Physicians on call: count the ways.(Obstetrics)

For ob.gyn. Susan Lacy, being on call was a challenge. With four young children at home, it's difficult for her to work overnight and come home at 8 a.m., just as her family starts its day.

But innovative thinking by her practice partners--and similar thinking among ob.gyns. nationally--is easing that challenge.

In Dr. Lacy's group, physicians start call around 5:30 p.m. and stay at the hospital until 5:30 p.m. the next night.

While they still work the same number of hours as they would if they started call at 7 a.m. or 8 a.m., after finishing their call shift in the evening, they can go home and get a full night's sleep.

"It's just psychologically a little easier," said Dr. Lacy who is in private practice in Memphis.

Lifestyle and family matter in today's practice climate, said Dr. Nancy Gaba, ob.gyn. residency program director at George Washington University in Washington. "There is life beyond your work," she said.

At George Washington, some of this push has come from residents, she said, but even attending physicians are adapting. They are rescheduling office visits when they are needed on call and splitting up some of their 24-hour call blocks into 12-hour blocks, she said.