Wisconsin Ob.Gyns. help each other manage call.(Practice Trends)

SCOTTSDALE, ARIZ. -- A telephone survey of 66 physicians, each representing an obstetric group in Wisconsin, found that most groups did not have formal rules regarding call responsibilities or provisions for physicians to recover after being on call.

Yet 16 groups delivered babies at more than one hospital, leaving open the possibility that there would be simultaneous call at different locations, according to a poster presentation at the annual meeting of the Central Association of Obstetricians and Gynecologists.

"Most of [the respondents] said, 'We just call one of our colleagues if we need extra help, and they will come on in. We help each other,'" one of the investigators, Dr. Charles W. Schauberger, said in an interview. "There is a real brotherhood and sisterhood of obstetricians who will cover for one another."

Avoiding call at multiple locations was the first of three "call best practices" recommended by Dr. Schauberger, medical director for quality and performance improvement at Gundersen Lutheran Medical Center in La Crosse, Wisc., and his coauthors.

The second and third best practices were, respectively, having a formal backup system and restricting work after being on call "to avoid difficult or complicated surgery or medical care," he said.

The survey found a wide variety of ways of handling call, but no perfect call system. Dr. Schauberger and coauthor Dr. Robert K. Gribble, of Marshfield Clinic in Marshfield, Wisc., conducted the physician-to-physician survey by telephone. Working with third coauthor Brenda Rooney, Ph.D., of Gundersen Lutheran, they identified 70 "call pools" and obstetric groups in the state. After accounting for two physicians who declined to participate and those who did not return calls, there was a total of 66 participants.

The size of call pools ranged from 1 to 11 physicians, with 5 physicians being the median staffing, according to the investigators. Physicians were usually on call for 24 hours, but many groups had longer call duties on weekends.