Author: Jon Delaney
A typical component of physicians' employment duties includes sharing in the emergency department call coverage. However, more hospitals and health systems struggle to staff this service. Factors include a lack of local physicians, the burden and intensity of call coverage, and poor reimbursement, among other issues.
Usually, physician employment agreements define base call requirements. These requirements may become blurred for physicians in leadership roles who dedicate minimal clinical full time equivalent (FTE) time. Organizations increasingly wrestle with whether physician leaders should take call coverage. If those leaders take call, should the organization pro-rate the call schedule to account for the reduced clinical FTE status?
Most organizations responding require physician leaders to take call
In response to these questions, Gallagher conducted a 2024 pulse survey of more than 50 US healthcare entities. The results offer insight into market norms for physician leader call responsibilities.
Based on the survey, 68% of responding organizations require physician leaders to participate in their specialty-specific call rotation. In general, most healthcare employers apply a policy outlining what the organization expects of their physician leaders.
Size of administrative role and net patient revenue drive call participation
Two main elements impacting the percentage of physician leaders who participate in call coverage include the size of the medical administrative role and the organization's net patient revenue. These factors aren't mutually exclusive, because in larger organizations, leaders in more comprehensive administrative roles oversee a larger number of providers. In turn, the organization generates higher net patient revenues.
Generally larger organizations with net patient revenue exceeding $500 million and larger administrative roles — greater than 0.5 administrative FTE — typically saw nearly a 50%-50% split between physician leaders who take call and those who don't. In small organizations with net patient revenue below $500 million and smaller administrative roles — less than 0.5 administrative FTE — approximately 80% of physician leaders participate in the call rotation.
For organizations that required their physician leaders to take call, the physician leaders were required to provide the general call rotation 72% of the time. The remaining 28% saw their call requirement pro-rated according to their clinical FTE status.
Gallagher can help
Gallagher's Physician Compensation and Valuation Consulting team can help your organization understand and navigate physician leader market trends concerning call requirements, FTE allocation, excess shift pay and more. Let our industry-leading data and expertise help to drive your decisions and face the future with confidence.
