Home call vs in-house call
In-house call means staying in the hospital for the whole call period; home call means staying reachable from home and coming in when needed.
In-house call means the physician stays at the hospital for the whole call period, often overnight or for 24 hours, immediately available for patients. Home call, also called pager call or at-home call, means the physician stays reachable, answers calls, and comes in only when a patient needs them. Some services pair the two: an in-house physician overnight with a home call physician behind them.
The difference matters for rest rules and pay. For residents and fellows in ACGME-accredited programs, every in-house hour counts toward the 80-hour weekly limit, and in-house call may be scheduled no more often than every third night, averaged over four weeks. On home call, only time spent on patient care counts, including phone calls, EHR work from home and time in the hospital after being called in. Home call is not subject to the every-third-night limit and does not trigger a required rest period, but it cannot be assigned on a resident's required day off. For hourly, non-physician staff, the Department of Labor treats on-call time on the employer's premises as work time, while on-call time at home is in most cases not work time.
Pitfalls: calling a busy line home call when the physician is in the hospital most nights, and not tracking how often home call physicians are called in.
Common questions
Does home call count toward resident duty hours?
Only the time spent on patient care counts toward the ACGME 80-hour weekly limit: answering calls, EHR work from home and time in the hospital after being called in. Reading and studying at home do not count. Home call is not limited to every third night, but it cannot fall on the resident's required day off.
Can the day after home call be a day off?
For residents, yes. The ACGME notes that call from home does not require a rest period, so the day after home call may be used as the day off. The day off itself must be free of all clinical work, including home call. After 24 hours of in-house call, residents need at least 14 hours free first.
How do you decide between in-house call and home call?
Look at how often the home call physician is called in and how long they stay. The ACGME says home call suits services where the intensity and frequency of being called are low, and asks program directors to monitor that workload. If the physician is in the hospital most nights, the line works as in-house call and should be scheduled and counted that way.
How Momentum handles it
In Momentum, in-house call, home call and backup call are separate lines, each with its own counters.