Family practice On call 1 week out of 5 and no compensation. Thoughts?

[TWR]

Working family medicine with 3 NPs and one other PA.  We take call for one week each so every 5 week for 7 days.  There is no compensation.  To be honest, calls are not frequent.  Is it the norm to just assume we take call?

[turnedintoamartian]

Just started taking call, every 3rd week. No pay or extra anything.

Its a point of contention among the APPs as previously it was physicians only but that’s changed. 

[rev ronin]

Salaries are evil, because they incentivize management to change workload without changing compensation.

I take call for a residential eating disorders clinic about one weekend in six, totally voluntary, usually about an hour's work entirely from home, never been woken up in two years doing it. Oh, and there's a psych provider on call too, so it's not everything. $75/day, physicians, NPs, and PAs get the same per-day call pay on top of their other compensation. I think that's fair and am happy to do it.

[ventana]

This is becoming a big issue. 
 

never take call with out compensation!   
hospitals have realized they can force call onto PA and NP and unload the docs.   Then they use the excuse they don’t pay the docs for call. 
 

I have argued (unsuccessfully) that since we are clearly not compensated as docs that is not a valid argument.   Also that since most docs have at least some part of pay as productivity (and we typically do not) it also is invalid.  
finally I have argued thus is a quality of life issue (clearly the reason to get PA to do call us improve the quality of life) it needs to be compensated.  
 

reply from corporate “no we do not offer pay for call”

my reply.  “Thank you bye bye”

 

(I don’t want to hijack this thread but this is where all PA and NP must stand together and refuse together!!)

 

 

[ShakaHoo]

In my Occupational Medicine clinic we rotate being "on call" every month.

A busy month of being on-call is 2 phone calls.  I have never in my career had to drive in to see a patient on a weekend.

If it is 10-15 minutesof work - I don't have much of a problem with it.

If it is hours of work... you need to be compensated.  

[sas5814]

Being on call is a work burden whether you get 1 call or 50 calls. You are limited in your activities and have to be reachable 24/7 whereas my "do not disturb" generally turns on at 8PM.

No pay. No call.

[Mayamom]

7 days per week 24 hours per day?  No you need some sort of compensation. 

[Brigid2010]

...just to echo the preceding posts: the old rule of thumb that's been passed down to me was exact

2 hours ago, Hemmingway said:

Being on call is a work burden whether you get 1 call or 50 calls. You are limited in your activities and have to be reachable 24/7 whereas my "do not disturb" generally turns on at 8PM.

No pay. No call.

2nd, 3rd, 4th this--my old clinic, when i was a permanent employee (now, very per-diem--like once/month where I've been for a decade, while i work as a communicable disease reporter from another local health dept to the state...), APPs took (phone only) call on weekends, rotating maybe every 3-4 weekends. Straight $50/day, Sat/Sun/Holiday if applicable-whether one was called or not.  Seemed fair, and a relatively nice way of earning some pocket-money. If you were called, it's maybe 1 call in a weekend, and rarely at that. Still, as stated, it's your time that's now their time--whether you're called, or not--and for that reason alone, compensation should be the standard. We start setting precedents w/ admin when work-for-free becomes the norm...

Edited August 9, 2023 by Brigid2010

[TWR]

I agree with all the above comments especially "whether one call or 50".  You are expected to answer and address the issues which in my case would be access to the EMR from home to address the issue as not all calls are from patients I have seen.  As for just saying "no" I won't take call without some compensation really is not an option if I don't want a job then okay.  The one answer I can see is "unions"!!!

Edited August 17, 2023 by TWR
addendum and correction

[Reality Check 2]

Being on call limits your activities despite cell phones. 
You must be reachable - in cell service. Some nice camping spots and lakes don’t have cell service.

You must be sober - I don’t drink but for some not having a Saturday night margarita is an inconvenience.

In Ortho, I had to be within 30 min of the hospital. In Dallas that was a feat in itself. No going to movies etc. 

You are ON CALL thus not 100% present for your family etc.

Compensation is a must. A fee for being available and MORE if you have to go in to an actual building to see someone.

Do Not work for free.

[rev ronin]

15 hours ago, Reality Check 2 said:

You must be sober

Sober?  I've been using a rule of 8 hours since last alcoholic intake before charting, let alone making active medical decisions. Since I average <5 alcoholic beverages per year, not much of a problem for me... but I'm wondering if everyone else has anywhere near that sort of practice.

[ventana]

Old school PA that I used to work with would be on call and not worry about having 1-2 drinks at night.  Says he always did it and there is no way anyone would ever know through a telephone.  

[sk732]

15 hours ago, ventana said:

Old school PA that I used to work with would be on call and not worry about having 1-2 drinks at night.  Says he always did it and there is no way anyone would ever know through a telephone.  

Since I'm like Rev these days and can count on one hand how many drinks I have in a year, I think someone would notice if I were slurring or garbled...or in my case, inappropriate.  I'm of the opinion, if you're on call, that means no wobbly pops and in the case of here in Canada and several states in the US, no weed.

As for call and no pay, yeah, NO, N - O, again for all the above reasons.  Someone is making money off of after hours stuff, therefore so should you and it's to compensate for being leashed for whatever time frame you're leashed for.  I'm a contractor now, but we still get compensated for call when I'm in my fly in community at $100/12 hours, on top of me making an extra $30/hour + per diem than I made in my previous jobs AND I get to bill for those extra hours if I have to go in.  Being on call is a big deal there - more often than not you'll have traumas, DKA's, suicide attempts, OD's etc which are time consuming, especially if you have to spool up a medevac.  You can't really go anywhere except the store (I like to hike and fish in my off hours) which can be an adventure unto itself, if you're leashed.  Our docs actually make less on their call stipend, but they're compensated differently and make more per day than we do, so it evens out.  Incidentally, in my previous life, my hospital ED gigs were unionized (as are most of the PA jobs in Manitoba).

$0.02 (CDN)

[PAMalignantHeme]

Sometimes on call just means you handle calls for practice ... like patient has a sore throat on a saturday an wants guidance ... urgent medicine refill ... concern about a drug adverse effect etc 

 

if the compensation is otherwise excellent and the calls infrequent maybe you can consider yourself compensated. But off the top of my head I would expect to be paid at least 5-700 each week I was on call. That is assuming the above where you are not actually seeing patients, going anywhere, or handling large number of calls. 

[turnedintoamartian]

We average 1-2 calls per week. Annoying but the remainder of the compensation package is reasonable and there’s a non compete.

[ventana]

17 hours ago, turnedintoamartian said:

We average 1-2 calls per week. Annoying but the remainder of the compensation package is reasonable and there’s a non compete.

Do not do call that is uncompensated (fine if you don’t care but you are hurting the rest of us that do)

[turnedintoamartian]

I fought admin for a full year on it and it was a losing battle. In the big picture it is not worth leaving over. Beyond that there’s a limit regarding my responsibility to the PA field as a whole and this isn’t it.

[CVTSPA]

Granted this was years ago, but I was paid less than the on call OR nurses per day to carry the pager for 7 days in a row for CT surgery call... If I remember correctly, it was something like $1 per hour?  It's an uphill battle with corporate medicine to get this compensated appropriately especially when you are salaried.  

[ventana]

All this talk of "up hill battle" and "not worth the fight" is so far off the point.

 

We need to stand up for ourselves and not just be taken advantage of....

[HMtoPA]

I'm confused.  Are you people not talking call salaried or paid hourly?  If the latter, I'm not sure how they can make you take uncompensated call?  If the former I can see an employer trying to screw you, but I personally would leave a job over that as soon as practicable.

Edited August 19, 2023 by HMtoPA

[ventana]

1 hour ago, HMtoPA said:

I'm confused.  Are you people not talking call salaried or paid hourly?  If the latter, I'm not sure how they can make you take uncompensated call?  If the former I can see an employer trying to screw you, but I personally would leave a job over that as soon as practicable.

In my case.  Hired for salary. No call.  After resigning my job before I started new job “oh by the way there is call”.  Asked for comp.  Told nope.  I should have stayed at my old job…….

[rev ronin]

1 hour ago, ventana said:

In my case.  Hired for salary. No call.  After resigning my job before I started new job “oh by the way there is call”.  Asked for comp.  Told nope.  I should have stayed at my old job…….

This is why I recommend negotiating pay for call even if "there is no call." This is a far too common occurrence:

"I want the clinic and I to have a meeting of minds in advance, so that if the business needs change in the future, you have a good idea what it will take to pay me to take call."