This spring, BuckheadFMV will resume data collection for our annual physician call coverage burden and compensation survey (expected summer 2022 publication). BFMV conducts a national direct-to-physician call coverage survey for a number of reasons. Initially, we sought to gain a better understanding of off-site/unrestricted call coverage "burden." Specifically, we hoped to capture the impact of unrestricted call on physician compensation. Since physicians are often the only party involved with direct knowledge of a variety of burden-related factors (phone calls received, in-person activations, etc.), we reached out directly to physicians. The 2021 survey is available in our shop.
The following is a list of four insights from the 2021 survey:
1. The physicians most likely to receive a stipend for providing call coverage services include specialists and surgeons.
This may not be surprising - but the survey supports the idea that highly specialized physicians, especially surgeons, are more likely to receive a call stipend than other physicians who also provide off-site call coverage. The specialties with the highest percentage of respondents receiving a stipend consisted almost exclusively of highly paid specialties, while primary care physicians were less likely to receive a call stipend in almost all cases.
2. Physicians with higher burden are more likely to receive a stipend than those with lower burden within the same specialty.
The more work you do, the more likely you are to get paid. For all specialties, we compared the median average in-person visits reported by physicians who receive a stipend with those who do not. For 19 of the 28 specialties with sufficient responses, the stipend recipients reported higher average in-person activation volume per shift, at the median, than the pool of non-stipend recipients. The opposite was true for only six specialties.
3. Physicians with higher burden generally receive higher stipends; however, the correlation is weak in many specialties.
When we graphed each of the burden statistics relative to compensation, the charts for most specialties look much like the ones for ophthalmology below:
While the resulting regression equations almost all run up and to the right — indicating correlation — the correlation isn't particularly strong, with significant variation visible within the data. We calculated r-squared for each specialty, which is a measure of correlation (or fit), representing the percentage of the variation that is explained by the linear model from 0% (no fit) to 100% (total fit). Only a handful of the equations accounted for more than 50% of the variation, which indicates one or both of the following is correct: 1) factors other than burden have more impact on call coverage compensation, and/or 2) there is a lack of relevant information available to the negotiating parties to appropriately match compensation with burden. My hunch is that #1 is a little bit correct - there are certainly other factors that impact call coverage compensation - but that #2 is more likely to be the primary culprit.
4. Compensated call arrangements commonly involve some amount of uncompensated call coverage per month, as well.
Among those physicians with compensated call arrangements, an average of 20% also provide some amount of uncompensated coverage, with 40% of certain pediatric and obstetric specialties including uncompensated components. On average, these physicians provide 6.2 uncompensated call days as part of their monthly call burden, ranging from 1 to 20 uncompensated days across those representative specialties.
More information about the 2021 survey is available here.