Physician On-Call Scheduling and On-Call Management Blog
by Justin Wampach

Where the Heck is the Middle Solution in Scheduling Software?

Posted by Justin Wampach on Wed, Aug 15, 2018 @ 10:33 AM

best buyIn a $116 million dollar per year market that is expected to reach $330 million by 2025, there does not seem to be a lot of middle ground in terms of price.  When researching software solutions that cater specifically to scheduling physicians for both office shifts and on-call, there appears to be a large player on the low end charging a few hundred dollars per year, and two larger companies on the higher end, charging tens-of-thousands of dollars per year.  Call Scheduler’s really the only solution in the middle. 

Midsized hospitals and clinics throughout the US and Canada need a physician software scheduling solution that is sophisticated but not costly, and easy to implement and maintain.  These healthcare organizations need a vendor who truly understands and supports their business objectives for technology, and who provide right-fit solutions. 

Why would medical groups want to spend more on software and features they don’t need?  Many would argue that some vendors have done a better job than others in convincing physicians and administrators that they must have tools that are well beyond their needs.  This is a classic case of “nice-to-haves” versus “need-to have”. 

Almost all medical groups that are switching from Excel or paper to automated, rules-based scheduling software will have a relatively small set of very specific tools needed to make the user experience positive.  These tools typically revolve around day-off/vacation requests, creating schedules and communicating the schedule.

Large enterprise vendors will often gloss over what they consider are very “basic” features and spend more time showing potential users many bells and whistles that you will certainly not use within the first few years of switching from Excel.  Clinic administrators and physicians sometimes underestimate just how difficult perfecting just those basics will be.  In fact, many medical groups struggle just to get the physicians to use a phone app to request vacations and time off.    

In the past several years we have heard of more “fear, uncertainty and doubt” being used by our competitors when talking to prospects comparing Call Scheduler to their offering.  Fear, uncertainty and doubt (often shortened to FUD) is a disinformation strategy used in sales and marketing.  It is a strategy to influence perception by disseminating negative and dubious or false information in an effort to appeal to fear.  From a psychological perspective this tactic is quite effective but unfortunately leads to over spending by buying way more than the prospect needs. 

For some reason as buyers we fall for the FUD trap.  Many of us seem to have a fear of missing out on something or assuming that just because something is more expensive, it’s better.  We also sometimes tend to oversimplify just how difficult change may be to implement within our organization.  I think the other thing some small and medium sized practices do is to forget how different they are from large and mega sized organizations.  Does a medium sized community hospital need the same feature set as a large healthcare system?  Maybe?  Probably not.

It’s funny, in some calls we talk to prospects who tell us they are going to use a top down management strategy when implementing new systems that involve key users such as physicians.  They say, “this is the way it will be” and that is the way it is.  In small and medium sized groups, we tend to see that physicians still have ultimate control and decision-making authority.  It’s not always what’s best for our clinics business, but what’s best and simplest for the doctors.  Physicians tend to be vulnerable to the message that more expensive means better.  The reason I point this out is that while some companies are selling you on the “nice to have’s” your focus should really be on your plan to fully utilize the most basic set of tools first, and that usually takes some time to not only learn but also time to become ingrained into the culture of your group. 

Money doesn’t grow on trees and buying the right sized tool to transition from Excel to scheduling software makes you a savvy business person and an informed buyer.

Call Scheduler can be tailored to your needs, let us explain how! Request Consultation

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Buy vs. Build Your Physician Scheduling Software

Posted by Justin Wampach on Wed, Aug 08, 2018 @ 10:04 AM

 

Buy vs. build your physician scheduling software
As the owner and account manager at a medical software company specializing in physician call 
scheduling software, I occasionally have a prospect tell us that they are "thinking about creating scheduling software in-house". Although I highly discourage this due to the complexity, staff requirements and amount of time that would need to be invested to re-create what we have already done, I thought I would be objective and tell you when I think it’s good to build versus buy.  

After researching this topic, the consensus appears to be: Buy when you need to automate commodity business processes or to standardize; build when you’re dealing with core processes that differentiate your company or to compete. “Everyone knows that the more standardized you are and the more you buy off-the-shelf, the more cost-effective it will be for both implementation and ongoing maintenance,” says Mark Lutchen of PricewaterhouseCoopers.


Eight Things to Consider When Making Your Decision

1. Upfront Scope and Requirements Costs

What do you want the software to do and how will it look and function. What are your expectations?
 

2. Upfront Development Cost 

You will most likely need project manager(s), lead architects, coders, and testers. Also, don’t forget the technology required to develop and test.
 

3. Upfront Time

Scope and requirements can take 2-3 months full time on a project that is medium in complexity. Development can take 6-9 months and testing another 2-3 month.
 

4. Plan Ahead

Plan for the “Oh, that’s what you meant” ... most projects have some amount of re-work required to move forward. This is usually greater if you decide to “off-shore” your project.
 

5. Ongoing Maintenance

Software becomes outdated the moment it is released, that’s why there are patches and updates. Not to mention that every time you update or patch something, chances are that you will break something else.
 

6. Software Maturity

This is the point when you have an ultra-stable system that is virtually bug-free. This is a moving target.

7. Staffing

What happened when your coder or project manager gets a better job offer or you have budget cuts and have to eliminate a key position?
 

8. Intellectual Property Rights

Don’t forget about the IP that will go into this project during the development. Although most companies have policies that state anything that is developed on company time is property of the company, that does not preclude your employees from developing “similar software” for another industry or building on a concept that was scrapped at work. The hardest part in this scenario is finding out that someone has a covert project going on at home.
 

Consider Your Goals 

I think a good argument can be made depending on your goals and objectives. As an example, we have developed custom on-call doctor scheduling software to sell to hospitals and clinics. We truly feel this is core to our business. But on the flip side we have purchased via SaaS model both CRM and Accounting software where better mousetraps had already been built. 
 
The key takeaway is to know what you’re getting yourself into and why are you deciding to build vs. buy software. For all you need to know about call scheduling software, request a consultation with us. It would be an honor to work with you and your administration. 
Call Scheduler can be tailored to your needs, let us explain how! Request Consultation

Topics: oncall, physician scheduling software

How Big of a Scheduling Tool do I Need?

Posted by Justin Wampach on Mon, Jul 30, 2018 @ 08:00 AM

long-handle-shovel-400x300A few weeks ago, over the 4th of July my family and I decided it was time to do some sprucing up to my mom’s flower garden at my parents’ lake home in Minnesota.  My parents’ home also knows as the “cabin” does not have a shortage of gardening tools to use for any projects, in fact it’s the opposite.  There is an abundance of different tools, the trick is choosing one that is the right size.

What we were attempting to do is dig-a-hole.  There are several tools that are appropriate for this type of job.  There are gardening hand tools that everyone is familiar with, there are many types and sizes of shovels.  There is also a large variety of power digging tools, and we can’t forget the oldest tool that most of us have, our hands.  Which one of these is the best for the job?  Well, it depends.  To make an informed decision we should know a little more about the hole we need to dig.  If it were the “old days”, and we needed to dig a small or medium hole only once or twice a year, the best answer may have been to use our hands.  If we needed to dig a bigger hole quarterly or monthly it probably makes sense to buy a shovel.  If you need to dig massive holes each day, and you need to do a lot of them, you may want to consider getting a tractor with a backhoe.  The last thing you should probably consider is your budget.  It doesn’t cost us anything, but our time, talent and sweat, to use our hands.  It is very affordable to use and buy a shovel.  Most of us would never consider buying a tractor with a backhoe due to the investment and learning curve regarding how to operate the machine.  For the clear majority of us, a shovel is a good tool to use to dig a hole.  It still requires work (sweat equity), but is very reasonable in price, readily available, and gets the job done over and over.  Using this analogy, it seems reasonable to conclude that using your hands to dig a hole is ridiculous in 2018.  Using a tractor with a backhoe is also ridiculous unless your needs are significant.  Although a shovel isn’t sexy, it doesn’t have all the bells and whistles that a tractor does, it does get the job done, and is a hell of a lot easier to use to dig a hole than your hands and most everyone can afford one. 

In my professional world as the President of a physician scheduling software company I can use a similar analogy to draw a parallel between digging holes and scheduling physicians.  Almost all our prospective customers come to us because it is so difficult to schedule physicians fairly and accurately by hand or using Excel.  This would be the same as using your hands to dig a hole.   These prospects need help but struggle to decide which tool is best for them.  As you can imagine, in the physician on-call and shift scheduling market place there are many great tools available.  Some are hand tools, some are shovels and some are tractors with backhoes.  As a “scheduler” or practice administrator you need to decide how big your project is and what is the bests size tool to meet your needs.  Remember your decision isn’t forever. 

Common sense tells you that you probably don’t need a tractor with a backhoe to dig some holes a few times per year.  The best tool for that project would be a shovel.  The same goes for scheduling software, if you are manually scheduling or using Excel today for a small or medium specialty medical practice, the likelihood that you need an overly sophisticated scheduling tool to do what you need to do today is unlikely.  As evidenced by the fact that you can accomplish what you need to by hand, but it would be GREAT if you could do it in a fraction of the time.  Lastly, consider the amount of time you need to spend on the “buying process” for a shovel as opposed to buying a tractor with a backhoe. 

As you begin to prepare to dig your next hole, aka creating your next physician schedule, don’t fall for the shiny new tractor with a lot of bells and whistles that you probably will never use, and costs way more than you want to pay.  Go buy a quality shovel and never have to dig by hand again.

No Thanks, I’m Too Busy to Automate On-Call

Posted by Justin Wampach on Tue, Jul 24, 2018 @ 10:27 AM

If you are a physician or administrator who creates the call schedule for the doctors using Excel, this post is specifically for you. I have heard the phrase over and over “I’m too busy to even look at something new”, “we’re too busy with (fill in the blank)”, and “the doctors are so busy” so often that it doesn’t even phase me anymore.   After some thoughtful reflection, I was unable to identify a group of professionals who are not busy. Can people be so busy that they can’t take time to learn something relevant to their business that will save time?  Really? 

Adjuvant Technologies is the second company I started. In my first company and even the first few years of Adjuvant, I was always busy. Often times too busy to eat lunch or even arrive home at a reasonable hour. Over the years, trusted advisors, as well as members of my Board of Directors would advise me to begin to off-load some of the administrative duties that were always making me so busy. One of the main reasons that prevented me from giving up some of these tasks was the daunting task of turning things over to someone else, bringing them up to speed, and then managing the process. It seemed easier to just do it myself. Although nervous, I thought I would take the advice and give it a try.

Freeing Up Precious Time

No Thanks, I’m Too Busy to Automate On-Call

One of the first things I “turned over” to someone else was the daily book-keeping and accounting duties. Although it was a long set-up process, looking back it was one of the best moves I made.  Although I am still very involved, I do not have to perform all of the daily duties.  This gives me more free time to do my job, which is selling, writing blog posts and running the business. 

When I look back several years, doing the accounting was a way for me to keep busy with a task that was relatively simple, gave me some sense of accomplishment and was easier than picking up the phone and trying to talk to a doctor or clinic manager who was always too busy. It was actually some form of not having to do my job because I was busy with something else. 

When I look at this in contrast to on-call physician scheduling software, I do wonder why there are so many busy doctors who take on the task of creating, updating, and communicating the call schedule for themselves and their partners.  And on top of that, when they do it by hand or with Excel, not taking advantage of software such as Call Scheduler.  Perhaps it is like doing a brain teaser, something to take their mind off of work, patients, families, and other “stuff” that looms in doctors' minds. 

Facilitating Growth

In my company we have decided intentionally not to be “too busy” to look at and explore things that will help me and the team manage and grow the business.  Because we are open to new, relevant ideas and concepts, we continue to find “bits of goodness” that hopefully, my competitors are “too busy” to see. One example of this is the blog you are currently reading. Although we try and write weekly, sometimes we miss that goal. Most companies are far too busy to blog, just ask them. 

Another example is that we use a robust Customer Management System (CRM) to manage all of our sales and customer activity. Many companies don’t use CRM systems like this because they are “too busy to set-up and continue to enter information into”. We invested in this system so we can do a better job memorializing the conversations and interactions that we have with our customers. This should make it easier on our prospects and customers in the long run. 

I try and make decisions that are in the best interest of the business and our customers. If I am too busy to look at something new that can save me time and help our customers, I may need to re-evaluate if I am doing my job.

Key Takeaway:  Maybe you are too busy NOT to look at something like physician scheduling software.  

 

Do you know what time you're spending on schedule creation and changes is  costing you? Find out. Download Free Cost Calculator

 

Topics: adopting on-call software

Reduce Physician Burnout by Sharing On-Call Duty

Posted by Justin Wampach on Mon, Jul 16, 2018 @ 04:42 PM

sharing linkAlthough 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.

Two groups decide to share call and one group takes this week, the other group takes the next week. Sounds easy enough right?  It might be that simple if you were talking about anyone but physicians.  Shared call when done incorrectly can make things worse for the physicians.  How so?  By getting called incorrectly over and over when they are not on assignment.  After getting 2 or 3 calls in an evening and having to tell an operator that it is not you or your practice, it’s the other group. Then they argue with you telling you that it’s not what the schedule says, you may as well just take the damn call, you have already been interrupted so many times that it may not even matter anymore.

As you can imagine there is a right way and a wrong way to share call.  Here are a few basic, but important things to think about.

  1. Be in the same or surrounding community. Many Medical Staff Offices have policies regarding the maximum time you can take to respond to an on-call request.

  2. Have privileges at the same hospitals. if you can’t admit another doctor’s patient to the facility that your colleague ordinarily uses, but instead must admit to your hospital, nobody’s bound to be happy. And if the patient can’t receive the services he needs at your hospital, you create an opening for a malpractice suit.

  3. Have the same skill set. If you have some choice this makes the most sends for the sake of patient care and risk management.  In rural areas this isn’t always possible. 

  4. Be careful of who you partner with. Never cover with someone who writes meds without seeing the patient, or writes too many narcotic prescriptions.

How many call partners do you need? According to an October 1, 2009 article from Physicians Practice titled Call Sharing for Small-Group Docs, “Five is the golden number for doctors who want a nightly rotation Monday through Friday, with a separate rotation for weekends. Going higher than five means even fewer hours tethered to your phone, but there’s a price to pay. Because you’re entrusted with a larger volume of patients, you could be eaten alive with the medical problems of total strangers.”

Once you have the right people its time to figure out the schedule.  There are two options, the first according to the 2009 article, “In the six-member call group of gastroenterologist Gregory Smith in Athens, Ga., doctors meet every three or four months over dinner to map out their schedule. Even so, doctors invariably need administrative help; not only for creating the calendar but also distributing it to call partners, the answering service, and hospitals — not just once, but every time it changes.”  Many doctors function as call-calendar czar, sometimes rotating the responsibility annually.  Back in 2009 this was the norm, dinner and manual scheduling by one person who clearly drew the short straw.  In 2018 modern practices use on-call scheduling software to create an evenly and fairly distributed on-call schedule where both practices can submit vacation requests and the schedule is created around the doctors time off.  Physician Scheduling Software also makes swaps and communicating the schedule to the hospital a breeze.  Everything is live and on-line, making it one source of on-call truth.  For detailed information on how to create shared call schedule between two small groups check out Amy's latest blog post.

When everything is said and done it also makes sense to memorialize the terms with a shared call agreement that is revisited each year.  Consult with your favorite attorney to have something simple but solid drafted.  Remember an EMTALA citation regarding on-call happens to not only the hospital but also the physician who was on-duty.  The fines can be $50,000 each.  It is very important to get this right. 

Sharing Call with the right people can make sense and help reduce physician burnout, especially in a smaller community.  They key is to make sure that all the aspects are thought through and covered in an agreement.

Call Scheduler can be tailored to your needs, let us explain how! Request Consultation

Photo courtesy of Stuart Miles

Topics: software for scheduling physicians

Overlooked Cause of Physician Burnout - Creating the Physician Schedule

Posted by Justin Wampach on Wed, Jul 11, 2018 @ 09:51 AM

bat1-18444If you are a lead physician in your practice or a practice administrator, you know that Physician Burnout is a hot topic in 2018.  Recent Studies from Medscape and Reuters continue to show that the problem is not showing any signs of slowing down.

According to “The Happy MD” blog posted by Dike Drummond, MD, “Numerous global studies involving nearly every medical and surgical specialty indicate that approximately 1 in 3 doctors are experiencing physician burnout at any given time, with some studies showing burnout prevalence as high as 69%”.

One of the things that can be done to prevent physician burnout is work-life balance and healthy boundaries between work and non-work life areas.  In many small and medium sized practices, it is still very common to have one of the physicians create, maintain and publish the physician on-call and work schedule.  This is most often created at home, nights and weekends, without any tools, such as automated on-call scheduling software.  We estimate that the physician scheduling process will take  approximately 30-50 hours per year creating, making changes to, and communicating for a group of 10-15 physicians.

While many of these physician schedulers are more senior members of the practice, and some even claim to like doing it, the large majority are not doing it for fun or the challenge.  They are doing it because either it won’t get done on time of they don’t do it, it won’t be done fairly, or it won’t be accurate.  All three of these items are important to the partners in the practice.

Spending 30—50 hours of time, that you are not compensated for, on nights and weekends does not promote a healthy work life balance and certainly violates the precious boundaries between work and home.  I am advocating that physician scheduling software tools are provided to make the job easier, less time consuming, and more self-serve for the physicians who do not have to create or maintain the schedule. 

Creating the physician work and on-call schedule is often overlooked and undervalued because the workload is burdened to one person (or a small group) and does not affect everyone as much as it does the physician scheduler.  Sometimes when a doctor wants to pass the baton to someone else there is peer pressure from other doctors to “just suck it up” and “do it by hand like I used to have to do”.  And we also hear that the partners are unwilling to change or could not possibly learn one-more “new thing” making the process more self-serve difficult.  FYI, I think all of that is BS.  I think the real reason is that some people are selfish and don’t care as much about others as they should.  If it’s not my problem, who cares about Scheduling Physicians, right.  WRONG.

Physician burnout is real.  The causes can be subtle and can take years to add-up.  Just be sure if you are an Administrator or physician leader that you are not part of the problem, but rather the solution.  

Creating a healthy work-life balance does not include spending 30-50 hours of your nights and weekends creating schedules for your partners.  Give doctors the time and tools necessary to do their job as a “scheduler” and encourage other doctors to use modern tools for things like vacation requests.  This is a small step in reducing the possibility that scheduling doctors is part of the burnout problem.  It doesn’t have to be.

Have questions or need more information? Let's talk. Contact Call Scheduler

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Hospital Transfers Need Accurate On-Call Information

Posted by Justin Wampach on Thu, Jul 05, 2018 @ 01:47 PM

On Call in the hospitalDo you want your hospital to be considered a regional referral center?  According to an article published in the September 2014 issue of Today’s Hospitalist “Transferring patients from one hospital to another, quickly and easily” has become a top priority for hospital leadership.  Why?  Transfers are a source of new revenue and according to Martin B. Buser, MPH “a way to shore up finances”.

They need to increase market share as quickly and dramatically as possible,” Mr. Buser says. “You want your hospital to be considered a regional referral center, which means giving the thumbs up to transfers.” And you don’t need to be a teaching hospital “to become a successful regional referral hospital,” he adds. “Large community hospitals are intercepting transfers that formerly went to universities because they can give better service and are more responsive.”  According to Mr. Buser, some client hospitals have realized a 15-to-1 return on every dollar invested in a new transfer center. 

There are several things that must be in place for a successful transfer.  One of them being accurate, up-to-date on-call information.  A hospitalist or emergency physician at a referring hospital should be able to quickly and easily find out which regional centers are open for a specific service before initiating the transfer request.

Many regional referral centers struggle to have one source of on-call truth.  In the absence of accurate specialty physician on-call information it can take 3-8 calls to get a patient accepted.  First, you have to find a center that is open for the service you need, then, you have to find a hospitalist or the on-call specialist to accept your transfer.  All of this takes time via phone calls and phone tag.  Time is the enemy of many patients critical enough to require a transfer considering the large volume of patients transferred directly into an ICU.

One simple way to build a single source of on-call truth is with a web-based on-call management system that can automatically aggregate an entire hospitals on-call information into one simple to use system.   Access to this system can then be given to referring hospitals who you wish to establish a better transfer relation with.  An on-call management system like this can send a clear message that we are open for business and we want to make the process of transferring appropriate patients from your facility to ours as easy as possible.

We have heard several times that a hospital will call another hospital to see if they are open for that service (for example Neurology) and after hearing “no” so many times, they stop calling.  According to Roy I. Sittig, MD, medical director of the hospitalist program and associate chief of medicine at the University of Connecticut Health Center in Farmington, Conn. The bigger problem, as he sees it, is that “the process to get someone in can be a labyrinth that is not user-friendly to referring providers.” Too often, there is no one number to call to get a transfer started. Then there’s confusion about whether to call an admitting hospitalist or a specialist.

Clearly there are many facets to building and running a successful transfer center, one of them being up-to-date and accurate on-call information.  This is one of the simplest problems to solve using a combination of process and technology. 

Have questions or need more information? Let's talk. Contact Call Scheduler

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Does Anyone Care How Much Time You Spend on the On-Call Schedule?

Posted by Justin Wampach on Tue, Jul 03, 2018 @ 08:28 AM

I was just reading a great blog post from a company that schedules restaurant employees and it was talking about an employee of the company displaying at a trade show and trying to talk to attendees as they walk by the booth.

The vendor said, “Hi, would you be interested in knowing more about online employee scheduling and forecasting?”  The man hesitated.  A-HA!  A browser! He turned and said, “What, you mean a tool to do the schedule on the computer?”  I replied, “Yes, absolutely, and a great deal more.”  He then said something I have since heard several times, but as this was the first time I’d heard it, it surprised the heck out of me.  He said, “I pay my manager a salary and I don’t care how long it takes them or how hard it is. That’s why they’re salaried.” 

This made me think of how many times I hear from the person creating the on-call schedule that no-one seems to understand or care how difficult it is or how long it takes. 

How Long Does it Take to Build an On-Call Schedule?

Over the past several years I have commented many times about trying to understand and articulate the value of your time when creating, maintaining, and publishing the call schedule.  If your partners or your boss is not aware how much time and energy is being spent, chances are it will never change.  I would go as far as to say that if you are being asked to do this task at night or on the weekends of your own time, and you are not an owner or stakeholder, you might want to strongly consider politely giving the project back.

Managing Overtime in Your Clinic or Practice 

GettyImages-947192610

It’s a common assumption that salaried workers can be asked to work overtime without being compensated extra. That assumption is not always true.

It’s not whether you’re salaried but whether you meet the test for exempt status as defined by federal and state laws. An employee that is exempt from the Fair Labor Standards Act is not entitled to overtime. An employee that is non-exempt from FLSA is entitled to overtime. The official stance is:

A salaried employee must be paid overtime unless they meet the test for exempt status as defined by federal and state laws or unless they are specifically exempted from overtime by the provisions of one of the Industrial Welfare Commission Wage Orders regulating wages, hours, and working conditions.

If you are salaried and are non-exempt, then you can calculate your overtime pay like this:

  1. Multiply the monthly remuneration by 12 (months) to get the annual salary.
  2. Divide the annual salary by 52 (weeks) to get the weekly salary.
  3. Divide the weekly salary by the number of legal maximum regular hours (40) to get the regular hourly rate.

As mentioned above it is somewhat different if you are an owner or stakeholder in the business. Although if you have a true partnership (an arrangement where parties agree to cooperate to advance their mutual interests) you should not allow any unfair treatment between partners. This causes friction in the relationship and could eventually cause a disillusion in the partner agreement.

One easy way to accomplish this is to answer the following questions (at least annually):

  1. What are your duties in the clinic outside of patient care?
    • Do I still like doing it?
    • How much time does it take?
    • How much does it cost?
    • Is this a good use of my time?
    • Are there any tools (like software) that can assist me?
  2. What are your partner’s duties in the clinic outside of patient care?
    • Do they still like doing it?
    • How much time does it take them?
    • How much does it cost them?
    • Is this a good use of their time?
    • Are there any tools (like software) that can assist them?
  3. Are these duties still a good fit for you and your partners?

Key Takeaway:  By reviewing and answering these questions you are showing your business savvy and also showing your partners that you care.

 

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Topics: adopting on-call software

Hospital On-Call Management: Building One-Source of Truth

Posted by Justin Wampach on Mon, Jun 25, 2018 @ 12:25 PM

tick-true-represents-in-truth-and-accurate-100288889Where do you go within your hospital to find out who is on-call for Cardiology or Neuro-Surg?  Do you trust the information to be current and accurate or do you have to call and verify?  How do you know if there has been a recent change? 

Accurate, up-to-date on-call information is paramount in running an efficient, modern Emergency Department and Transfer Center.  I hear this over and over.  That was the goal of a medium sized hospital CIO on a call last week, “we need to build one source of truth” for this on-call information.  I was intrigued by his choice of words “one source of truth”.  When asked to clarify, he told us that the amount of schedule changes is “chaotic” and often times are not documented correctly and re-distributed throughout the organization.  What has happened in this specific organization is that the current system is seen as “broken” due to it’s inaccuracy. 

Some of you reading this might be thinking, who cares?  So, what if it takes a few extra minutes to find the correct on-call physician?  Those are fair questions, let me dive a little deeper into the pain that on-call can cause within a busy hospital.

  1. Wrong physician getting called when not on service. Each time this happens, depending on the individual physician, this call can cause frustration and stress to the doctor.  This is often referred to as physician dissatisfaction.  I think we can all agree that most of the doctors that we interact with are extremely busy and a lot is expected of them not only in the clinic but also in the hospital.  The last thing a busy person wants on their day-off or in their downtime is someone calling for a consult when they are not on service.  Often, calling the wrong physician when they are not on-call will be brought up and looked into by the Vice President of Medical Affairs.  I have heard of physicians leaving practices over the repeated practice of calling the wrong person.
  2. Employee satisfaction and turn over. This is the other side to the wrong doctor getting called, this is the person calling the wrong doctor and often being verbally reprimanded on the phone for the error.  Often, we see a telecom person, or someone in the ED looking at outdated inaccurate information.  Rarely is the person calling the wrong doctor the person who made the mistake.  The mistake is traced back to an outdated paper system that does not account for the large number of changes in coverage that we see as common today.

  3. Extended wait times, delay in patient care while trying to locate the correct physician. This area is one that seems the most obvious to me.  In 2014 the CDC reported that the average ED wait time was about 30 minutes, and 90 minutes waiting for treatment.  Ask any mother of a young sick child what the experience is like in the waiting room of your favorite hospital, it feels A LOT longer.  There should never be a delay in care due to outdated paper on-call information, especially not when there is robotic surgery going on in the basement. 

  4. Decrease in transfers from other facilities. How easy or hard is it to make a transfer into your hospital ED?  Do others have to call you to see if you even have coverage of that service?  Why is it that many ED’s have wait times posted on their website, but they make other hospitals call them to see if they have an on-call Neuro Surgeon available for a case.  Remember that transfers are a source of revenue for your hospital.  Make them as easy as possible for other hospitals to work with your hospital.

  5. EMTALA. It is a requirement of participation in the Medicare program to maintain a list of physicians who are on call for duty after the initial exam to provide treatment necessary to stabilize an individual within an emergency medical center.  Failure to do so can produce fines of $50,000 for both the hospital and the physician.

Where do people in your organization go for one source of on-call information truth?  Sophisticated, cost effective on-call management solutions exist that can quickly and easily transform your hospital.

 

Call Scheduler can be tailored to your needs, let us explain how! Request Consultation

 

Photo courtesy of Stuart Miles at www.freedigitalphotos.net

Free On-Call Scheduling Software

Posted by Justin Wampach on Tue, Jun 19, 2018 @ 09:36 AM

Medical Groups should be providing valuable tools for physicians to use, for free, to create maintain and communicate their on-call and work schedules.  Physicians should have access to free tools to use to do their job. Free to the physicians, not free to the medical group. In some professions, it is acceptable to expect the resource to provide his/her own tools to be able to complete the job. Think the building industry or mechanics.

Is Free Scheduling Software Too Good to be True? 

Free On-Call Scheduling Software

If I could go back in time and be sitting in some of the early meetings at the large pharmaceutical companies when they had the brain-child idea of buying their way into the physician’s office using free drug samples, I would definitely have had something to say. This model has plagued the non-pharmaceutical medical industry for more than 40 plus years as medical offices have an expectation of being able to try something for nothing before they buy it or even consider it.

In 2010, Adjuvant, the maker of Call Scheduler spent money to customize a way for doctors to come to our website and request a free-30-day-trial of our Call Scheduler Lite product. We thought this would work because many doctors are not available to speak with our sales team during the day, they're too busy seeing patients. We thought it would be great to give them a self-serve method that they could do when it was convenient for them. The free trial was for our product to help them create, maintain, and publish a call schedule for their partners. In addition to our investment to automate the set-up process, we also needed to create many do-it-yourself videos so that the doctors would know how to set-up the system and be able it use it. 

We had a large number of doctors sign-up for the free trial.  Out of the total group of doctors that signed-up for the service, the large majority of them never completed the set-up part where you enter the doctors' names. Not one of the free trials turned into a sale. Why? I’m not sure.  I have some thoughts though.

  1. No money was invested (easy come easy go).
  2. Realized there was work involved, perhaps the volume seemed overwhelming.
  3. Realized that they did not have all of the necessary information to set-up the system.
  4. They thought that our set-up interface sucked and therefore moved on.
  5. They really didn’t have a problem.

On-Call Scheduling Make Better Tools

Many of the physicians who look at our Call Scheduler demos and or that call into the office are still creating the work and on-call schedule for their partners on their own time, and by hand without any tools other than perhaps Excel. That is so important I am going to say it again, most of the Physicians that I speak with (several hundred each year) still have to create the call and work schedule for all the partners on their own time, and without any tools. This averages about 40 hours per year, of nights and weekends.

In many industries outside of medicine, this concept would have ended 20 years ago.

For example in the technology/software industry if you don’t provide time and tools for your most valuable employees, or if you expect them to perform duties that are time-consuming, and difficult, and on top of it, have people gripe about the results, they would pack up and go somewhere else. Technology people are so valuable and in such demand they will simply leave. I have learned over the past 10+ years that most physicians are very mild mannered people. They are not looking to rock the boat, nor are they looking to make a big deal out of something that others find trivial. The physicians who fit this profile are typically the ones who get talked into doing the on-call schedule for their partners.

I think that a few items are at play when we talk about doing work for free without the proper tools.  First, medical groups are very cost conscious organizations about certain things.  Like all good businesses it is important to make investments in the places that show a financial return.  For example, an MRI machine has a large cost, but also has a large return.  The individual physicians are expensive to employ, but also have a large return on investment.  Tools and services are often seen as a burden, and are considered optional.  The second item at play is that many groups have certain doctors doing scut work, like the on-call schedule, because they will do it and not push back. 

The Ultimate Buy-In

Or if they do push back, they can be easily bullied into taking on the added responsibility, for free, without any tools.  In my opinion, both of these things are pretty sad. I say that because it is a very black and white way of looking at the world, and unfortunately there are many shades of gray. For example, when you’re looking at a return on investment sometimes it can be easy to forget about the “soft” benefits and only look at the “hard” benefits. An example of a soft benefit would be physician satisfaction or work/life balance. Everyone wants to see a hard dollar return on everything that is not considered essential to whoever makes the decisions.

Funny story, a new service was being offered in my community, Oopie Poopie Scoopy service. It was a guy who came around each week to clean up dog waste.  At first I thought who in the world would ever use this or spend money on something like this. Until I became a pet owner of a 75lb Husky /German Sheppard mix. Let me tell you, it was the best $40 per month that I had ever spent. Once I had the crappy job (pun intended) and my mind changed, quickly! 

Sometimes it is important to look at things from someone else’s perspective. I hear physicians tell me all of the time “my partners won’t pay for software, they don’t think we need it and it will not benefit everyone, only me, the person who creates the schedule”.  Obviously, they are wrong, on-call scheduling software benefits all of the physicians, the staff, and even patients in the end. Each person will benefit in a different way, some will be greater than others, but everyone still benefits.   

 

I have said it before and I will say it again, if you are a physician in a practice that is doing the call schedule for free, on your own time, without any tools, STOP.  Politely go back to your partners or practice administrator and say, no thank you. The same way you would if they asked you to clean the toilets without rubber gloves. I am willing to bet my last pair of clean socks that either you or the next person will get at the very least some software to help them out.  

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Topics: scheduling software, on call schedule, free scheduling software