There are few questions as contentious as “should a physician be able to approve their own swaps requests without the consent of a scheduler” when adopting physician on call scheduling software such as Call Scheduler? I have been in meetings with medical staff where shouting matches have taken place between medical staff and administration. Things can get ugly quick. Physicians think that because they are the doctors, they should have the right to have someone cover their shift whenever they need and want. Administrators don’t want to be blamed for lack of coverage, burnout or having to spend additional dollars when someone goes over their coverage duty limits and now is owed prime pay. My conclusion on this issue is that both sides have very valid points, but as long as certain conditions are meet, yes.
Physicians and Advanced Practice Providers who use on call software and who take call and other assignments should have the ability to trade or swap shifts under the following conditions:
- They find their own swap partner.
- The tally reports are not expected to be made fair by someone else due to the swap.
- When you swap you are swapping the entire assignment, not just part of the assigned time.
- By swapping you are not obligating another person or entity to have to spend additional dollars to comply with a previously negotiated contract agreement.
- Both parties must agree.
- There must be agreement documentation.
- Somehow the answering service and ED must be notified.
Administrators who have purchased physician scheduling software or are schedulers should agree to allowing providers to approve their own swaps if the following conditions are meet.
- All providers must adhere to the same swap rules.
- The system will be used only for good.
- There will not be any gaps in coverage that cause a delay in patient care.
- The organization will not be bound to make a prime coverage or additional coverage payment if it is the result of a provider approved swap.
- Providers are not expecting a scheduler or administrator to balance out fairness tallies at the end of the year due to swaps that made them seemingly unfair.
- The scheduler is not expected to have to check or approve any swaps if this feature is enabled. The providers will be responsible for approval via email.
Swapping call duty has been around since about two weeks after being on-call was invented and some doctor forgot to check with his/her spouse and needed to make a quick change to avoid getting in trouble at home.
The goal of Call Scheduler when adding this new feature to our physician scheduling software was to make the swap request and approval process easier for the providers and the schedulers.