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

Call Scheduling: A Thankless Job

Posted by Justin Wampach on Thu, Oct 14, 2010 @ 11:09 AM
 Evaluating the Costs of Your Clinic’s System.

 As a leader of a technology company focused on creating, maintaining and publishing physician on-call schedules, I hear stories almost every day from frustrated physicians who have taken on the pro-bono assignment of creating a call schedule for others in their practice.

It’s is one of the lone clinical duties still done this way. Over the years, clinics have moved other key functions like accounting to paid, in-house responsibilities to ensure accountability, quality and sustainability. In the end, the good intentions of physicians who volunteer to do the call scheduling results in the other partners not understand what it takes to provide a fair and accurate schedule.

Time’s Ticking
In practices of all sizes, I’ve seen a physician spend many hours of personal time at home or in the office after hours to help out the practice. Behind the scenes, the physician scheduler aims to simultaneously adhere to the complex rules and regulations and meet the personalized needs of the physicians. Duties range from coordinating meetings to discuss fair rotations and juggling time off requests to creating daily schedules.

A schedule is rarely finalized. Often, schedulers make countless changes and provide a series of revisions to accommodate swaps and adjustments after a schedule is published. A scheduler spends a week’s worth of work every quarter to create, maintain and publish a call schedule for a practice with 14 providers. That’s a month’s worth of time a physician could be spending with patients or doing other activities.

Evaluating Costs
When most physicians are asked what it costs their practice to do call scheduling, their response is zero -because another physician takes care of it. That’s deceiving to the practice’s bottom line, not to mention devaluing to the person doing the job.

The time spent on the call schedule may not be billed – but it could be. If a specialty physician earns $300,000 a year and works an average of 80 hours a week, their hourly rate would equal $72. Multiply that times 105 – the average hours spent on creating, publishing and maintaining a schedule a year – and the actual cost is more than $7,500 annually.

The soft costs are rarely recognized, but can be equally as important. Imagine if the physician scheduler spent 105 more hours with his wife or kids. Imagine the ability to spend more time reading medical journals, relaxing on the golf course and getting involved in the community.

No matter how long a physician volunteers to do the scheduling, eventually he or she has to hand it off. When that happens, I often receive a call from the new physician in charge asking about technology the practice can use and a free trial. They believe that Call Scheduler - or any tool for that matter - would be better than doing it by hand so they ask for pricing and presents it to the partners. But the belief that the practice currently gets the schedule for free prevents the partners from moving forward.

Getting Results
Practices cannot make informed decisions until they effectively evaluate the hard and soft costs of their current system – even if it is done by hand for free. Here are three steps partners can take to ensure the resources are optimized:

1. Keep track of each hour that a scheduler spends creating, maintain and publishing the on-call schedule. (Paid or unpaid)

2. Create invoices with the true costs. The physician scheduler can continue to no charge. This will provide a track record of the cost.

3. Give the project back. Explain to partners that the time spent and the benefit received are not equal. Perhaps a “paid” staff member within the group can pick-up the duties.

These steps have been proven to help practices better evaluate the effectiveness of their current scheduling system and make changes to better position them for the future. The creation of the call schedule for providers is no less important than the EMR, CPOE or accounting software. Physicians will see a sizable return when they take the time to ensure they have a call management system that is efficient, scalable and sustainable.