ASOPRSFall Scientific SymposiumSyllabus
63
ThePracticeofOculofacial Plastic Surgery
Moderator: JohnD.McCann,MD, PhD
1:40pm
OculoplasticHospital Call CoverageUtilization: AProspectiveStudy
CraigCzyz
1,2
, AdamStrittmatter
1
, KennethCahill
2
, Jill Foster
1,2
.
1
Oculofacial Plastic andReconstructiveSurgery, OhioUniversity,
Columbus, OH, UnitedStates,
2
Ophthalmology, Oral andMaxillofacial Surgery, GrantMedical Center, Columbus, OH, UnitedStates
Introduction:
According to a recent survey, the amount of physicians compensated for call coverage has increased 25% in the past
year to 60% overall
1
.While the study did report on “surgical subspecialists” therewas no breakdown for specific subspecialties.
Further, the study did not comment on the patient volume or resources and time required tomeet the on-call duties.Whilemost
institutions have ophthalmology call coverage, oculoplastic subspecialists are routinely requested for “subspecialty” consultation,
especially at higher-level trauma centers.
Methods:
Prospective study of hospital on-call coveragewhere oculoplastic evaluation and/or treatment was requested. Datawas
collected over a consecutive one-year period at the following sites: 1. (1) Level 1Trauma Center; 2. (1) Level 2Trauma Center;
3. (3) Community Hospitalswith no trauma rating. None of the sites had institutionally employed ophthalmologists or oculoplastic
surgeons. Datawas aggregated based on trauma level rating. Consultswere reviewed to determine if theywere appropriate to
require oculoplastic evaluation, rather than general ophthalmology.Those not meeting inclusion criteriawere excluded from the study.
Results:
The Level 1Trauma Center had the highest average number of consults per week (1.0), follow by the Level 2 center (0.47),
and community hospitals (0.27).Themajority of consults at the Level 1 center were for inpatients (63%) versus the Emergency
Department (37%).The opposite trendwas found at the Level 2 and community hospitalswhere Emergency Department consults
were significantly higher (69% Level 2 and 79% community).The consults that required surgical interventionwere highest at the
Level 1 center (96%), followed by the community hospitals (71%), and Level 2 (62%).Approximately half the patients requiring
surgery at the Level 1 (42%) and Level 2 (50%) centerswere uninsured versus 10% at the community hospitals. Overall, 42% of all
Level 1 patients encounteredwere uninsured, compared to 35% for Level 2, and 15% for the community hospitals.
Conclusions:
The data indicates that oculoplastic surgeons providing on-call hospital coverage aremost frequently summoned to
higher trauma rated centers,where surgical intervention is routinely required.While the amount and complexity of service provided is
highest at Level 1 centers, nearly half the patients treated are uninsured.The nationwide trend for paid hospital call coverage should
include oculoplastic surgeonswho provide a complex level of care oftenwithout compensation for their services.These factors should
be part of the conversationwhen negotiating call coverage contracts.
References:
Kearns,Madelyn. “On-call compensation is on the uptick.”Medical Practice Insider. 14May 2014.Accessed 31May
2014.
DetailedProgram
—Thursday,October 16, 2014
