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UPJ INSIGHT Exploring the Demands of Urology: On-Call Compensation, Frequency, and Variability

By: Roei Golan, BS, Florida State University College of Medicine; Amanda North, MD, Montefiore Medical Center, Bronx, New York; Kate H. Kraft, MD, MHPE, University of Michigan, Ann Arbor; Parth K. Modi, MD, University of Chicago, Illinois; William Meeks, MA, American Urological Association, Linthicum, Maryland; Alexis Helsel, Phd, MPH, American Urological Association, Linthicum, Maryland; Emily Galen, BS, American Urological Association, Linthicum, Maryland; Andrew M. Harris, MD, University of Kentucky Medical Center, Lexington Lexington VA Medical Center, Kentucky Veterans Health Administration, Lexington, Kentucky | Posted on: 20 May 2024

Golan R, North A, Kraft KH, et al. Exploring the demands of urology: on-call compensation, frequency, and variability.Urol Pract. 2024;11(3):569-574. doi:10.1097/UPJ.0000000000000542

Study Need and Importance

On-call duties for physicians blur the boundary between personal and professional life, impacting physician well-being. This study aimed to analyze on-call patterns among US urologists, focusing on gender, subspecialty, work hours, AUA section, salary, and practice setting.

What We Found

Significant differences were observed across various factors, including being required to take call to maintain hospital privileges (reported by 76% of female urologists vs 67% of male urologists; P = .026), getting paid for weekend call (28% of females vs 38% of males; P = .030), and making over $500 per day when taking weekend call (18% of females vs 32% of males; P <.001). When analyzing AUA section, 51% of Western, 47.4% of Southeastern, and 53% of South Central sections reported being paid to take weekday call. Meanwhile, 8.2% of Northeastern, 13.1% of New England, 19.1% of New York, and 21% of North Central sections reported being paid to take weekday call (P < .001). Lastly, practice setting differed in likelihood of being paid over $500 for weekday call (44% reported by private practice urologists, 7% reported by academic urologists, 14% reported by institutional urologists; P < .001; Figure).

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Figure. Variation of call characteristics by gender, subspecialty, work hours, AUA section, salary, and practice setting. P values highlighted in green indicate significant difference in variation (P < .05). For example, for the requirement of on-call duty to maintain hospital privileges, variation was identified by gender, hours worked per week, salary, and practice setting.

Limitations

The study faced limitations typical of surveys, like sampling and recall bias. The response rate for the 2022 AUA Census was 13.7%, but poststratification sampling weights were used to enhance representativeness. The study primarily examined bivariate associations, and future research could benefit from multivariate analysis to account for confounding variables. Lastly, the large number of factors examined increased the risk of type I error.

Interpretation for Patient Care

This study’s findings provide valuable insights into the on-call component of urological practice, highlighting gender disparities and differences across various domains. Understanding these variations may help urologists in contract negotiations and job expectations.

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