Survey: on-call surgical specialists hard to find; lack of incentives may be a root case.

A new study suggests that EDs across the country are experiencing difficulties because they don't have adequate on-call coverage by surgical specialty providers. The lead author indicates the root cause of this problem may have more to do with a lack of incentives for providers to accept on-call coverage responsibilities than an actual shortage of surgical specialists. Solutions to the problem may include a greater use of mid-level specialty providers, and more regionalization of care so that resources are managed more effectively. According to a survey of ED directors, three-quarters of respondents report having difficulties with inadequate on-call coverage. Respondents from the South reported the most difficulty, with 81% indicating they have problems with on-call coverage. The most serious problems reported with on-call coverage pertain to plastic surgery (81%), hand surgery (80%), and neurosurgery (75%).