On-call scheduling - A thankless job

Creating the physician on-call schedule is a thankless job, no matter who does it or how it’s done, manually or through software.

But it is necessary.

As I’ve consulted with several hundred physician groups over the years, there have been several recurring themes that seemed to make the process less painful than it might otherwise have been. 

Certain tenets make the process bearable, which are important whether your group does the on-call schedule the old-fashioned way – Excel, for example – or a more high-tech way, using scheduling software. These ideas have been around in various permutations since the late 1970s.

Define ‘fair’

Define what is fair and unfair when it comes to the on-call scheduling. Is it how we cover holidays or weekends? Is it that Dr. Jones is always wanting to change a weekend schedule at the last minute? Have the discussion. It won’t be easy, but it’s necessary. Start here.

Develop policies/rules/tenets for on-call schedules

Develop them together, and agree on them. What’s the timeline for establishing the on-call schedule? When are requests for time off due? When is the on-call schedule published? When is it distributed? Who can make changes in the schedule? What are the basic rules for creating the schedule?

Establish accountability

Physicians are accountable for the on-call schedule. It’s up to the physicians to hold each other accountable for complying with the schedule and complying with the policies that have been adopted, and complying with the understanding of ‘fair’ as agreed to.

Manual vs. software

That’s up to you and the group. Creating a call schedule manually takes significant time. Employing software may require less of a time commitment. Whether your practice employs manual or software, any schedule is only as good as the basic assumptions and policies that were used to develop it, and the willingness of the physicians to hold each other accountable for complying with it.

The on-call schedule czar must be a physician

If a conflict arises, or if there’s a need for a last-minute change, physician to physician is the solution. It is not reasonable to place the administrator in the position of denying a last minute schedule change to a physician, or respond to “I’m taking my family out of town tomorrow, you have to find a replacement for me.” These are all about physician to physician accountability.

On-call scheduling is a thankless job and certainly challenging, however, it does not have to be as contentious and problematic as it often is.

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