Thursday, September 8, 2011

Night Call

What do you think about these two posts that mention diametrically opposite perspectives on night call that were published within the last few days?

On September 7, 2011, NPR posted a story about a trauma and burn surgeon named James Jeng, who was on duty at Washington Hospital Center on September 11, 2001. He cared for a number of seriously burned victims from the Pentagon. In discussing the intensity of the post-burn care of these patients, he said this:

I had fallen into an automatic rhythm of 36 hours on, 12 off in-house duty. Every other night, then, I would get home to be with my family.

This, of course, is against all the new rules but somehow Dr. Jeng and the patients got through it despite the potential detrimental effects of “decision fatigue” and sleep deprivation.

On September 3, 2011, the following from M. Schoen, MD appeared on Sermo, a website devoted to physician issues:

In my group most of the new docs joining in the past couple of years are refusing to take internal medicine night call. These are both docs who are subspecialists (but who also practice medicine) and docs who are only internists. Meanwhile the bulk of the night call is being taken by the older docs (of whom 7 of the 25 or so docs are over 60). The group refuses to consider what will happen in the future when there will be no one to do night call. Is it common for groups to allow this? And what will happen down the road? 

This has attracted 286 comments with most of them deploring the situation.

So where is this all going? I think I know, and it’s not a good place.


Felix said...

Dear Doctor, I think it comes down to compensation and pay.

I too work in a mission critical profession albeit a different industry. The On-Call Night Call situation is similar here whereby the "older staff" like me take the Night Call duties as part of our job. However, the younger generation staff are somewhat resistant to eagerly volunteering for such duties. I asked them about this situation. The feedback is that if the employer provides a more generous compensation wage during off hours then they would gladly sign up for Night Call/On-Call. However, if the expectation is they will do this without compensation then they would rather NOT sign up and instead spend time with their families.

The conclusion I draw from this unofficial survey is that if organizations pay and compensate the employee for the Night Call/On-Call then we will see more people signing up for that time slot.

Thanks for your time.

Mission Critical Contributor

Skeptical Scalpel said...


You may be right but I know docs who won't take night call even for pay.

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