Backup call (jeopardy call)

Backup call is a second call line behind the primary one. The backup physician is not expected to work unless something changes: the scheduled clinician falls ill, a family emergency comes up, two critical patients arrive at once, or the primary physician reaches a rest or hour limit. In residency programs the same role is often called jeopardy call. In obstetrics, it is typically the physician behind the in-house labor and delivery shift.

Backup call usually runs as home call. For residents, the ACGME requires programs to have policies that ensure coverage and continuity of patient care when a resident cannot work, without negative consequences for that resident, and a jeopardy line is one way to meet it. Hours worked after activation count toward the 80-hour weekly limit, and backup home call cannot be assigned on a resident's required day off. Under EMTALA, hospitals must also have written policies for when an on-call physician cannot respond because of circumstances beyond their control.

Pitfalls: leaving backup call out of the fairness counters because it is rarely activated, which hides a real burden; not recording activations, so no one sees that a primary line is chronically short; and putting the same person on primary and backup call for the same night.