Onerous on-call schedules are a major cause of physician burnout and ill health. There is no financial incentive to remain on-call. A designated colleague with a similar scope of practice is the most appropriate surrogate provider. Failure to make specific arrangements can lead to virtual abandonment of patients. The use of the telephone to advise patients is controversial.
Some physicians believe telephone advice is risky or even negligent.
There is, however, an increasing reliance by patients and physicians on the telephone as a medium for consultation. Telephone consultation services already exist in Alberta and elsewhere, and are growing. Many of these services have established protocols for common medical problems and defined thresholds for advising an immediate visit to a physician. A clinical record should be created that includes the content of the call and the advice given to the caller. Liability issues must be understood and managed.