What's Ahead for Physician Emergency Call Coverage

Call coverage agreements comprise a staggering portion of many hospitals’ physician spending costs. How did we get here and what does the future hold for call coverage compensation?

While EMTALA (1986) did not immediately result in paying physicians for taking call, it contributed heavily to changing attitudes toward emergency coverage. When physicians graduated from medical school 30 years ago, many had the intention of building their own private practice. Taking emergency call coverage facilitated private practice growth, and was often a requirement of being on a medical staff.

Over time, however, fewer physicians are leaving medical school with the intention of building private practices. Today, most physicians are acutely aware of the increasing burden of the uninsured seen in emergency rooms. This burden has contributed to fewer physicians willing to take voluntary call, leaving hospitals no other choice but to pay physicians to take call coverage shifts in order to comply with EMTALA.

Over the past two decades, hospitals have gone from spending next to nothing on call coverage compensation to spending millions of dollars each year. Once a hospital starts to compensate one physician or one specialty, requests from other physicians or specialties often follow. It’s easy to see why total facility call coverage compensation amounts have ballooned in hospitals across the country in the past decade. The average hospital spends more than two and a half million dollars per year on coverage.

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