Community Benefit

Paying Physicians to be On-Call

Please Take Note: The information provided does not constitute legal or tax advice. The material is provided for informational/educational purposes only. Please consult with counsel regarding your organization's particular circumstances.

Question: Our specialty physicians (including surgeons, orthopedists, neurologists) no longer accept emergency department on-call responsibilities as part of being on the medical staff. This cost was not budgeted and we are not adjusting the cost of emergency department visits to cover the cost. If we did not pay for emergency on-call physicians, patients would not have access to specialty care or would have to travel considerable distances to access the services. Can we count paying specialist for emergency on-call? (Note, our state permits counting.)

Recommendation: The task force realizes this is a growing problem for many hospitals, but recommends not counting physician payments for on-call as community benefit for the following reasons:

  • It does not distinguish a hospital as a not-for-profit organization because all hospitals in an area must bear the same cost.
  • Paying for on-call is increasingly a cost of doing business.

If, however, the emergency room as a whole qualifies to be counted as a subsidized health service and these costs are counted as part of the cost to operate the emergency room, then the cost of these payments would be counted.

(Updated June 2012)


Question: Can we count the on-call costs for trauma care?

Recommendation: The task force recommends including the cost of physician on-call for a trauma program when the overall trauma program must be subsidized and on-call costs contribute to the need to subsidize the program. The cost of subsidizing the overall program should be reported, but not individual costs, such as the expense of on-call.