Dr. Harris discusses variation in on-call patterns among urologists

In this video, Andrew M. Harris, MD, highlights the background and key findings from the study, “Exploring the Demands of Urology: On-Call Compensation, Frequency, and Variability.” Harris is the chief of urology at the Lexington VA Health System, an associate professor at the University of Kentucky, and the chair of the Workforce Task Force and a member of the Quality Improvement and Patient Safety Committee for the American Urological Association.

Video Transcript:

Could you describe the background for this study?

I appreciate your question and appreciate the opportunity to be with you today. The question behind how this study got started, is really, our effort to better understand the frustrations our colleagues feel in everyday practice. We had a paper come out in the Journal of Urology last year talking about burnout in the working population. From that work, we started to ponder, well, how does call maybe factor in? And is there really any standard about call and the frequency and pay for call and those interesting questions about call throughout our working population? We didn't know the answer. So, we figured we might ask some questions through the Census to see if we could get to some of those answers.

What were the key findings?

The key findings were that the call is wildly variable across many of the demographics and variables of which we asked. They are different by gender; they are different by subspecialty; they are different by section; they are different by practice type, salary, number of hours worked. We see call differences, significant differences, in all of these domains. So, the main takeaway for us is that it is widely variable and very specific to the type of practice or location or subspecialty or those other variables to what kind of call you may experience.

When we look at gender, there were significant differences and gender and the requirement to take call to maintain hospital privileges. We saw 76% of women vs 67% of men having to take call to maintain hospital privileges. We also saw differences in the average pay per weekday of hospital call; 32% of men reported receiving over $500 per day [of] weekend hospital call, but only 18% of women reporting the same. Also, 72% of women indicated they did not receive per diem compensation for weekend hospital nights, in contrast to 60% of men. So, we really see some differences with respect to gender in call patterns and call pay, which we thought was interesting. We also saw differences in subspecialties, with those in general urology having different call requirements than more subspecialty urology, like oncology, for example. Interestingly also, is pertaining to hours worked. We saw differences in how much call and other call variables if we worked less than 40 hours a week, or 41 to 60 hours a week, or over 60 hours. Then we also saw differences in sections. So, 51% of the western section, 47% of the southeastern section, and 53% of the south central section reported being paid to take weekday call. And 8.2% of the northeastern section, 13% of New England and 19% of New York, and 21% of north central section reporting being paid to take weekday call. So, really quite a bit of difference also with the geographical location.

This transcription has been edited for clarity.