You might be surprised to know how many times we get calls from Physicians that start out by saying, “I’m going to be taking over creating the on-call scheduler for our group, can you help me get started?” Our answer is always of course, we’re happy to help. I have heard this enough times that it now warrants its very own blog post. This is primarily directed toward physicians and schedulers who are creating just the on-call portion of the schedule for the doctors. In many practices, there is a physician that creates the “on-call” portion of the schedule, while someone does the office type assignments. Today’s post is more focused on the on-call side of the schedule.
Let me politely begin by saying, "why ever did you volunteer for this job?!" Do you have any idea what you’re getting yourself into? And you thought dealing with patients was difficult, you haven’t seen anything yet. Ok, it’s not really that bad, unless your group is all for #1, and none for all or unless all of the physicians in your group are concerned about their own schedule more than fairness for the group as a whole? Either way, it's your turn to do the physician schedule, where do you go from here?
I would suggest that you look at this new "assignment" in the same way you look at most things, through your scientific lens. Ask questions like; What is the current situation? What is the groups desired outcome? How do we get there?
Step 1: Review the current state of the physician on-call schedule
- How has it been created in the past?
- How have the holidays been determined?
- How do physicians submit vacation and other day-off requests?
- Who approves and denies vacation and other day-off requests?
- How far in advance is the schedule created? And why?
- Are there rules that govern how the schedule is created?
- Are the rules fair and do they have some logical basis?
- What are the top 3 issues with the current “scheduling” process?
- Is the physician schedule considered “fair” by the doctors?
- How is the on-call schedule communicated to the doctors? How about to the answering service or the hospital ED?
- Who handles changes to the schedule? How are they communicated?
TIP: You are going to hear a lot of “I’m not sure, that’s how we’ve always done it”. That’s a nice way of saying, “I have no idea”. Do not accept that as an answer. That is precisely how bad process continue to live on in good organizations. If there is no good reason for a policy or way of doing things, perhaps it doesn’t need to be done that way anymore.
Step 2: Suggest changes or modifications
- Considering what you learned during the step 1 review process, is there anything that needs further review or modification?
- Are there any special items or things that are specific to one physician and not to others? If so, those should be discussed. Things that may be considered unfair.
- Are there any new initiatives that need to be considered? New locations or services that are being considered.
Tip: People are resistant to change, think about your patients and how many times they do illogical things just because there comfortable doing it that way. Modifications or changes are made to a process because they provide more value than they way things are done today.
Step 3: Assess the tools available to create the physician schedule
- Review what tools you are going to have access to in-order-to get the job done. If your practice or partners would like you to create the physician schedule without any software tools such as Call Scheduler, I would recommend politely giving it back and declining the extra work. They clearly don’t understand the amount of work required and they don’t value your free time.
These questions are a great place to start in having a conversation about the past, present and future of scheduling physicians for on-call.
Key Takeaway: Do not accept the current physician on-call scheduling process as it is, and always has been, as the way it should be in the future. Now is a great time for a review and may also be a good time to make some changes.
PS, you might enjoy a past blog post titled "How to Give Away a Skunk", which talks about how to make a not-so-fun job "less stinky".
Image courtesy of stockimages at FreeDigitalPhotos.net