ER Compensation

July 11, 2008

My hospital has recently started paying certain specialists to take ER calls. Other specialists continue to be required to take ER calls as a condition of medical staff privileges. Is this legal to force some physicians to take uncompensated ER coverage while others are being paid by the hospital?

Q. My hospital has recently started paying certain specialists to take ER calls. Other specialists continue to be required to take ER calls as a condition of medical staff privileges. Is this legal to force some physicians to take uncompensated ER coverage while others are being paid by the hospital?

A. I cannot think of any legal grounds to contest the hospital's privilege arrangement. Freedom of contract is pretty endemic to our society. Hospitals often contract with specialties that are needed to provide financial loans or other incentives. Doctors can refuse to contract for privileges or can negotiate terms.

You might review the hospital's by-laws but those can of course be amended. The pressures of the marketplace may prevail if one specialty is needed over others in your area. And you may be able to exert political pressure if all the doctors in your specialty were to make a unified request.

-Lee Johnson

Lee Johnson, who can be contacted atlj@bestweb.net, is a healthcare attorney in Mt. Kisco, NY, specializing in risk management issues.

The answers to these queries are general opinions and are not intended as substitutes for legal advice. You should not rely on these replies in making decisions involving questions of law, but should instead consult with competent legal counsel.