Expectations of On-Call Physicians/APPs and Consultants

Did you know that, during their coverage period, St. Mary’s on-call physicians/APPs are expected to:

• Be immediately reachable by telephone throughout the on-call coverage period.

• Respond to calls from the ED and hospital in a timely fashion:

  • Respond to calls within 30 minutes (or sooner based on patient acuity).

  • For those on “unrestricted call” (as opposed to in-house call): Maintain the ability to be on site within 30 minutes, when requested.

• Respond to calls from the Regional Command Center (Transfer Center).

  • Respond to the RCC and requester with courtesy, professionalism, and respect. (These calls are recorded!)

  • Determine whether the patient requires transfer to St. Mary's for a higher level of care, and whether St. Mary's has the capability to meet the patient's needs. (The house supervisor can help determine whether we have capacity.)

  • If you feel transfer to St. Mary's is appropriate (clinically indicated, with capacity and capability) but you will not be the admitting service, let the RCC know so they can contact an admitting service.

  • When appropriate, collaborate with the requesting provider and facility regarding stabilization and transfer planning.

• Collaborate with ED providers, hospitalists, nursing staff, department leaders, and other practitioners in the interest of safe patient care.

• Accept and manage patients appropriately referred during the coverage period when the required care falls within their privileges and St. Mary's capabilities.

• Arrange qualified backup coverage and update the call schedule whenever coverage responsibilities change.

When asked to consult on a hospital patient, on-call physicians/APPs are expected to:

• Respond to the consult request in a timely fashion.

• If there is disagreement regarding the need for a consultation, the judgment of the requesting physician/APP prevails, and the consultation is expected to be performed.

• Clarify the urgency and anticipated timing of the consultation when contacted. If you have questions, speak with the requesting doc/APP.  (This often makes your job easier!) 

• The St. Mary’s Clinical Rules state that a satisfactory consult goes beyond just reviewing the relevant medical record – you must examine the patient. Scheduling the patient for a future office, clinic, or procedure appointment does not replace the expectation to perform and document the requested inpatient consultation unless the requesting provider and consultant mutually agree that an inpatient consultation is not needed.

• Communicate recommendations to the requesting team when clinically indicated.

• Document the consultation in the medical record.

• Complete your documentation before any procedure(s), except in emergencies.