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

Considering an On-Call Scheduling Software Pilot? Which Specialty?

Posted by Justin Wampach on Mon, Feb 19, 2018 @ 11:43 AM



We speak with practice administrators and IT professionals all the time who are interested in conducting a pilot or trial of physician on-call scheduling software within their organization. What helps sell a project better to management than a trial or proof of concept?  Great idea in theory, but what many don’t know is which specialty calendar/department to use as the test case. Sometimes they will often pick the most difficult specialty or the group that is screaming the loudest at that time. Or sometimes they will pick a department who has the primary user who is unwilling or unable to participate in the process. How should a practice decide who to use in a trial? What goes into a trial? What we have found is that the person leading the pilot can and is often more important than which specialty itself is choosen.

Here are some characteristics that may be helpful when selecting candidates. Obviously, there are not hard and fast rules in this process, but make no mistake, the department/specialty as well as who from that specialty you choose to do the work will have a tremendous amount of impact on the success or failure of the project.  If you would like more information about selecting vendors check out a previous blog post "11 Traits that your Physician Scheduling Vendor Should Have".

Characteristics of someone that would be a good candidate for a trial:

  • Excited about trying something new and or thinking about the problem in a new way
  • Clearly understands the current manual / paper process and how to schedule physicians
  • Does not have to ask someone else’s permission or how-to when it comes to process
  • Understands technology and software
  • Understands that software is an iterative process
  • Has clear and reasonable goals regarding what outcomes it is expecting
  • Willing to complete training / onboarding
  • Is not trying to mimic current paper/manual process with software
  • Is willing to do the homework or necessary data entry in-order-to evaluate results
  • Understands that there several people who need to receive value from this type of software within an organization and everyone’s will be different
  • IS willing to commit to goals and success criteria for the trial so that it is not a moving target for your vendor partners

Characteristics of someone that would not be a good candidate for a trail:

  • Schedules but cancels many training sessions
  • When in a training session, not present (texting, answering emails)
  • Trying to mimic current manual process
  • Unwilling to do homework, data entry
  • Unwilling to run scenarios (thinks it should be perfect the first time)
  • Doesn’t understand the difference between rules and preferences
  • Doesn’t understand the difference between a user not knowing how to do something and the software application not being able to do something
  • Unreasonable expectations based on what a blank sheet of paper can do
  • Is more concerned with counting clicks than results

Characteristics of a Group / Department NOT to Choose:

  • Not a group with the most difficult, eat-your-face-off calendar that no one has been able to figure out in years. 50 doctors and 100 jobs
  • Not the simplest schedule either with 5 doctors and 1 job
  • Not a group or department that is in the process of merging or in some way changing
  • Not a group with a new scheduler
  • Not a group with a scheduler who is just handed a paper schedule by a doctor and then they just enter it into software (doesn’t actually create the schedule)
  • Not a group where the doctors can’t agree on what “fair” looks like
  • Not a group who has a scheduler who knows it all and is not interested in changing
  • Not a group where the scheduler is using the scheduling software as a “secret weapon”
  • Not a group where the scheduler will not let other users (doctors) use certain features
  • Not a group where the users are unwilling to recognize how the entire enterprise level projects fits together

Tip: I know it may be counter intuitive but remember that vendor/partners also have a rigorous selection criterion for giving a potential customer a trials and pilot. If the vendor gets a department schedule that is next to impossible to automate or schedulers who are unwilling to participate in the process, it can be disastrous.  If both the vendor and the department work hard to select the right people and get the work done together, the proof-of-concept should be a win/win every time. 

Learn More About Call Scheduler

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Does One Physician Scheduling Software Solution Meet Everyone’s Needs?

Posted by Justin Wampach on Mon, Nov 06, 2017 @ 03:03 PM

ID-100158316.jpgA trend that we in the physician work and on-call scheduling software space continue to see grow is the enterprise wide adoption of physician scheduling software by healthcare systems. Organizations go through an extensive vetting process to try and find a vendor with the best feature set at the lowest price and attempt to make that vendor a “standard” or a “preference” within the organization. I suspect that standardizing solutions makes it much easier on the IT Department in terms of contracting, negotiations and end support. I wonder if the users who create schedules for the physicians benefit from this type of “standard” adoption? My gut answer would probably be, sometimes.

Why Standardize: My best guess is that standardization does not originate at the department level. I don’t think that individual departments have that much concern for how things are being done in other departments. Not that they don’t care, but more because they have so much to focus on in their own area that there isn’t much time to concentrate on other areas. Therefore, I think this does come from IT or even purchasing to make the purchasing process easier for others down the road.

The technical argument for standardization is pretty cut and dry. A health care system can benefit from standardizing the “physician schedule creation process”, the “physician schedule change process”, the “daily call roster creation process” and the “availability of on-call information”. They can achieve this by choosing one vendor to provide on-call creation and on-call management software. The organization can create and enforce new “standards” that ultimately can help support the mission of the organization. As long as each department or specialty has the same needs and does things the same way, its more than likely a great idea. The big question is “do individual practices they have the same physician scheduling needs and “create, maintain and communicate” it the same way”?

Standardization Pros:

  • Every department gets a bucket of tools to use to assist them in the creation of the physician schedule. Some of the tools are intended to reduce the time it takes to manually schedule physicians.
  • Often the solution will be paid with IT’s budget.
  • Often better negotiated pricing and terms (volume discount)
  • Reduction in the manual “data entry” process needed to create daily on-call rosters.
  • Increased accuracy in the on-call information that is available to end users

Standardization Cons:

  • Some specialty groups are much more complex to schedule than others. Who do you buy the software for? The most complex group or the least complex group? Or perhaps somewhere in the middle? In my opinion standardization ultimately will give some groups way more tools than they need, and it will give others not enough. This is the classic “3-Bears” scenario.
  • Some groups may already have a vendor relationship that they are already happy with. They don’t want or need to change. They do not see any personal value in changing.
  • The cost could be higher by forcing small groups to use certain software that has more features than they need and is therefore more expensive.

Both pro and con lists have merit. I would not discount the largest and most poignant con of all, listed as number one. How do you overcome the three-bears scenario? I think it’s great that a Health Care System would choose a single vendor for a solution such as physician scheduling to attempt to standardize the process and tools.

Key Takeaway: Not everyone is the same. Specialty groups have unique needs, unique rules, unique processes, unique ways of paying and accounting for time worked. Maybe in the best interest of creating a great physician schedule, we should make it easier on the “schedulers” and “physicians” who must create and then work those schedules as opposed to those who buy and manage technology.

If standardization isn't your issue, but convincing your physicians that scheduling software will benefit them, you may enjoy this blog post "How to Get Physician Buy-In for Scheduling Software Adoption".

Learn More About Call Scheduler


Image courtesy of artur84 at FreeDigitalPhotos.net

How to Get Physician Buy-In for Scheduling Software Adoption

Posted by Justin Wampach on Wed, Oct 18, 2017 @ 09:41 AM

ID-10062966.jpgSpecifically, how to get your doctors to use an electronic vacation and day-off request system;

“My Doctors won’t do it that way.” “My doctors are so busy they can’t learn one more thing”. “My doctors just want to do it the old way”. If you are in healthcare and are a practice manager, clinic manager or in a leadership position, how many times have you heard the statements above? My guess would be almost every time you try to do something new. How is it that some physicians are open to change and trying new things, while others are not? I have a sneaking suspicion its all about the approach.

When trying to move a new initiative forward and gain physician buy-in, be it a new clinical documentation initiative or trying to  adopt a new electronic vacation and day-off request system, some of the basic techniques still apply.

  • First and foremost, there must be a compelling purpose. Why are you wanting to do what you are proposing? Who will it help? Who will it hurt? Who cares? These answers need to be carefully considered. If your answers are not strategically aligned around your organizations long and short-term goals, then you may want to reconsider what you are trying to do. Be sure that the problem that you are solving is real and effects more than just you. The “purpose” you are identifying is needed in gaining support and buy-in. In our specific example, you need to clearly illustrate how moving from sending request emails to the scheduler to using the "new system" is meant to benefit the doctors. How? By reducing errors in translating request emails. It was designed to make it easier to submit requests by making the system available on the physicians computer or via an app on their phone. Clearly show them what is in it for them.  You may find this previous blog post helpful "Who are you Buying On-Call Software for"? if you need some help identifying what is in it for the physicians.
  • Find your “white knight”. Never tackle a large initiative alone. You need to find at least one person, of influence, that can help be a pollinator of your proposed idea.
    In our specific example, find a doctor that most everyone respects. Do not pick the person who everyone already thinks is weird or the “techie” doctor. Just pick someone who understands why the practice needs to move away from a paper based vacation request system and sees the value as a physician in being able to do it him/herself when it is convenient for them. If you have to sell them on the “why” pick someone else who just "get’s it" without any convincing.
  • Let the "white knight" pollinate. Just like a bee, your pollinator will fly around and talk with several others about the project. Show them how things work, dispel myths, and answer questions. In our example it would be ideal to download the app onto your physician pollinators phone. Be sure they are fully trained on requesting vacations and days-off on-line. Have them submit all their requests using the “new way” and give honest feedback to his/her partners about their experience. You want the pollinator to be able to compare and contrast his/her new experience to someone who is doing it the old way.
  • Track where everyone is at. If you have a larger organization you can use Excel to track who is supporting your initiative and who is not. This is not done to punish, but more to see if your new process is making a difference. If you have 20 physicians and you have everyone on board except 2, then you may choose to move forward despite the laggards. In our example you need to clearly understand who is on board and who is not. Go through this list with your "white knight" and see if you can strategize on how to convert the stubborn ones.
  • Remember The Pareto Principle. 80/20 might be good enough. Physician adoption can sometimes be slow. You may have to settle for 80% of your providers adopting a new way of doing something. When the 80% are happy and seeing the benefits of the new process or initiative, it is easier to mandate that the others now must join-in. In our example you may not get everyone on board right away. 100% participation may require some attrition, meaning the stubborn older providers to retire. The younger physicians are going to expect to participate electronically, for some its all they know.  
  • Stand by your decision and enforce new policies. Everything is going to be harder and messier in the beginning of implementation. Nothing will work perfect, there will be glitches, people may even be termporarly inconvenienced. All of this is part of change. One of the biggest mistakes you can make is to give-in or give-up too early. If this happens often you can have a whiplash type of effect where there is too much change back and forth and people are confused as to which they should follow, the old way or the new way.  This also can taint your next project, so be careful.  Unless it is a disaster, claw your way to success. You will be happy you did. In our example please remember not to give up too soon. Take the time to work with those who are struggling. Resist the temptation to give up. Remember what your alternative is, going back to emails and sticky notes on your chair.

Key Takeaway: Anything worth having is going to take some time to learn and adjust to. If physicians clearly understand what is in it for them, they have some best practice examples to follow, and they are given ample time to convert and adjust, you will most likely be just fine, as long as you take the correct approach.  Although making a transition from an email day-off or vacation request from the physicians to an electronic systm will make everyone's life so much easier, it will be worth the transition.

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Image courtesy of digitalart at FreeDigitalPhotos.net

What to do When Your Physicians Don't Care About the "How"

Posted by Justin Wampach on Fri, Oct 06, 2017 @ 11:56 AM

ID-100414155.jpgThis is a guest post by Gina Loxtercamp. 

I Don’t Want to Keep Driving a Gremlin!  

What do you do when your group is content for you to spend your evenings and weekends working on your physician schedule – without compensation? 

I had talked to an administrator recently that is ready to change how she creates, manages and communicates their practice’s physician schedules – so ready that she walked me through what would be important to the physicians, strongly emphasizing not to discuss any benefits the scheduler would have -- because they do not care about that.  Wow!  I was stunned (still am), and thought this couldn’t really be the case.  Unfortunately, it was.

Jill has cared about her practice and the physicians for many many years, and wants to transition from manually scheduling on paper to software.  She would like to have cloud-based physician scheduling software to create, manage changes and vacation information, and communicate an accurate, real-time schedule to drastically reduce how much time she spends on her own time doing all of this today.  Another goal that is important to her – essential -- is to make this as seamless as possible to her physicians, and ensure they have an accurate schedule wherever they are, easily accessible by whatever device they prefer to use -- especially a mobile App.  The physicians do want the mobile and “live” schedule.

Upon meeting the group, the providers wanted to change just about every aspect of how the software does what it does – you name it, they had a preconceived idea about how to take exactly what they were doing on paper, and try to bend software into that form.  When the discussion came around to pricing, they actually encouraged Jill to keep a separate vacation calendar for those that aren’t essential to the schedule to save dollars (a few physicians, PA’s, and NP’s).  Again, WOW!  Managing all the time out of the office is one of her most cumbersome tasks!

With all due respect, they are focusing on the wrong things – we are the programming and physician scheduling experts.  What a practice should focus on is how to help their practice become more efficient, actually SAVE time, resources, reduce errors, improve employee satisfaction, and of course their own satisfaction – all to benefit patient care!

What can an administrator or scheduler do when the physicians in their practice seriously under-value what they do every day to make their lives easier?

Here are a few thoughts:

  1. Identify if your practice is ready for change.
  2. If yes, do your homework and document the time required for today’s process, errors that have cost the practice a loss of revenue or patient dissatisfaction, and schedule errors that have resulted in the wrong physician being called in the middle of the night!
  3. Identify your top 3 or 4 pain points that you must solve, and let the experts help you do it – we want you to succeed!
  4. If no, there still is hope. Start charging the practice for your nights and weekends, and read this blog post on how to give away a skunk.

Key takeaway:  We want to help you have a seamless transition from a more manual process to our software – if your practice isn’t ready and you are willing, we will help you find a way!

Learn More About Call Scheduler

Image courtesy of Sira Anamwong at FreeDigitalPhotos.net

The Value of Electronic Vacation Requests in Physician Scheduling

Posted by Justin Wampach on Mon, Sep 25, 2017 @ 03:18 PM

ID-100207213.jpgI’m sure you have heard many times that the 6 most dangerous words in business are “we’ve always done it that way”.  I am surprised occasionally when we are conducting annual client success reviews and I hear a practice administrator tell us that they still process vacation requests and other time-off requests for the physicians via email or telephone or even sticky notes.  Really?, I ask.  How come you don’t do it electronically? I hear something that resembles “the doctors don’t want to change” or “it’s just easier that way”.  Is the scheduler resistant to change?  read here to find out more in a previous blog post.  

As a business leader, I can’t think of anything more contentious than figuring out day’s off and vacations for the team at the top of the food chain.  Especially if we have limits regarding how many people can be “off” on any given day.  I also think that as a physician, your time off is so valuable and necessary to reduce the possibility of burnout.  O-kay.  I’m not here judge or to force the use of any features upon a practice.  And I certainly understand that each practice has policies and procedures, some of which may be older than myself, that have worked for years.  But that old-style thinking has some major flaws that can lead to practice inefficiency.  Why change now?  If you're using physician scheduling software there are many reasons to give it serious consideration.


The problem with processing vacation and day-off requests via paper or email:

  • Schedulers are not telling doctors about the electronic tools available to request time-off.
  • Doctors are asking for time off without having immediate feedback regarding their request. For example, “we already have the max number of providers off on that day”.
  • Physicians have to submit requests when and how it is most convenient for the scheduler.
  • The scheduler is spending extra time processing vacation and day-off requests manually.
  • The paper trail for both the scheduler and physician is limited, at best.
  • Approved and declined requests do not come back in a consistent manner.


Benefits for the Physicians

  • Easy secure access to the Provider Request Area from your laptop, tablet or smart phone.
  • Submit requests 24 hours a day. 365 days per year. Very accessible.
  • Reference other assignments while submitting your request.
  • Edit and retract requests that have not been processed when your plans change.
  • Get instant feedback when there are too many pending requests or approved requests on the day that you want off.
  • The ability to “override and submit anyway” when you receive the notice of too many requests so that the scheduler knows you still want this day off, even thought it may already be full.
  • Using the iPhone or Android app, you can make requests on the go, anytime and anyplace.


Benefits for the Scheduler

  • The ability to decide when you will accept electronic vacation and day-off requests and when you will not. (open and close the provider request area at will)
  • Decide what types of requests your providers can submit. You choose which day-off types display in the down-down lists.
  • Decide how many “total days” each provider gets per day type. How many vacation days, how many CME days, etc.
  • Limit the number of providers that can be off on each day of the week. For example, only 3 people can be on vacation on Monday’s. Even choose a specific day, “black Friday or cyber Monday”.
  • Customize the message a physician is sent when a request is approved, declined or the max number has been reached.
  • Get an email notification each time a new day-off request is submitted.
  • Sort all unprocessed requests by provider, date submitted, date effected, or assignment.
  • If you have a multi-step process, visual indication of an “update” to a request.
  • Quickly do an advanced search to review all past approved and denied requests.
  • Edit or change the request type on the fly
  • Once you approve a “request” it will automatically place the assignment on the calendar and update the tally report.

Key takeaway: It's clear that giving your physicians easy tools to request vacations and time-off has a lot of benefits for both the physicians and the scheduler.  These benefits can save time, prevent errors and contribute to a more satisfied medical staff within your practice.

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Image courtesy of Stuart Miles at FreeDigitalPhotos.net

What's Contributing to Physician On-Call Burnout?

Posted by Justin Wampach on Wed, Aug 02, 2017 @ 12:14 PM

ID-100260935.jpgAre physicians being asked to do too much?  How different is the workload today than it was 40 years ago?  What contributes to physicians getting burned out?  These types of questions are being asked across the United States by medical practices and hospitals small and large.  How do we acknowledge and reduce physician burnout?

Younger physicians seem to have a different view on what their work day looks like than they did 40 years ago.  Young doctors often have one or both parents who may have been a physician or practitioner and grew up having very little contact with them because their work was their life.  Although they have a passion for medicine, they do not want their kids and family to grow up the way they did.  Younger physicians are negotiating and taking less and less on-call duty, and when they are on-call they expect to be heavily compensated for that time away from their friends and family. 

According to a November 7, 2016 New York Times Article “A Doctor Shortage?” The overall shortage of physicians is getting worse each year.  The AMA is projecting that by 2025 there will be a shortfall of between 46,100 and 90,400 doctors.  This scenario is putting more pressure on the existing workforce and making it extremely more difficult to create and maintain the physician on-call and in-office schedule.  In fact, for many specialty practices creating the physician schedule has become so complicated that it requires a Doctor to do the work.  You can read more about that topic in my blog post “ Went to medical school to create on-call schedules, Eh?”  Work, office, and the growing number of small satellite locations have providers spending up to 1 hour in their car each way to see patients.  Many physicians spend their day’s off catching up on “charting” or updating ERM systems, training and some even spend it creating schedules for their partners.

Because of just a few of the things we mentioned above, we see a direct correlation between how physicians are scheduled and burnout.  According to a 2016 Medscape Lifestyle Report, the top five specialties that are most burned out are Critical Care, Urology, Emergency Medicine, Family Medicine and Internal Medicine. 

is it a problem.jpg

how severe.jpg


gender difference.jpg


speciality difference.jpg



On a scale of 1-6 the average severity of the burnout is about 4.1 and the study shows no noticeable difference between men and women.  There is no surprise that there is a noticeable difference between happiness outside of work and at work.  There is also no big surprises when looking at which specialities have the happiest doctors, they are primarily the areas that have the least on-call duty requirement, Dermatology and Ophthalmology.  In addition to on-call the causes of burnout also include too many bureaucratic tasks, increasing computerization (EMR), too many patient appointments in a day and dealing with difficult colleagues.

It seems clear that on-call directly contributes to physician burnout and happiness.  Is there anything that can be done?  I think that all the companies that work directly in the physician scheduling industry would agree that yes, there are things that can be done to immediately reduce the burden that on-call places on doctors.   

Here is Call Scheduler’s top list:

  1. Ensure that the provider schedule is fair and balanced.  There is enough stress taking call on nights, weekends and holidays without the feeling of unfairness.  This is easy to achieve and even easier to prove.
  2. Ensure that your providers have easy tools to access information when and where they need.
  3. Ensure that your providers have tools to make vacation and other day-off requests when and where it is most convenient.
  4. Ensure that whoever creates and maintains the physician schedule has all of the available tools to automate and systematize as much of the process as possible.
  5. Ensure that your providers are not creating scheduling rules and scenarios that are so complex that they are unable to be automated.
  6. Train your providers to be open to change and to persist in the face of resilience to change.

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Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Image Source:  Medscape Lifestyle Report 2016: Bias and Burnout.  
Peckham  |  January 11, 2017

Persistence is the Key to Physician Scheduling Success

Posted by Justin Wampach on Thu, Jun 22, 2017 @ 03:56 PM

ID-100290992.jpgOne of our main goals at Call Scheduler is to help make our existing and new customers “wildly successful”.  As you can imagine, that’s not always an easy task.  One of the top reasons is that we are competing against a blank sheet of paper, or perhaps Excel.  With paper or Excel, you can do anything you want, put anyone where you want, you can even violate all the things you say you never do when creating your physicians schedule. 

Although our goal is very ambitious, we strive to accomplish it by doing the following:

  1. Expert onboarding and set-up.  We use the term “expert” because the people who you will work with during this process are seasoned, experienced physician schedulers.  Although they are experts in Call Scheduler, they are also experts in creating fair, balanced, even schedules for physicians.  When you are transitioning your on-call and office scheduling process from paper or Excel to software such as Call Scheduler you need someone who knows a lot more about scheduling than they do about the software.  We have spent a ton of time and money making the software easy to set-up and use.  What take the most time and is most complicated is helping the customer manage the transition. 
  2. Transitioning from manually scheduling your physicians to rule based automated placement is an iterative process. Iteration is the act of repeating a process to generate a sequence of outcomes, with the aim of a desired goal or targeted result in our case.  The main objective is to bring the desired result closer to discovery with each repetition (iteration).  Configuring rules and understanding the impact of each rule, how new rules interact with the other rules, along with other limits and restrictions such as skills, teams and physician’s day’s off, not to mention countless assignments, there are a lot of moving parts to work through.  This is one of the most important areas to remain persistent.   It’s also one of the top areas in which we tend to find customers go from excitement to frustration.  Amy Engebretson, VP of Training and Support has termed this stage “the dip”.  Check out a previous blog post by Amy "Are you Stuck in the Dip"


Figure 1:  From “Customer Success” by Mehta, Steinman and Murphy

As you can see in Figure1:  which was taken from the 2016 book “Customer Success” by Nick Mehta, Dan Steinman and Lincoln Murphy, when a customer decides to purchase software they are excited and most can’t wait to get started.  Then they begin the process of getting the work done and iterating to get their desired results.  This often takes the customer down into the “dip”.  As you can see by the image, the dip is temporary and most people, through work and persistence, make it out of the dip and begin seeing the light at the end of the tunnel. 

  1. The third way that we try to make our customers Wildly Successful is by taking the time after we have worked out all the kinks in the new process to document the new process. Scheduling physicians for office assessments as well as on-call and vacations is not something that is done every day.  In fact, most of our customers create schedules quarterly, semi-annually or annually.  Because of this, it’s not uncommon that someone may need a little refresher before they begin to create their next schedule.  Our customers feel confident because they have a document that they can refer to that will remind them of the steps they need to take to create the schedule.  Please note this has nothing to do with the Call Scheduler software.  It has to do with the order in which things are done.  For example, choosing who works holidays is done first, not last.  Processing vacations and other day-off requests happened before you begin auto-scheduling, not after.
  2. The final way we help our customers become and stay “wildly successful” is via our Customer Success Manager. This position at Call Scheduler is to relentlessly monitor and manage each of our customers health.  It’s our job to work with you on a constant basis to be sure we understand what success means and looks like to each of our customers.  We need to know how our customers will declare victory.  Once we understand this, we can be of assistance.  Our Success Managers also know that our customers targets move constantly as their practices change, this is why our we’re relentless in our pursuit to help.

Persistence is the key to success in scheduling physicians for work and on-call using software such as Call Scheduler.  Customers need to be persistent in their journey to achieve value and our team needs to be persistent in helping them achieve the value they expect and need. 

Key Takeaway:  Nothing happens overnight, it’s an iterative process, but one that is well worth the time and effort.  You will get out of physician scheduling software what you put into it.

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Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Went to Medical School to Create On-Call Schedules, Eh?

Posted by Justin Wampach on Fri, Apr 07, 2017 @ 02:10 PM

ID-10084441.jpgI am not a physician, but when I think about all the reasons that someone may decide to become a physician, you think of the basics, like, I wanted to help people, and make a difference in their lives; I was inspired by the challenge of diagnosing and fighting disease; I came from a medical family and had seen firsthand how satisfied my parents were with their careers.  All that makes perfect sense.  What I have never heard is that I became a physician so that I could practice less medicine, see fewer patients and do more administrative work.  According to many studies, the increasing amount of administrative work has become one of the top surveyed reasons that physicians are dissatisfied with their job.  I have spoken with thousands of physicians in my time at Call Scheduler, I have never had one doctor tell me that he/she went to medical school so that they could learn how to effectively schedule their peers.  In fact, it’s often referred to as one of the things they dread the most.

This post is about one way that certain physicians can offload one of the nastiest administrative tasks, creating the on-call schedule for them and their partners.  When we started Call Scheduler many years ago, Patrick Zook, M.D. and myself set forth on a journey to assist in solving some of the complex administrative tasks in medicine, in fact that was our first tag line.  Our idea, in which many other companies have followed, was to create software that could assist a physician in creating, maintaining and communicating the on-call schedule for the group.  What we failed to realize is that although software is a great tool, it is not the true solution to the problem.  

Let me illustrate with an example.  I love dogs.  I hate cleaning up dog poop.  I hate it because it makes me gag and sometimes even throw-up.  Several years ago, I found a “tool” at the big-box pet store in my community that is designed to help you clean up dog poop.   You may have seen one of the devices that they sell today to help you so that you don’t have to touch the poop, instead they offer a small rake and a dust-pan like thing to collect it, and then you throw it away.   When I first saw this I was really excited.  I thought, this is a great idea.  I purchased one right away.  It was much better than my current method.  But it didn’t take long before I realized that I was still picking up dog poop.  Regardless of how cool my new tool was, I was still doing the crappy job.  Then I learned about a young guy in my community that had started a business that cleaned up the dog poop in people’s yards for a small weekly fee.  I think it was $10 per week, per dog.   I really thought the idea was brilliant, mainly because it solved my problem of having to clean up the waste.  I quickly realized that the first tool I purchased, although cool in concept, still required that I do the work.  Contracting with a guy to do the work for a small monthly fee made all the difference in the world.  My problem was solved.  Now no matter how many dogs I choose to have, I can have my preverbal cake and eat it too.

The concept is the same for physician scheduling.  If you are a physician spending time at night or on the weekends to create, manage and communicate the on-call schedule for you and your partners you have a task that you hate to do.  Buying software, like Call Scheduler can help you make that crappy job better, but you still must do the work.  But outsourcing that work, or contracting with a qualified professional to do the work allows you to manage the process, but not have to get your hands dirty.  That truly solves the problem once and for all. 

If you are a physician who has the pleasure of creating the on-call schedule for your partners you may want to strongly consider skipping the software and going right to outsourcing the work to someone who has decided to make that their business. 

Key Takeaway:  sometimes you need more than a pooper scooper to solve your problem.  Sometimes you need someone else to just clean up your poop so you don’t have to.

For more reading about this topic check out my post about "How to Give Away A Skunk".

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Why is Your Physician On-Call Scheduler Resistant to Software?

Posted by Justin Wampach on Thu, Mar 23, 2017 @ 07:01 AM

ID-100360901.jpgJust yesterday we spoke with an Anesthesiologist who called to tell us that despite how great our “free software trial” worked for her and her partners, the administrative person who creates, changes and communicates the physician on-call schedule didn’t want to change their current process and wasn’t interested in using software.    The doctor seemed bummed and told us that she would try again and would talk to us later.

This lead me to ponder why someone would not want to change from the “old” way of creating the on-call schedule to using software.  In a previous blog post I wrote “Who are You Buying the On-call Software for” we discuss who the main benefactors are when you make the transition to physician scheduling software.  Many times, the person who benefits most from something is not the user, but the organization or the mission.

Consider this, if five years ago, you would have surveyed physicians and asked them if they wanted to switch from their existing “medical record” to an “electronic medical record (EMR)” I would be willing to bet you that the clear majority would have said “NO”.  Why, because it was not sold as a direct benefit to them, it’s perceived as more work.   If you took a different approach and explained to the same group of physicians that by switching to EMR it would dramatically benefit the patient by having immediate access to accurate medical information, and the medical research community by being able to aggregate population data to look for health trends, I think many physicians would have seen the value for their patients and would have been more open to the discussion.  My point is that value comes in different forms for different people.  Not everyone has to benefit in-order-for value to be perceived and or delivered.

Back to how this impacts the physician work and on-call schedule.  If you ask your oncall scheduler if they want to ditch their current comfortable process, the one that they have been doing for years, and switch to something that they need to learn, and initially needs to be configured, and tuned to meet a groups specific needs, I think it’s safe to assume that most would politely say, no thank you.  I mean who wants to do more work that doesn’t directly benefit them?  I’ll tell you who, a great team member/employee/administrator this supports the mission of the organization and wants their organization to be the best it can be, that’s who.

Here are a few tips on how to build a case for logically convincing the “scheduler” to consider software for scheduling physicians for on-call and work assignments.

  • What’s in it for them? I would start here, most people need to wrap their head around what’s in it for them, before they care about others.  Here are just a few carrots to use when talking to your scheduler about what’s in it for them:
    • Automation to assist them in creating the schedule. Usually saves a significant amount of time.  70%, 80%, 90%.
    • Auto generated reports. No more “counting” each time you assign a provider or make a change to the schedule.
    • Process documentation. Although all of us want to feel needed and wanted, most physician schedule processes are undocumented.  That means if your scheduler is sick or injured, creating the next schedule would be a nightmare. 
    • Step-by-step process notes. Most schedulers do not “schedule” every day, which can mean that the process is different each time, which means that results are not consistent.  Written documented process can help ensure that you do things the same way each time.
    • Online
    • Auto-backups
  • Remind them who the intended primary and secondary beneficiary are of the new software. Primary is the physician, secondary is the patient.
  • Remind them that it takes time to learn and adjust to new things. But the just the few benefits that I outlined above would offer a lot of value to the “scheduler” in time savings and convenience.
  • Remember the mission. We (you as a clinic or medical practice) exist to provide our patients with the best medical care possible.  In order to do this, we must balance, preserve and accurately schedule our physicians to best meet the needs of our patients and community.

Why is your physician on-call scheduler resistant to change to on-call software?  My guess is that it wasn’t presented to them properly to show the value.  Medical people are special, once they see how things tie back to patient care, people jump onboard quickly. 
Keep trying!   

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You’re the New On-Call Scheduler, Now What?

Posted by Justin Wampach on Fri, Mar 10, 2017 @ 02:46 PM

ID-100362465.jpgYou 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

  1. How has it been created in the past?
  2. How have the holidays been determined?
  3. How do physicians submit vacation and other day-off requests?
  4. Who approves and denies vacation and other day-off requests?
  5. How far in advance is the schedule created? And why?
  6. Are there rules that govern how the schedule is created?
  7. Are the rules fair and do they have some logical basis?
  8. What are the top 3 issues with the current “scheduling” process?
  9. Is the physician schedule considered “fair” by the doctors?
  10. How is the on-call schedule communicated to the doctors? How about to the answering service or the hospital ED?
  11. 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

  1. Considering what you learned during the step 1 review process, is there anything that needs further review or modification?
  2. 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.
  3. 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

  1. 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".

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