call is 1 in 30 to 1 in 20, would you take additional call?

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          • #6
            Originally posted by RocDoc View Post
            I don’t know your age, but I worked a lot and did extra call in my younger years.

            My older self (age 57) who doesn’t have to work anymore unless I want to, profusely thanks my younger self! In view of the current dangers of covid, I especially thank my younger self. A dear 70 year old co-worker is currently in ICU with covid. He did not have the financial option of cutting back shifts when covid became prevalent.
            I am in my mid-40s. Plan to retire before age 55. The extra call money will be icing on the cake. Doubt it will really move the needle much.

            I hope your colleague will be ok.

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            • #7
              If you typically keep your phone on and answer your phone 24/7 because you have a big heart, then yes I would do it and get paid. Otherwise no I don’t think it’s worth taking more than q3 call regardless of pay.

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              • #8
                Originally posted by Sundance View Post
                If you typically keep your phone on and answer your phone 24/7 because you have a big heart, then yes I would do it and get paid. Otherwise no I don’t think it’s worth taking more than q3 call regardless of pay.
                agree. plus if the hospital will lose the pt anyway (transfer to other hospital) are you sure the call rate is non negotiable for extra calls over the contracted amount?

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                • #9
                  The one factor is how often you drink alcohol. If you have a drink or couple drinks most nights, and enjoy that, then no I wouldn’t pick up more call. If you don’t mind giving up alcohol most nights I would take every weekday of the year.

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                  • #10
                    If the cases are not urgent and you often see them the next morning, why not simply take call, get paid for the call, respond by phone, tell them to admit the stable patient to the hospitalist service, and then go see the patient first thing in the morning?

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                    • #11
                      Originally posted by Sundance View Post
                      If you typically keep your phone on and answer your phone 24/7 because you have a big heart, then yes I would do it and get paid. Otherwise no I don’t think it’s worth taking more than q3 call regardless of pay.
                      I usually keep my phone on 24/7 because I cover my own established patients all the time unless I am out of town.

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                      • #12
                        Originally posted by abds View Post
                        The one factor is how often you drink alcohol. If you have a drink or couple drinks most nights, and enjoy that, then no I wouldn’t pick up more call. If you don’t mind giving up alcohol most nights I would take every weekday of the year.
                        I don't drink alcohol at all. So taking call does not impact my lifestyle other than the small chance of having to go in to operate.

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                        • #13
                          I think it's awesome you stay available for your established patients, especially being in smaller hospital/community, but the hospital system is taking advantage of you if they call you when you aren't on call. If being on call doesn't interfere with your evenings or life, then by all means charge them.

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                          • #14
                            Originally posted by hw View Post
                            Hypothetically speaking, if the chance of having to come into the hospital after hours while one call is 1 in 30 to 1 in 20, would you take additional call?
                            Yes, you could pay me $18,000/month to maybe work one or two nights. I would take call every night I was in town.

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                            • #15
                              how about this

                              if the hospital paid you $18,000 per month to take call every night, how many nights would you choose to write a check back at $600 each, to not take the call?

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