Increasingly, on-call specialists are refusing to answer emergency room pages to treat patients. Many states have noticed the trend and are taking steps to stop it. The root of the problem is greed. Many patients are uninsured, poor, have no family doctor and use the ER as their primary source of medical treatment. As such, answering an on-call page is a money-losing proposition for many doctors.

The practice of having a doctor "on call" began in the early 1900s when young practitioners seeking to impress hospital officials volunteered to work in emergency rooms. However, in today's era of managed care and HMO's, the practice has encountered serious problems. Often, on-call doctors are not on the ER patient's HMO physician list, or they have no insurance at all. As a result, doctors know they will not get paid for their efforts.

Although failing to answer emergency calls is against the law, doctors face few repercussions. Patient advocates are outraged by the practice, accusing doctors of placing money above patients' urgent medical needs.