Over the last 10 years the number of physicians who are now in charge of creating the physician work and on-call schedule has continued to increase. One of the top reasons for this is due to the increasing degree of complexity that is involved in making all of the parts fit together. For many advanced specialty practices the days of just creating a simple primary and back-up on-call schedule are long gone. As metropolitan practices continue to merge and form mega-groups or fold into large health care systems the number of “jobs” or things that need to be scheduled in any given day increases. It is not unusual for a Cardiology or Radiology or even a Pathology group to service several hospitals, clinic sites, outpatient surgery centers and emergency rooms. All of these individual locations pared with the unique skill sets like interventional, non-interventional, or the ability to offer an opinion on a frozen section of most anything and even reading certain types of pictures. As you know most of these specialty doctors work so many long hours that they need three, four, five or six weeks of vacation each year as well as CME days. As you know, there are a lot of moving parts to the physician schedule.
Back in the “good old days” it was easy to create a simple rotation or even a random schedule that you could justify fairness with an Excel or hand scratched tally report, not any more. Many physicians don’t work full time, now its point this and point that. And last but not least many doctors have partners who are also physicians so these complex schedules need to be coordinated so that they can actually have holydays and time off together. It’s no wonder you can’t find an administrative assistant type person and pay them $15-20 per hour to try and figure this out. It’s also challenging because some of the doctors aren’t, shall we say, not so diplomatic about voicing their frustrations to the administrative people who are trying their best to accommodate everyone’s needs. So what do you do? You can keep doing what your doing. But do we really need medical doctors taking time instead of seeing patients and creating RVU’s or spending time with their families or should they be making physician on call schedules?
The answer is no. What you really need are four things working together and you can alleviate or at least be on a path or alleviating the physician scheduling pain.
- Clear process. Someone needs to take the time and document all of the unique things that someone needs to take into consideration when creating the physician schedule. Rules, jobs, skills, etc. There has to be a plan or else it’s like asking someone to build you a house, and you say “there is no plan, I will just know it when I see it”, so build and I will tell you what I like and you can tear down what I don’t like and you can try again, over and over until I am satisfied.
- A local physician decision maker. Someone still needs to approve vacations, time off requests, change requests and break ties.
- A willingness to let go. I hate to break it to you Doctor, but although you may be an incredibly talented physician or surgeon, you are not the best schedule creator. In fact if you do not believe me, ask your partners. You don’t do it often enough to be good. You may be ok, but you are not good and surely not great. Juggling all of these moving parts and getting them to line up into a workable, fair schedule is not an easy task. Give the experts some credit and let them do the heavy lifting. And by the way, by expert I don’t mean you assigning this to someone in your clinic or group who has some extra bandwidth. I mean someone who creates 50-500 schedules per year and has created for every specialty. A true specialist.
- Last but not least you need to be willing to pay a specialist what they are worth and also spend money on software so that they have the proper tools to get this job done. A 10 person Cardiology group may spend $500 per month on outsourced call scheduling to a specialty scheduling company like Call Scheduler, but you have to ask yourself how much your spending today to get the results that you are not happy with.
Key Takeaway: Deciding to use outsource scheduling services is no different than hiring a painter to paint a fresco in your home, or going to a mechanic to have your BMW serviced on or going to a Cardio Thoracic Surgeon to have an Aortic Valve replaced. Experts have their benefits.
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