Call for staff neurologists

[DeeplySuperficial 1]

Hello everyone! I was wondering what call is like for staff neurologists who work at community hospitals (without residents). Do they frequently have to go in overnight while on call? Thank you.

[ACHQ 121]

11 hours ago, DeeplySuperficial said:

Hello everyone! I was wondering what call is like for staff neurologists who work at community hospitals (without residents). Do they frequently have to go in overnight while on call? Thank you.

I'm not neurology, I'm GIM but I work in the community and have a friend who is a community neurologist. I also can only speak of the GTA (but I think it is probably consistent with other places as well). I think there is a neurology staff on these boards that can comment (probably better than I can)

Unless you work in a designated stroke/tPA center (there are a few tPA centers that are community sites) then you will rarely (if ever) have to come in *overnight*. All neurology admissions and consults from ER will go to GIM on call and they will decide to admit or d/c to outpatient follow up. If they need a consult they will ask neurology to see in the AM usually.

IF its a more complicated/acute case which requires neurology input: e.g. Acute GBS, Myasthenic Crisis, weird inflammatory encephalitis's or myelitis's etc... AND I'm worried I would speak to the neurologist on call overnight and run the case by them and get their preliminary input/blessing on my plan (and they can decide whether they need to come in or not). Not sure how often this actually happens because MOST of those Dx wont be made in the ER right away anyways...

Also often when a neurologist is on call, they maybe in hospital doing consults late and therefore may see a patient/consult in the ER/ward since they are already there.

All bets are off if you work at a tPA center

[Borborygmi 234]

I have a couple of resident colleagues who just recently began community neurology (BC, ON, QC). The general tone of call is 1 week of home call per month block. Most times it's not super busy, but of course being on call takes its toll whether you're receiving questions/consults or not. Many community centers will now do tPA (if they have CT) and transfer patients for EVT. So, you generally cover acute stroke as well.

 

Conversely, community hospitals that do have neurologists available by day, but whose facilities are within the catchment area of tertiary care centres will often just call the residents on call at said tertiary care centre with their questions. In which case, the day neurologists that cover aren't bothered overnight.

It really depends on where you're located.