According to the Center for Studying Health System Change, the nation’s community hospitals are facing increasing problems obtaining emergency on-call coverage from specialist physicians, in part because of physician reluctance. 

Factors contributing to this reluctance include decreased dependence on hospital admitting privileges, inadequate payment for emergency care, and quality-of-life issues.

Doctors may dislike providing on-call coverage because it requires them to be available around-the-clock, obliging physicians to leave their practices during the day to response to an emergency call and potentially interfering with personnel obligations.

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