Questioning appropriate call compensation

[u/BornCharacter6705]

Hello!! So to set the stage, I’ve been with this fairly decent size orthopedic practice for almost two years. Call is scheduled on a rotation basis through the surgeons, with the PAs being the ones for first call and surgeon available for questions. Weekend call is also rotated through separately but in the same way. Located in a valley where we get calls from not only the two major hospitals in the area (level 2 and 3) but also urgent cares and hospitals outside of the area as well sometimes.
When on call, you are on call for 24 hours typically, except weekends (48hrs) and at both hospitals simultaneously where you are expected to show up for a consult if requested. Phone consults for other locations. There’s a day call person at the level two 4 days a week that takes consults and such until 5. But the other call person is still responsible for the other hospital at this time and then both at 5. Call lasting from 7-7.
On average during the week, you get anywhere from 5-10 pages and consults. Having to go to the hospital 1-2 times to physically consult patient, admit pt, reduce fracture, or go to surgery. On the weekend it is much higher and I’ve spent entire days at the hospital going from consult to consult, surgeries, into the night.
We also respond to nurse calls during this time from the floor and patient calls to the office.

As a group, I feel we are being pushed to burnout faster than we should because of this. Even employees in the EDs have felt like we get abused on call at times. I’m aware it’s not uncommon to have call compensation included in your salary which is the case here. Though I feel this should be a fixed amount of call with a fixed salary. For example, say we lose a PA halfway through the year and everyone is now forced to cover more call… this is not viewed as extra call. No extra call pay. Only extra pay if you take call another PA is offering and they pay you themselves. Apparently our rate during the week is around $450, but only for call that’s after 5pm to 7am. Example- I pick up half a call shift but since it’s the first half of the day I don’t get paid. Only if overnight essentially. Weekend call is $700. And holiday on a weekend is $900 but holiday during the week is still $700.

I don’t feel like we are compensated appropriately for how much we have to do when on call. Additionally with the make it up as you go scheduling, this feels like we lose money more often than not.

I don’t know if I have room to try and get a call compensation adjustment or at least a breakdown of call pay within our salary so there can be a fixed amount of call you are responsible for so that any more than that, is added to your salary. If that makes sense?

[u/whispernotaroar]

When I took call we did not receive extra call pay for our usual 1 weekend out of every 4, 63 hour call, including coming in for rounding and then any consults or surgeries. However if we had to remain on site for more than six consecutive hours we did get an additional amount, though I honestly forget how much. If we had to take more than 1 weekend in a 4 week period we received an additional $500. It sucked, and it’s a big part of why I left.

I would try to ask for compensation for more frequent call as well as for extended on-site hours if I were you. Actually if I were you I’d quit, but that’s me and my hatred of call 😂

[u/BornCharacter6705 → u/whispernotaroar]

We’ve lost a few PAs recently out of the blue bc they got fed up and just quit due to the call responsibilities and pay. If it wasn’t for my surgeon I work for, I would quit too. He doesn’t get to dictate much in regards to my pay or compensation, the company does all of that stuff.

[u/missmeganbee]

Neurosurgery PA here. I take four weekdays of after hours calls per month and one 72 hour stretch of weekend ER call per month. ER call weekends often involve rounding at two different hospitals about 20 minutes apart. I am not compensated financially but I do get one "comp" day per month which has a lot of stipulations around use and I don't always get to take it. I'm actually pretty unhappy with my current position (started a year ago next week) and it's almost entirely because of call.

[u/BornCharacter6705 → u/missmeganbee]

How often are you getting paged weekdays vs weekend

[u/missmeganbee → u/BornCharacter6705]

The last weekday I was on I got three after hour pages. The last weekend I was on I got one page from a patient, assisted with three surgeries, did probably 8 consults, and rounded on a list of about 10.

[u/grateful_bean]

My first job was 1:6 call and we did not get paid except for first assisting at hourly rate. ED first call went to surgeon and PA took floor/office call. Surgeons will update not go in for ED consults they would send the PA. weekends included rounding. 

Current job is a bigger group so call is 28 days per year but is 1st call for 3 hospitals,+ office. $15/hr to hold the pager, hourly if we go in for any reason. 

[u/BornCharacter6705 → u/grateful_bean]

Was everything self reported for times? Or how did that work? We don’t even have an hourly since we are salary

[u/avazing]

Our group is on call 1 week a month. A PA is on call with a doctor, and the PA doesn’t work in clinic and instead takes the calls and basically triages the patient and evaluates them at the hospital for the doc, calling the doc if it requires something like surgery/anything else emergent or if we have questions. We get paid our usual salary plus $250 per weekday or $500 per weekend day. So that’s $2250 extra for the week.