Oregon Emergency Departments Lack Access To On-Call Specialists, Study Finds

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 14 Apr 2008 - 8:00 PDT

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Two-thirds of Oregon hospitals were unable to provide on-call coverage for at least one specialty from 2004 to 2006, according to a study published this month in the Annals of Emergency Medicine, the Oregonian reports. For the study, John McConnell, an economist at Oregon Health & Science University, and colleagues surveyed executives at 43 of the state's 56 hospitals in 2005 and 2006. The survey found about half of the hospitals that did not have on-call specialists transferred patients to other hospitals on a case-by-case basis.

According to McConnell, a disproportionate number of ED patients are uninsured and cannot afford to pay for specialists. Jack Cioffi, chief medical officer for Legacy Health System, said that some specialists believe they have a greater risk of malpractice lawsuits by treating ED patients, with whom they do not have an established relationship.

The study found that some hospitals have been paying physicians stipends of $1,000 per night of on-call duty to combat the problem. The study found stipends increased from an average of $227,000 per hospital in 2005 to $487,000 per hospital in 2006. In addition, about one-third of Oregon hospitals are guaranteeing physicians full payment for treating uninsured patients (Rojas-Burke, Oregonian, 4/9).

An abstract of the study is available online.

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