Call Coverage, Weekends, and Holidays: How to Negotiate Without Burning Bridges
When reviewing a physician employment contract, many residents and fellows focus on salary and bonuses. But one of the most overlooked — and most impactful — parts of the agreement is call coverage. The frequency and structure of call duties can determine whether your first job feels sustainable or overwhelming.
Understanding how call is assigned, and knowing how to negotiate, can help you protect your lifestyle while building positive relationships with your new employer.
Why Call Coverage Matters
- Work-Life Balance: Call responsibilities often spill into evenings, weekends, and holidays, impacting family and personal time.
- Compensation: Some contracts compensate for call, while others treat it as part of your base duties.
- Equity Among Physicians: Uneven call assignments can lead to frustration and burnout.
Questions to Ask About Call Coverage
- How often will I be on call?
- Is call shared equally among physicians?
- Are weekends and holidays included?
- Is call in-house, or can it be taken from home?
- Is there additional compensation for call duties?
Common Red Flags
- Contracts that do not define call responsibilities at all.
- “To be determined” language that leaves scheduling entirely at the employer’s discretion.
- No mention of how call is distributed among staff.
- High call burden without additional pay or time off.
How to Negotiate Call Coverage
Negotiation doesn’t mean making demands — it’s about asking thoughtful questions and seeking clarity. Here are strategies that protect your interests while maintaining goodwill:
- Request Transparency: Ask for call schedules or averages from the past year to understand expectations.
- Propose Reasonable Adjustments: If the call load seems heavy, ask whether it can be shared more equitably or compensated fairly.
- Focus on Fairness, Not Avoidance: Employers expect physicians to share call, but fairness is a reasonable request.
- Negotiate Alternatives: If call duties are high, ask for offsetting benefits such as additional vacation days or higher salary.
Balancing Professionalism and Advocacy
It’s possible to protect your work-life balance without harming your reputation. Employers respect physicians who ask clear questions and advocate for fairness. The key is to frame the conversation around sustainability and equity rather than avoidance.
Before you sign, review your contract with our Physician Contract Checklist to ensure call expectations are transparent. For a deeper review, ContractGuard MD can help identify hidden risks and offer negotiation insights tailored to residents and fellows.
Frequently Asked Questions
Do all contracts include call coverage?
Not always. Some specialties have minimal or no call, while others (like surgery or OB/GYN) may require frequent coverage.
Can call coverage be negotiated?
Yes. While you may not eliminate call, you can negotiate fairness, compensation, or offsetting benefits.
How can I tell if call assignments are fair?
Ask for data from the past year. If one physician carries a disproportionate load, that’s a red flag.
What if the contract doesn’t mention call at all?
This is a major red flag. Always insist that call responsibilities are defined in writing before signing.
