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Use of stipends for on-call compensation on the rise

Emergency Management Alert, October 9, 2006

Use of stipends for on-call compensation on the rise

It's widely understood that physician on-call pay is given to practitioners to compensate for time they spent waiting to work. A form of pay often used for on-call service is a stipend. Although the approach to paying of stipends is changing almost as quickly as the need for on-call compensation is increasing, there are established stipend models, as drawn by authors Kimberly Mobley, Richard Sheff, MD, and Bradley Zlotnick, MD, FACEP,in Emergency Department On-Call Strategies (HCPro, Inc., 2006):

• Daily stipends If considering daily stipends, examine benchmarks from other local organizations. Further, determine whether the rate is based on 16 hours, which would typically include covering an evening or night shift, versus 24 hours of work.
• Weekly stipends This form of stipend is based simply on the provisions of on-call services for a week.
• Monthly stipendsAlthough less common, some hospitals determine the call stipend based on the monthly number of on-call hours. This stipend models is most often used to pay a physician group for its on-call services.
• Annual stipends Like monthly stipends, annual stipends are most commonly used when a hospital compensates a group of physicians for the practice's participation in the on-call panel. Some hospitals bundle a non-clinical administrative stipend, as for a group director, in larger-interval payments.

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