Although CMS does not require small groups of physicians to be on-call for a service every day if it is overly burdensome due to the size of the practice, but the hospital may feel differently. It is tough for a hospital to only be “open” for a service on certain days when they have physician on-call coverage. How is EMS or the public supposed to know if you are open to receive patients without calling in each time. This can cause potential patients and other hospitals from bringing in business to the ED. For this and many other reasons some small practice groups have elected to share the on-call duties with other practices to lessen the burden on the physicians while maintaining service levels for the local hospital. A true win/win, when done correctly.