The No-Call Premium Question
Every CRNA weighs this trade-off at some point: Is freedom from call worth a lower salary? The answer depends on the numbers—and they vary more than you might expect.
Current Salary Differentials
| Setting | With Call | No Call | Difference |
|---|---|---|---|
| **Hospital (urban)** | $220,000 | $195,000 | -11% |
| **Hospital (rural)** | $250,000 | $215,000 | -14% |
| **ASC** | $210,000 | $205,000 | -2% |
| **Office-Based** | N/A | $190,000 | No call typical |
| **GI Centers** | N/A | $200,000 | No call typical |
Key insight: ASCs and specialty centers often have no call built into the model, so there's minimal penalty.
Where No-Call Jobs Actually Exist
Inherently No-Call Settings
These practice environments rarely or never have call:
- Ambulatory Surgery Centers (ASCs)
- GI/Endoscopy Centers
- Office-Based Anesthesia
- Pain Management Clinics
Hospitals Offering No-Call Tracks
Some hospital systems now offer differential tracks:
| Track | Compensation | Call |
|---|---|---|
| Standard | 100% base | Full call rotation |
| Reduced Call | 95% base | Weekend only |
| No Call | 85-90% base | Zero call |
These positions fill quickly—often through internal posting before external advertising.
The Real Math: Is No-Call Worth It?
Scenario: Hospital CRNA with Call
- Base salary: $220,000
- Call pay (1:4 rotation): $25,000/year
- Total: $245,000
- 40 hours/week clinical
- 80 hours/month call (10 nights)
- Disrupted weekends and holidays
Scenario: ASC CRNA, No Call
- Base salary: $205,000
- No additional call pay
- Total: $205,000
- 40 hours/week clinical
- Zero additional hours
- Every weekend and holiday free
The Hourly Reality
| Position | Annual | Hours/Year | Effective $/Hour |
|---|---|---|---|
| Hospital w/ Call | $245,000 | 2,880 | $85/hour |
| ASC No Call | $205,000 | 2,080 | $99/hour |
No-call often pays MORE per hour worked.
Quality of Life Factors
What You Gain Without Call
- Sleep quality — No 2 AM pages
- Weekend freedom — Actually make plans
- Relationship stability — Present for family
- Reduced burnout — Sustainable long-term
- Second income potential — Locum on your terms
What You Might Miss
- Variety — Trauma and emergencies build skills
- Team bonding — Call creates camaraderie
- Higher acute care skills — Use it or lose it
- Some income — Call can be lucrative
Finding No-Call Positions
Search Strategies
- Filter for "No Call" in job boards — Anesearch, Gaswork, Indeed
- Target ASC networks — USPI, SCA Health, Amsurg
- Search "outpatient" + "anesthesia" — Captures many no-call roles
- Contact GI groups directly — Often not posted publicly
- Network with pain management practices — Growing demand
Questions to Ask
Before assuming "no call" means no call:
- "Is there truly zero call, or is there occasional coverage?"
- "What happens if a case runs late?"
- "Are there any weekend requirements?"
- "Is the no-call status guaranteed in the contract?"
Transitioning from Call to No-Call
Making the Switch Successfully
- Financial preparation — Budget for lower income initially
- Skill maintenance — Consider occasional locum for variety
- Contract review — Ensure no-call is contractually guaranteed
- Expectations — Different pace, different challenges
Common Transition Paths
| From | To | Typical Adjustment |
|---|---|---|
| Community hospital | Multi-specialty ASC | Minimal learning curve |
| Academic center | GI center | Faster pace, simpler cases |
| Rural hospital | Urban office-based | Less autonomy, more structure |
Hybrid Approaches
Best of Both Worlds
Some CRNAs optimize with hybrid strategies:
- 0.8 FTE at no-call ASC
- Weekend locum for extra income
- Control your own call exposure
- No-call primary job
- Cover holiday call for premium pay
- Targeted income boost
- Take position with call
- Pay colleagues to cover your shifts
- Network for this arrangement
Market Outlook for No-Call Positions
Growing Availability
- ASC construction continues to grow 7% annually
- Office-based surgery expanding
- GI volumes increasing with aging population
- Hospitals creating no-call tracks to compete
Competition for These Roles
- Experienced CRNAs prioritizing lifestyle
- Working parents
- Those approaching retirement
- Burned-out hospital CRNAs
These positions often have more applicants per opening.
Making Your Decision
Choose No-Call If:
- Work-life balance is your top priority
- You have other income sources available
- Call significantly impacts your health or relationships
- You're in a financial position to accept lower base pay
Keep Call If:
- Maximizing income is your primary goal
- You thrive on variety and acute cases
- Call doesn't significantly impact your quality of life
- You're building emergency skills for future opportunities
Conclusion
No-call positions offer genuine lifestyle benefits, often with a smaller financial penalty than expected—especially when calculated on an hourly basis. The key is finding settings where no-call is the norm (ASCs, GI, office-based) rather than a special accommodation. As the market evolves, expect more no-call opportunities as employers compete for experienced CRNAs who prioritize quality of life.
Market data from Anesearch analysis, January 2025.