Taking Call – Is it a Burden?

Today I received an email from an NP who is looking at starting up her practice in a community a few hours away from me.  One of her questions to me is about taking calls.

“What concerns me the most is call.  I don’t have a partner so I am thinking I will need to be on call 24/7.  How do you handle call?  Also, how do you handle your vacations?  My husband would not be a happy camper if I never went on vacation with  him. I do not want to be married to a practice yet I don’t want to be under the thumb of a group of physicians or a network of clinics.”

Taking call was a concern for me as well. It’s difficult to join a call group in my community as they are all physicians, and they all see patients in the hospital. My local hospital does not offer NPs independent privileges. (I would possibly work out something with someone for a fee, to have them become my supervising physician to see my pts in the hospital, but I would not be able to admit.)

A side note:  Many insurance companies, require you to have a physician who has admitting privileges be listed when you credential. Depending on your relationship with that physician, you may or may not be in a call group with her or him.

So this is what I do. I have a cell phone that is strictly for the practice. I never answer the phone, but it has a voice messaging system on it. After-hours, the office phone is forwarded to this number. The message says it’s our after-hours message center and suggests that the caller leave a message if they need to speak with us.  I return appropriate calls, though often times someone just calls about an appointment change or other non-urgent matter.  My patients know that they will get a call back for urgent or even semi-urgent matters that cannot wait for the next day.

In the recent months, a second NP owned practice has opened here in town. We now have an agreement to cover one another when either one of us is out of town. We’ve not yet taken each other up on that idea, however, in this small town chances are we know each other’s patients anyway.

After talking with others regarding answering services, this seemed like the best way to handle this. A few months after opening, I needed to close down for a week and visit my Mother in CA. My cell phone still got the messages, and I was able to return all calls as was necessary with too much of a problem.

There is some teaching that goes into on-call. My patients now know we do not refill medications on the weekend, and they need to contact their pharmacy first as chances are, their lisinopril has a refill on it already. Occasionally I’ve had to educate a few as to what constitutes urgent (hot flashes, while they can be uncomfortable, are not an emergency).

Overall, on call has not been the burden I feared it would be. Now, if I can just get away from some of the paperwork, hat is my burden.

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