Shortage of On-Call Specialists at Hospitals is Costing Patients

Hospitals are having difficulty staffing their 24 hours emergency “on-call” shifts with specialists, causing patients who need immediate attention to wait. A nationwide survey by the American College of Emergency Physicians found that 73% of all emergency department directors believe they have a problem getting adequate on-call coverage from specialists in neurosurgery, orthopedics, and ob/gyns.

The number of emergency room shortages is on the rise from 67% in 2004. Part of this rise is caused by the fact that trips to the emergency room are up about 18% in the last 10 years. At the same time, the number of hospitals that still operate 24-hour emergency departments has fallen by about 12%. This causes patients to have to be transported to further distances to receive the proper care.

So why have the specialists backing out of the 24 hour business? A number of them have cited a reluctance to pay for uninsured patients. Others are complaining that being on call for a 24 hour period is too much of a disruption to their daily lives.

These type of complaints are a departure from the typical way that medicine was practiced in hospitals. Traditionally, specialists had to agree to perform on-call duty shifts in exchange for privileges at general hospitals. But, with the advent of the outpatient surgery center, many doctors have decided to forgo hospital privileges in exchange for greater personal freedom.

The shortage of specialists has become so extreme that one hospital – the Covenant Medical Center in Lubbock, Texas – has had to resort to telemedicine. The hospital has set up a system that enables neurologists to evaluate stroke victims over a television screen and make treatment recommendations.

Some specialties are in greater shortage than others and as a result, some emergency rooms are paying stipends to their on call physicians. As many as 25% of ER directors say that they pay on call general surgeons and 16% pay on call neurosurgeons.


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