|Hospital Expenditures For Physician On-Call Pay Rates Increase
Physician on-call pay expenditures have increased over
the past year, according to a survey released by Sullivan, Cotter and
The 2008 Physician On-Call Pay Survey Report has data
from 132 healthcare organizations nationwide and outlines physician
on-call pay practices and rates paid for 33 physician specialty areas
along with data reported for trauma centers and non-trauma centers.
Nearly two-thirds of the survey participants report that
their physician on-call pay expenditures have increased within the past
From 2006 to 2008, the median expenditures reported by
trauma centers for physician on-call pay have increased by 88 percent;
the median expenditures in non-trauma centers increased by 91 percent.
The practices vary in terms of how a physician is
compensated when called in to provide services. "To secure the required
call coverage, organizations may have to supplement traditional
professional fees with subsidies for unassigned/under insured patients,
fee-for-service payments, flat hourly rates and malpractice subsidies,"
according to Kim Mobley, the survey director and principal of
These subsidies may also apply to the follow-up care to an unassigned patient.
The majority of the survey participants (86 percent)
report providing on-call pay to non-employed physicians with admitting
privileges; about one-half (54 percent) report providing on-call pay to
their employed physicians.
The majority of the survey participants (91 percent)
report that the physician on-call pay is funded solely by the hospital;
however, 8 percent report that the medical group is also providing some
of the funding.
Not all physicians receive on-call pay. According to
Mobley, another emerging trend is pay for "excess call only;" provided
only after a specified number of shifts or hours.
According to the survey, 21 percent of the organizations have adopted the policy.
Mobley believes the percent of organizations adopting
this approach to physician on-call pay will likely increase in light of
the ever increasing on-call pay expenditures. Coupled with the number
of specialties requiring on-call pay and the Office of Inspector
General’s September 2007 Advisory Opinion, which suggested that
physician on-call pay should be related to the amount of call provided
and the likelihood of being called in, the trend could continue.
The key variables impacting physician on-call pay rates,
according to the survey, are the rates of local and national markets,
frequency of the call coverage provided and the likelihood of being
called in for service.
The survey identified a significant variance in the
on-call rates paid by specialty; some specialties are far more likely
to receive on-call pay than are others. "This data represents national
market norms. Local market rates paid to physicians providing call
coverage can vary," said Mobley, who notes that on-call pay is still an
"Some highly compensated specialties receive relatively
low on-call rates of pay. These samespecialties are often the ones that
are not as likely to receive on-call pay. While physician on-call pay
is still an evolving market trend, it appears that there is some
relationship between the likelihood of being called in to work and the
on-call rate paid," she added.
Address: Sullivan Cotter and Associates, 3011 West Grand Blvd., Suite 2800, Detroit, MI 48202; (313) 872-1760, www.sullivancotter.com.