Saturday, August 9, 2008

24/7 No rest, always working

One problem with many areas in medicine is "call". This is when the doctor is on call for patients. There  are many laws and regulations regarding call. You have to round on a patient with in 24 hours after hospitalization for non-emergent issues. There are time limits on how quickly you must respond to a call. There are mileage restriction during call. I am realizing that call takes a considerable toll the physician, especially for individual doctors. If they do not have a partner then they are on call every night. The disadvantage of having partners is that when it is your turn to take call, it will be a much busier call due to the volume of patients. 

Often the doctor never feels like he/she never really gets anytime off. Also there is so much going on during the day that many times charting and other things have to be done after seeing patients. The doctors I am working with now seem to have to work 65 hours+ when you consider all of the after hours responsibilities. Generally this is typical of many specialties. 

ER doctors are protected from this in many ways. They do not have to take call because they do not have any patients. They see the patients during their shift and then are not required to follow the patients. All of the charting is done during the shift. Many times they will stay an hour or so after a shift to complete some of their charting, but because they are paid hourly they do get paid for these extra hours. When you are off the clock, you are truly off the clock. You can actually take vacations. This is a major draw for many people to pursue emergency medicine. There are not many other areas in clinical medicine that allow for this freedom. 


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