Call pay for physicians: Who gets it and how much?

A new report found that only one in five physicians are paid for call, and the amounts that they receive go from a high of more than $2,000 per shift to almost nothing.

A Marit Health survey of more than 15,000 physicians in 34 specialties asked physicians whether and how much they’re paid for call. An analysis of the data from Marit looked at the factors behind hospitals’ decisions to pay for call and the fairness of pay for physicians who take call in the hospital.

Which specialties are paid to take call?

Orthopedic surgeons reported being paid for call more than any other specialty, with nearly half (48%) getting compensation. Other specialties that are most likely to be paid for call included neurosurgery (47%), anesthesiology (41%) and oral maxillofacial surgery (39%).

On Marit’s list of specialties that are paid for call, internal medicine was ranked No. 19. That means only 12.6% of internists reported they’re paid for call. (Hospitalists weren’t specified on the list.)

There were specialties that fared worse when it came to taking call. Not a single allergist/immunologist, for example, said they are paid to take call. Among radiation oncologists, 2% were paid for call. The numbers were similarly low for nephrology (4%) and family medicine (9%).

How much are docs paid per shift for call?

When it comes to how much physicians are paid for call, neurology topped the list with an average call reimbursement of $2,200. Anesthesiology and radiology tied for the No. 2 spot for call pay at $2,000.

While only about 13% of internists are paid for call, the amount they reported receiving was seventh on Marit’s list: $1,200.

Here’s a look at the highest- and lowest-paid specialties when it comes to call:

Top specialties for call pay

Neurosurgeons: $2,200.

Anesthesiology: $2,000.

Radiology: $2,000.

Oncology: $1,500.

Ob/gyn: $1,325.

Worst specialties for call pay

Pulmonology: $232.

Infectious diseases: $300.

Podiatry: $350.

Pathology: $429.

Family medicine: $480.

Factors in paying physicians for call

Analysis from Marit said the decision to pay physicians for call comes down to reimbursement and coverage.

“A hospital that holds a trauma designation needs orthopedics and neurosurgery available around the clock,” Marit said, “or it loses that status. An OR does not run without anesthesia.”

Marit’s analysis also said that cognitive specialties tend to suffer the most financially when it comes to taking call. “These physicians take overnight calls that require clinical judgment,” the analysis concluded, “and roughly six in seven are not paid for it.”

One exception, Marit found, was psychiatry. On the list of specialties paid for call, psychiatry ranked seventh, with 31% of its physicians reporting they’re paid for call. That put psychiatry ahead of general surgery, plastic surgery and gastroenterology.

While the report noted that “nobody bills a procedure for a psychiatric consult at 2 a.m.,” it added that hospitals need to be prepared to cover a psychiatric hold in the ED. As a result, they’re willing to pay psychiatrists for call coverage.

Where do physicians take call from?

Marit’s analysis discussed one other factor in physician call: where they’re located when taking call. Marit said the distinction is important because “a meaningful percentage of physicians across several specialties” take call from the hospital, not their homes.‍

Rob Anderson, MD, a founder of Marit and an anesthesiologist, argued “there should be no debate about whether those physicians should be paid.” When physicians give up their sleep and personal time to be in the hospital, he said, they should be paid.

“The fact that a significant portion of internal medicine, ob/gyn and anesthesiology physicians do exactly that without separate call compensation is one of the most striking findings in this data,” Anderson wrote.

For more information, see Marit’s analysis of its survey data. 

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