Call can be a delicate issue for physicians at any career stage, but physicians transitioning to practice may simply not know what to expect. How much time is involved? How do you get paid for it? And how should it be defined in your employment contract?
The AMA has teamed up with Resolve, a contract review and negotiation firm specializing in physician employment, to provide custom contract review to AMA members at a discount. Resolve offers personalized legal experience to help physicians secure the best employment contract terms no matter where they are in their careers. Ready to access your AMA-member Resolve discount? Learn more now.
To help physicians better understand expectations and compensation for call hours, one Resolve podcast examines how employment contracts typically outline call, as well as what sort of call scenarios physicians should look for.
Call is a common concern
In Resolve’s consultations with clients, call comes up “almost every single time,” said Bryce Krieger, an attorney with Resolve.
In addition, only a small proportion of physicians won’t have to deal with call.
“I'd say less than 10%,” Krieger said.
Still, there is wide variety in how much call physicians take—it differs not just by specialty but also by employer—and even where they take it. Some doctors only have to deal with after-hours call for clinic patients, while others might take call in inpatient settings or the emergency department. Some may even be required to do all three.
If you’re seeking your first physician job after residency or fellowship, get your cheat sheet now from the AMA.
Avoiding ambiguity is crucial
The key when considering a job offer, then, is arriving at specifics around call expectations, Krieger noted.
“Physicians want some sort of cap” on hours, he said, although employers often are reluctant to go into much detail in the employment contract. “It's usually quite open-ended. They are looking for as much flexibility as possible—and that's typically to the downfall of the physician, unfortunately.”
Being specific about compensation for call is vital too.
“A lot of employers will try to bake it in and just say it's part of the base compensation,” Krieger said, adding that while some may pay more for call performed on weekends and holidays, many try to include this in the base too.
He noted, however, that about one-quarter of physicians receive some dedicated compensation for call in the form of stipends, although this usually applies to only a subset of physicians, such as anesthesiologists. It is usually paid per day or shift.
Get tips on your transition to practice
Make your transition from resident to attending physician seamless with expert advice.
Given that some employers might require a physician to be on call for, say, six days per month, whereas others will require 10 days per month—these being “one in five” and “one in three,” respectively—it is critical that expectations are laid out clearly in both the job interview and the employment contract.
“Am I getting compensated for this?” is what to ask, Krieger said. “Am I taking on, for the same amount of compensation from offer A and offer B, one in three call versus one in six?”
Note: Circumstances can change
Call is shared by physicians in a call group, which means one’s share of the call responsibility can fluctuate with staffing changes.
“We see that a lot in renegotiations,” where a physician expected call to be at a certain level, “but there was a mass exodus of physicians” in the group and suddenly they were taking double the call they expected when they signed their contract, Krieger said.
“It's important to maybe search in the area—in terms of locums work—as to what would it take for them to pay another [physician] to come in,” Krieger said. “That's really helpful in terms of negotiations if call is a lot more frequent than what you expected.”
AMA members get a 20% discount on all Resolve contract review packages. With Resolve, you get:
- Custom contract review for any type of employment contract.
- Access to experienced attorneys who can negotiate on your behalf.
- Real-time, comprehensive compensation data and benchmarks to help you understand your worth.
- An instant contract-review option, powered by Resolve’s attorney-trained AI model.
- Free tools such a contract scorecard that can give a quick overview of where your contract stands.
Find out how to redeem your AMA-member Resolve discount.
