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On-Call Specialist Shortage

On Call SpecialistEmergency physicians often have to call on other specialists such as neurologists, orthopedic surgeons, and cardiologists to help in the care of seriously ill patients. These specialists do not work in the emergency department and are considered “on-call specialists” because they are specialists that are called into the emergency room when needed.

In recent years, there has been an alarming shortage of on-call specialists. In fact, three-fourths of emergency department medical directors responding to a 2005 survey, the most recent available, reported inadequate on-call specialist coverage, compared with two-thirds in 2004, according to a report released by the ACEP, in conjunction with researchers from Johns Hopkins University and funded by a grant from the Robert Wood Johnson Foundation (RWJ).

The top five shortages were among the specialties of orthopedics; plastic surgery; neurosurgery; ear, nose and throat; and hand surgery. Seventy-three percent of emergency department directors reported problems with inadequate specialist coverage, compared with 67 percent in 2004.

The consequences of the shortage are dire. Patients have died in transport or simply waiting for a specialist to agree to come into the ER to treat the patient.

ER staff often makes frantic calls to specialist throughout the city, state and even surrounding states before finding one that will treat the patient. Once located, patients sometimes have to be transported out of the city or state – depending on where the specialist is located – just to be treated. Meanwhile, precious time to address the medical situation has been lost. For brain- and heart-related illnesses, the results of delayed specialized treatment can be tragic.

The reasons for the on-call specialist shortage include:

  • Fear of malpractice lawsuits
  • Reluctance to perform services on uninsured patients and not be compensated
  • Growing intolerance for personal lives and private practice to be disrupted
  • Decrease in work for hospitals

If passed by Congress, the Access to Emergency Medical Services Act can help address the issue of the on-call specialist shortage in our nation’s emergency rooms. Take action now by contacting your legislators today to urge their co-sponsorship of this important legislation and to hold hearings on the critical state of emergency care.

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