Expanding call coverage

Q: Our local hospital has approached us to expand call coverage. They are offering a modest stipend. We want to help the hospital, but there is a limit to what we can do. One of the problems is that there is a diminishing supply of younger doctors in our specialty and the medical staff by-laws allow senior physicians to opt out.

A: The hospital has apparently recognized that call coverage has some financial value. One approach might be to meet with them to determine if they can adjust the stipend to a level that will make it more attractive to your group. Other options might include an offset of the call schedule with occasional locum tenens coverage. You might also suggest that the hospital staff review the call process to see if there is more that the hospital-based providers (hospitalists and emergency department staff) can do to make sure that the use of your group is limited to only those instances that are a critical need for a patient.

Call coverage is an area that has been ignored in most medical staff planning exercises and it can catch hospitals, and groups like yours, by surprise. In the last decade, more accreditation and regulatory standards have defined the need for emergency coverage by specialty groups, but many medical staff by-laws have remained unchanged. You might also want to see how call coverage is affecting some of your colleagues and approach the hospital with the idea that its requirements (and resource commitments) should be reconsidered.

Answers to readers' questions were provided by Allison Farey, Wells Fargo Practice Finance, Emeryville, California, and A. Michael La Penna, The La Penna Group, Grand Rapids, Michigan. Send your practice management questions to medec@advanstar.com