Arranging Call

Question: Is ours the only practice left that still arranges call by seniority? The practice founders take very little call but the new recruits cover a lot of hours. This used to be common, but now we are having a hard time recruiting, apparently because of this policy.

Answer: Actually, quite a few practices still use the seniority model - and you are absolutely right that it is a barrier to recruitment. In repeated surveys, fellows and residents say they are more likely to choose a practice based on lifestyle issues than even compensation.

Note that this is partly about wanting more free or family time than constant call allows, but it's also about not wanting to work in a job where one is seen like a serf bullied about by omniscient masters. Partners - even "partner-someday" employees - want to be treated like partners.

Some practices do manage to recruit more naive young physicians, but within a few months those recruits are writing to us asking how to get out of their contracts with these obnoxious senior physicians.

I understand how the senior physicians feel - they put in their long hours when they were young, expecting more time off when their time came. It is not unfair of them, per se, to expect the payoff they worked for. But the fact remains that the rules have changed.

Together, groups need to work out a compromise that everyone can live with.