Pay for On Call

From the Arizona Daily Sun

Local baby doctors and Flagstaff Medical Center are in a dispute over caring for walk-in patients without being paid to be on call.
Depending on how the issue is resolved, it could wind up costing FMC up to $1 million a year or mean less local care for pregnant women.

In 2003, according to its tax returns, FMC had total revenues of more than $235 million.

The OB-GYN department at FMC has voted 7-4 that, without a daily on-call payment, it would not agree to be placed on the hospital's rotating call list to take patients who are admitted to the emergency room or show up at FMC without a private physician.

The department has given FMC officials until Aug. 20 to put a "cogent and decent" offer on the table for negotiation.

The doctors contend that other medical specialties in Flagstaff are paid hundreds of thousands of dollars a year to be on call, and they deserve the same consideration, especially because many of the pregnant women who come to FMC have not had adequate prenatal care and are high-risk patients.

Carlson said some specialists are compensated for call -- neurosurgeons, orthopedic surgeons, general surgeons and psychiatrists -- but that's because FMC is required by federal law and, in the case of the psychiatrists, by state law, to cover the emergency room "commensurate with its capabilities."

FMC is one of only seven trauma centers in the state and the only one north of Bell Road in Phoenix, said Carlson, and it sees about 1,600 trauma cases a year.

According to the FMC's 2003 tax return, it paid Northern Arizona Orthopaedics and Neurosurgery $526,483 and Forest Country Anesthesia $477,731.

"We have to compensate them for that additional demand," Carlson said, adding that obstetrics is not considered "trauma care" according to industry standards