Are you paid for taking call?

[susiemw]

Up until now only the physicians in our practice have taken call(phone only).

Today all the PAs and NPs got an email stating we would all be taking phone call. This is not part of any of our contracts and letters of agreement. No discussion has preceded this email even though we were told that would happen. We are told we will also do this for NO COMPENSATION! lol!. It will be one week every 10 or 12 weeks for FP providers and every 3 or 4 weeks for the pediatric providers from monday at 5 pm to the next monday at 8 am

. Until now just the Docs have been taking call as well as  one pediatric PA who has been doing call every day for two years! (his preference) was paid $50.00 a night. Realistically there aren't many calls expected but none of us are willing to be start taking call without compensation. We already have to work in the walk in clinic one weekend every 5 weeks (for the last two weeks it was every 3rd weekend due to staff leaving and not being replaced). The physicians are not expected to work in the walk in clinic.

if anyone would like to let me know how much they get paid for taking call I'd appreciate it. We are pushing for a lunch time meeting tomorrow. Thanks for your help! this would be evening and nights only and not during the work day.

[Reality Check 2]

The solo family practice I am leaving has no-pay call a week at a time every five weeks. A component of why I am leaving.

Ortho used to pay $100 a weeknight to be on call and $500 for weekends. Plus billing percentage for any OR time and procedures. 

An old semi-corp family practice used to give 1/4 day off per night of call - comp time. Sooo not worth it.

My new job - no nights, no weekends, no call.

My call standard would be bare minimum $50 per weeknight and $300 per weekend and $150 for any holiday EXTRA. And they will likely tax all that.....

[CornellSPA]

Hi!

I would not volunteer to work for free either! In my UC we also cover FP office and it is from 1700 to 0800 and two hours pay for the night.  On call in my general surg job is 1/2 hourly rate and time and a half if you get called in!

Also if you are on call you can use your phone as a tax writeoff or have your practice cover part of the cost-- what PA wants to pay their own cellphone bill??

Get it all in writing!

 

Keep us posted!

[DizzyJ]

Compensation is a must.  If you are on call you need to be available and that means you can't do many things.  Can you go to a concert and be on call?  Can you go have cocktails and be on call?  Nope...so you should be compensated for your time. 

[mgriffiths]

The pay for being on call usually varies with how busy it usually is.  Of course any call is inconvenient and affects your evening, but if the expectation is that you are called multiple times every day and/or called in somewhat regularly the call will pay more than if you almost never get called in and get one call every few days.  Again, still inconvenient and should be compensated, but that is a factor.

As for how much compensation: used to work in ortho  - was paid $150 per evening call, $300 per weekend, automatically paid hourly (don't know the amount) if you were called in and were paid for minimum 2 hours and any portion of an hour used (so if you worked 15 minutes = paid for 2 hours, work 3 hours 12 minutes = paid for 4 hours).  Any surgical cases I was paid my normal surgical fee.  I was never actually called in which was nice, but could have used the money.  Job I recently interviewed for in FM does not have extenders on call schedule, but they mentioned  it is something they are considering changing - I made it clear that would change the compensation and they agreed.

[sas5814]

I don't have call at all right now but my FP I was at for 12 years everyone took call and nobody was paid for it. It really was a great practice but they wanted everyone to act like they had ownership in the practice and when I started asking about partnership for the PAs I was rebuffed. So I started making noise about getting paid for call (and it was a PAIN) I was told there was no money for it but it was required and good for the practice. I finally left because of the "we are all in this together" except we weren't. Never again. Call is work and work deserves compensation.

[BruceBanner]

I used to take phone call every 2nd or 3rd weekend and it SUCKED. Actually, it wasn't near as bad a real hospital call, just annoying. Patients always seem to call when you're in the middle of something, usually asking for a refill.

I was not compensated and was told upon hiring it was "part of my salary". Bottom line is, it's work. You cant be inebriated, you have to be in phone range and able to answer your phone. You should be compensated.

What will probably happen is you wont get paid because the docs dont get paid a separate stipend for it. Definitely have everything spelled out in your contract.

[GetMeOuttaThisMess]

Me personally, I wouldn't consider a position that requires taking call.  Been there, done that.

 

[sas5814]

3 minutes ago, GetMeOuttaThisMess said:

Me personally, I wouldn't consider a position that requires taking call.  Been there, done that.

 

Couldn't agree more. It was the least favorite part of every job I have had. "My baby has a rash. Should I go to the ER?" or my personal favorite a woman who had just left the ER with her son who got Xrays, IV fluids and IV antibiotics, labs all for some kind of URI who wanted me to call her at midnight on Sunday (keep in mind they just left the ER 30 min ago) because "they didn't do enough and I can't wait until the clinic opens" (in 8 hours). She wanted me to call the ER and set them strait.

Can't make this stuff up.....

[FSUnoles]

currently battling with my hospital system which only pays us a measly 48/hr for going in on weekends when we're on call

m-f we get $0 compensation for call for our 2 provider practice. what was supposed to be 1 weekend a month has turned in 2 and 2 weeks a month

We have had numerous discussions about being compensated and the large hospital HR ( they own about 6 area hospitals and employ 16k people) can get a compensation package set up for us. We have been doing it for 6 months now

 

any suggestions. This is not in our generic PA job description either but us not taking any call would directly impact our physicians and is maybe 5-10 calls per week 

[ventana]

Call  

 

MUST be paid......  Why do you think they are trying to force you into it???? Cause the doc's all hate it, and want out of it....

 

 

I am paid in both jobs

 

primary job I am on call 24x7x345 (days off for vacation)  paid somewhere around just under $100/day   This figures out to about 30k per year for call pay

Second Job - if I cover I get 3 hours of straight time pay for 24 hours of coverage on weekends - (and my hourly is up there almost triple digits per hour)

 

 

 

NEVER agree to do call - it stinks - it restricts you - it is a PIA and everyone except the new PA knows this, but now they try to sucker the new PA.... NOPE   Stand together and say you need compensation......  period.  

[cbrsmurf]

For reference, my last job I took phone-only calls one night a week and no ED consults, unpaid, but it was part of my contract agreement.  1 SP, 1 PA private practice.

I now work for big corporate and am part of the nursing union.  Call once a week or once every two weeks, 12-hour overnight call.  $14/hr on call, regular pay for telephone consults, 1.5x pay for going in to the hospital, minimum 2 hour of OT pay everytime I go in, even if it's for a 5 minute ED/inpatient consult.  

 

Still not worth it though and most of our other PA's in our group would rather not take call.  A 

[Dexter42]

My job just did the same freaking thing. Actually, I just started 2 months ago, asked explicitly about call, nothing in my agreement about it and today they said it was a policy to take call. I wouldn't have even taken the job!I had another offer and would have taken it instead. I feel sick to my stomach this is only my second job and I just keep getting screwed over.

[rev ronin]

6 hours ago, Dexter42 said:

My job just did the same freaking thing. Actually, I just started 2 months ago, asked explicitly about call, nothing in my agreement about it and today they said it was a policy to take call. I wouldn't have even taken the job!I had another offer and would have taken it instead. I feel sick to my stomach this is only my second job and I just keep getting screwed over.

So don't take call until they renegotiate it.  What is so hard about that?

[Dexter42]

You have be ready to walk. Normally i would be. My girlfriend lost her job and is on my health insurance so it's just bad timing and a kick in the balls.

[rev ronin]

1 hour ago, Dexter42 said:

You have be ready to walk. Normally i would be. My girlfriend lost her job and is on my health insurance so it's just bad timing and a kick in the balls.

Not necessarily.  If you address it politely and play stupid you may get better results:

Boss 1: You're taking call.

PA 1: F that.

Boss 1: You're fired.

*****

Boss 2: You're taking call.

PA 2: Awesome!  I'm all about contributing to the team.  How much extra compensation will I earn?

Boss 2: None, you're just taking call.

PA 2: You mean to tell me you just negotiated an employment agreement with no call, and then expect to modify it without additional compensation?

Boss 2: Um....

PA 2: I would be happy to renegotiate the terms of our recently-concluded employment agreement; why don't you think about what's fair to pay for call and get back to me?

Boss 2: (drops it)

[BruceBanner]

Awkward as it may be you do have to stand firm on it. They cant legally fire you for refusing to do something that was not in your contract. You did have a contract, right? If not you are kind of screwed.

Another thing I've noticed employers will do is have vaguely-worded job descriptions in contracts. This is standard practice for clinical jobs....partly because we have a broad job description but also because it gives them leeway to control you should the need arise. That's why you should ALWAYS have things like call and work hours spelled out in your agreement or contract.

It's easy to take someone at their word in the interview, too. You're excited, want to give them the benefit of the doubt....but dont.

[GetMeOuttaThisMess]

I've NEVER had a position that they don't modify something somewhere down the line and thus screw it up to where I start looking at other options.  The closest to perfection that I've found is the one that I'm in.  Challenging?  Not really, but at my stage in the process I don't need challenging anymore.  I'm just a hired gun at this point.

[Dexter42]

1 hour ago, BruceBanner said:

Awkward as it may be you do have to stand firm on it. They cant legally fire you for refusing to do something that was not in your contract. You did have a contract, right? If not you are kind of screwed.

Another thing I've noticed employers will do is have vaguely-worded job descriptions in contracts. This is standard practice for clinical jobs....partly because we have a broad job description but also because it gives them leeway to control you should the need arise. That's why you should ALWAYS have things like call and work hours spelled out in your agreement or contract.

It's easy to take someone at their word in the interview, too. You're excited, want to give them the benefit of the doubt....but dont.

I'm learning the hard way. I never had this problem until I worked in medicine.

[rev ronin]

22 minutes ago, Dexter42 said:

I'm learning the hard way. I never had this problem until I worked in medicine.

I negotiated time-and-a-half over 80/2 weeks for my last job. Used it when another provider left unexpectedly.  They had appropriate motivation to fix the problem promptly, and I was compensated fairly.  Straight salary doesn't protect against abuses.

[DelusionalEnthusiasm]

We had issues with this as a group as we started expanding PA hours when we hired more people. We were covering vacations, working night shift and weekends without additional pay. Eventually we all banded together and requested that they employ similar pay structures to other practices. It was intimidating but paid off and the awkwardness passed after a week or two. We have since then successfully negotiated overtime for anything over 40 hours, a night and weekend differential, overtime for covering another's shift, and most recently call, which is paid at 25% an hour and then we get full time pay for any calls we handle at night. 

The one thing that helped us the most was pointing to similar pay in other groups local to our area and them needing to be "competitive", trying to just ask for it or fight it out on the principle is a harder battle than pointing to the practice down the street. 

One thing I've learned is that as the practice grows the job slowly morphs from one thing to another. Now at each change I say what are the PAs going to do now that they didn't do before and what should they be getting for that as a fair compensation. As they broach the subject with the idea of something like call I either have a figure in my head already from reading here, or I say something like well usually there is additional pay for that, let me do some research and let you know what that typically runs. It's been much easier to handle things as they arise then try to change the system after it's been implemented. 

[Reality Check 2]

We need to put this all together in a checklist for PAs becoming employed.

Not quite like PA Contracts for Dummies but something simple and allowing for check marks and points of discussion.

I am embarking on my last week of call and last week of employment for a solo private doc. ZERO compensation for taking phone call for 7 straight days including shared call with another private group. I am not looking forward to it.

You sleep different when on call. You are leashed to your phone. I hate it. Don't feel I can do my normal stuff or go anywhere. And don't even get started on the inane phone calls at 4 am.

I was out in the back acreage trying to fix something - sweating my butt off and making noise - damn phone rings and I try to be patient while listening to a patient who is not even from our practice tell me about a rash that is rapidly expanding up her arm and her telling me she doesn't want to go to the ER. Can she send me a picture of the rash........................ NO. A rapidly expanding pruritic rash cannot be evaluated by phone and NO you can't FaceTime or Skype with me in my backyard. 

The other office is also NOTORIOUS for not calling in benzos - or so the patient says - after hours. I say no. I tell them I have no access to records or to even prove they are a real patient. They get bent but - well, no, not going to do it.

I hope to NEVER take call again in my career - no call at the VA. But - never say never.................

COMPENSATION OR NO CALL. No longer debatable in my mind. 

 

[sk732]

I've been lurking a bit here...it's in my contract to pay a stipend for call as well as extra time when called in.  Part of my contract was to do OR assist prn - if they want me to come in, they pay the stipend and the extra time.  Unfortunately, I've been getting calls from docs in the ER asking me to come in because they're a little too used to having someone else there and aren't capable of doing solo coverage in a busy ER because they're too slow...I'm one of two and we work 12 hour shifts.  I'm very guarded of my time off, as that place is maddening and if I'm working with a doc that can't carry their fair load, I get pretty tired after a 3 day weekend of what amounts to a full work week.  One of those docs had the gall to ask my wife (one of our ER Clerks) to call me herself to ask...they're now a little pissy about it.  I'm not paid to answer my phone, so now I don't answer my phone - management will soon find out tomorrow that I will not answer a call if it's not from the ER director or manager anymore.  If they want me to, they can pay me to (a Code Orange not withstanding of course).

 

SK

[ventana]

On 7/23/2017 at 0:39 AM, DigitalFusion04 said:

We had issues with this as a group as we started expanding PA hours when we hired more people. We were covering vacations, working night shift and weekends without additional pay. Eventually we all banded together and requested that they employ similar pay structures to other practices. It was intimidating but paid off and the awkwardness passed after a week or two. We have since then successfully negotiated overtime for anything over 40 hours, a night and weekend differential, overtime for covering another's shift, and most recently call, which is paid at 25% an hour and then we get full time pay for any calls we handle at night. 

The one thing that helped us the most was pointing to similar pay in other groups local to our area and them needing to be "competitive", trying to just ask for it or fight it out on the principle is a harder battle than pointing to the practice down the street. 

One thing I've learned is that as the practice grows the job slowly morphs from one thing to another. Now at each change I say what are the PAs going to do now that they didn't do before and what should they be getting for that as a fair compensation. As they broach the subject with the idea of something like call I either have a figure in my head already from reading here, or I say something like well usually there is additional pay for that, let me do some research and let you know what that typically runs. It's been much easier to handle things as they arise then try to change the system after it's been implemented. 

 

 

THIS IS KEY

 

READ IT - ABSORB IT  LIVE IT

[RhymesWit9]

On 7/22/2017 at 11:39 PM, DigitalFusion04 said:

We had issues with this as a group as we started expanding PA hours when we hired more people. We were covering vacations, working night shift and weekends without additional pay. Eventually we all banded together and requested that they employ similar pay structures to other practices. It was intimidating but paid off and the awkwardness passed after a week or two. We have since then successfully negotiated overtime for anything over 40 hours, a night and weekend differential, overtime for covering another's shift, and most recently call, which is paid at 25% an hour and then we get full time pay for any calls we handle at night. 

The one thing that helped us the most was pointing to similar pay in other groups local to our area and them needing to be "competitive", trying to just ask for it or fight it out on the principle is a harder battle than pointing to the practice down the street. 

One thing I've learned is that as the practice grows the job slowly morphs from one thing to another. Now at each change I say what are the PAs going to do now that they didn't do before and what should they be getting for that as a fair compensation. As they broach the subject with the idea of something like call I either have a figure in my head already from reading here, or I say something like well usually there is additional pay for that, let me do some research and let you know what that typically runs. It's been much easier to handle things as they arise then try to change the system after it's been implemented. 

Great strategy! How did you obtain information about compensation, etc from other practices? Did you have personal connections to other practices in the area? I know some information can be had from the AAPA salary report, but am curious about how you all were able to do this. Thanks!