The Podcast by KevinMD Unpaid on-call shifts are driving doctors into early retirement
Mar 1, 2026
Corinne Sundar Rao, an internal medicine physician and commentator on physician labor, argues that unpaid "call" masks real work. She discusses how privileges force mandatory overnight coverage, contrasts old models with modern hospital realities, and highlights alternatives like hospitalists and nocturnists. The conversation urges treating on-call time as measurable, paid labor with required post-call rest.
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Call Is Invisible Labor Not A Noble Sacrifice
- The word call masks unpaid, measurable labor that hospitals extract from employed physicians.
- Corinne Sundar Rao explains call is treated as invisible standby work where physicians show up, carry a full patient load next day, and receive little compensation.
No Rest Rules For High-Stakes Medical Work
- Other high-stakes professions mandate rest protections while surgery still expects overnight work without mandated recovery.
- Rao compares pilots' regulated rest to surgeons being allowed to operate after night shifts to highlight the safety and fatigue mismatch.
Hospitalist Model Turned Endless Call Into Defined Shifts
- The hospitalist model converted continuous clinical responsibility into finite shifts when the old model failed.
- Rao recounts hospitalists' 1996 recognition and how defined shifts replaced unsustainable open-ended call for inpatient care.