Specialist Pay for ED Call

From the annual meeting of the Society for Vascular Surgery in Denver:

Payment for specialist coverage of emergency department call is increasingly a hot-button issue dividing physicians along generational lines.

The traditional view was ED call was an obligation physicians fulfilled gratis in return for receiving hospital privileges. It was also viewed as a chance to give back to the community as well as an opportunity for younger physicians to build their practice.

In the past few years, however, a growing number of physicians–mainly younger ones–have decided that what was historically an obligation has become an imposition. It takes time away from their office practice, family, and nonmedical interests–and they want to be reimbursed.

Roughly half of U.S. hospitals now collectively pay out $1 billion per year to some specialists for ED call.  Dr. Robert P. Winter cited a 2007 American Hospital Association survey indicating 16% of hospitals provide reimbursement for some or all vascular surgery ED coverage.  The per diem for vascular surgery coverage varies wildly–in Florida, it ranges from $150 to $2,000, according to Dr. Winter, chief of staff and medical director of surgical services at Florida Hospital, Orlando.

He and his colleagues persuaded the hospital board of directors to grant payment for vascular surgery ED call in 2005. His advice to physicians elsewhere who’d like to win compensation for ED coverage: forget about the ’squeaky wheel’ approach and instead build a reasoned case based upon data highlighting the volume of ED calls received, the hours spent in caring for ED patients while on call, the payer mix, and the medicolegal liability risk. It’s very helpful to enlist the help of an experienced outside consultant, he added.

— Bruce Jancin
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Filed under Emergency Medicine, Surgery

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