Many hospitals, including a few in the Dayton area, are finding it difficult to get specialist doctors to respond to emergency room calls. Some specialist physicians, such as neurosurgeons and plastic surgeons, are resisting being on call for emergency rooms, where many of the patients have less ability to pay the doctors for their services than the patients specialists treat through referrals from primary care doctors.
Source: bizjournals.com/industries/health_care/hospitals/2005/11/21/dayton_story2.html

Why don’t plastic surgeons want to take ER call? It is pretty simple: money and liability.

If you want plastic surgeons to take an interest, your insurance company needs to pay a specialist enough to allow him to make a profit without exposing him to undue liability. Even insured emergency surgery pays poorly and exposes surgeons to much more liability than better paying cosmetic work. This assumes that the patient is insured. Many emergency patients are “freebies.”

Just try to get a plumber to come to your house at 3 AM and tell him he is doing it free half the time.

I have limited my emergency room exposure in response and dropped Provider status for most insurance plans. You might see me in the ER, but you might end up paying me cash and loking ot your insurer to reimburse you.

Best Regards,

John Di Saia MD