Finding specialists to answer ED call getting even harder

Some hospitals are trying to solve on-call shortages by paying daily or monthly stipends.

By Damon Adams, AMNews staff. Dec. 17, 2007.

Emergency departments are finding it increasingly difficult to get specialists to provide on-call coverage, a growing problem that threatens patient access to quality and timely care at hospitals, a new study said.

The study, released in November by the Center for Studying Health System Change, said hospitals have struggled during the past decade to get specialists to be on call at their EDs. But hospital executives and others interviewed for the report said the situation is worsening.

"Across the country, the traditional role of physicians taking call is unraveling," said study co-author Ann S. O'Malley, MD, a senior researcher at the center, which also studied on-call problems in 2005.

The new study found several reasons why specialists avoid taking call. Many physicians are shifting focus from hospitals to their practices and outpatient facilities as more procedures are done outside of hospitals. Treating ED patients takes time and money away from office practices.

"Doctors can get fees for the procedure and get facility fees for doing it at their own center. That's the biggest reason," said Dr. O'Malley, whose study is based on researchers' visits to 12 communities, including Boston, Cleveland, Indianapolis, Miami, Phoenix and Seattle.