The Shortage of On-Call Surgical Specialist Coverage

A National Survey of Emergency Department Directors

Patient care suffers when emergency department directors have difficulty in obtaining on-call coverage by specialists.

Emergency department (ED) directors count on having access to specialty physicians to consult for patients who show up with emergencies and traumas. Hospitals, providers and patients face increased wait times or may need to transfer patients to another more distant facility to meet their urgent specialty needs when there are not enough specialists providing on-call coverage.

These researchers surveyed a nationally represented sample of ED directors and solicited the following information: How frequently they reported on-call coverage problems; whether they recently lost on-call coverage; whether their current on-call coverage was reliable; and the potential effect of on-call status on emergency care provision.

Key Findings:

  • Seventy-four percent indicated that their ED had inadequate on-call coverage by specialists.
  • Sixty percent reported a loss in ability to provide 24/7 coverage for at least one specialty in the past four years.
  • Twenty-six percent reported unreliability in their current on-call coverage.
  • Twenty-three percent said their trauma center designation level had been affected by on-call coverage.

With 21 percent of cases of ED deaths and permanent injury linked to shortages in specialist physicians, deficiencies in the on-call system need to be addressed through a collaborative effort of policy-makers, professional societies and providers.

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