Surgeons commanded more than $1,000 a day for being on-call at the hospital, while primary care physicians reported compensation rates of around $150 a day, according to annually compiled data.
Family physicians whose practice included obstetrics reported the lowest median daily on-call compensation -- $75 -- while anesthesiologists reported the highest -- $2,400 -- for days on call, according to the MGMA Medical Directorship and On-Call Compensation Survey.
Median daily on-call pay rates for some specialties in 2012 and 2011, respectively, included:
- Family Medicine (without obstetrics): $150, $100
- Obstetrics/Gynecology: $500, $500
- Neurology: $600, $650
- Orthopedics (all surgery): $953, $854
- Cardiology: $900, $650
- General Surgery: $1,000, $920
- Radiology: $1,000, $1,000
- Anesthesiology: $2,400, $1,500
"It used to be, of course, that physicians would apply for hospital privileges and build portions of their practice out of the emergency room or from inpatients at the hospital," said Peter P. Cebulka III, director of recruiting and training with Merritt Hawkins, a physician search and recruitment firm headquartered in Irving, Texas. They would share a call rotation of those patients, he explained.
But that has changed drastically, he said, because the process is more driven by outpatient medicine as opposed to inpatient medicine.
"There's a very strong trend toward hospital employment at this point," with some physicians employed full-time by the hospital paid additionally for on-call services, Cebulka said. The on-call compensation rates reflect compensation that has been broken out into a separate category outside of salary and bonus.
The trend now is to minimize on-call responsibility and increase quality of life, he noted.
"A lot of hospitals are using an on-call daily rate compensation as a retention tool," Cebulka said, "to keep positions in the community and help maintain a strong relationship with the medical staff."
The data are based on responses from 3,950 providers in 295 groups, said Todd Evenson, director of data solutions at MGMA-ACMPE in Englewood, Colo. , formed by a merger of the Medical Group Management Association and the American College of Medical Practice Executives, is a membership association for professional administrators and leaders of medical group practices, according to its website.
Some data for daily rates was affected by increases in sample size. In one specialty, the association received 35 responses in 2011; for the same specialty a year later, the association received 135 responses.
Cebulka said he believed neurology rates declined from $650 down to $600 because the statistical sample may have increased from 17 respondents in 2011. If the median numbers in this year's MGMA report indicate a decline it likely there was just a different sampling of respondents, he said; however, on-call compensation for neurology has been an important topic in recent years, he added.
Many private practices have given up medical staff privileges at hospitals where they are not paid for call, Cebulka explained. Some smaller hospitals have responded by building health systems that employ neurologists. Larger hospitals have leaned toward hiring neurologists who can focus on cerebral vascular neurology while handling hospital inpatient call as well.
In some instances, a larger base salary is required to recruit and employ physicians, leaving less in the contract for on-call compensation. "That can have an effect on driving down overall on-call compensation rates within the medical specialty," he said.
More than 35% of responding physicians reported receiving a daily stipend as on-call compensation. More than 12% percent reported an annual stipend for on-call coverage, while only 7% of physicians reported receiving hourly compensation for on-call services and 3.39% reported receiving monthly compensation.
"The number of organizations paying for call in some form or another appears to be increasing as new physicians enter the workforce," said Jeffrey B. Milburn, a certified medical practice executive with MGMA. "Call compensation may address multiple variables, and methodologies can range from being a fairly simple hourly rate or annual stipend to a more complex arrangement addressing time and additional subsidies for uninsured patients, retention of professional fees, and restricted or unrestricted call coverage."