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

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What happens when one Doctor holds all of the provider scheduling knowledge?

  
  
  
In many provider owned medical practices it is not uncommon to see a senior physician creating and maintaining the provider on-call schedule by hand or using Excel.  It has been their pro-bono contribution to the practice for years.  With the baby boomers getting closer to retirement age, it may not be as easy as it was in the past to find the “kind hearted” doctor to take over this colossal task.  The new “generation X” Doctors are going to want to know what’s in it for them.  Not only will making the transition from one person to another difficult, but the larger question should be “is it beneficial for the group to have all of this information in a person’s head?”  We talk to medical practices almost daily who think the answer to this question should be NO.
 
Hazards
 
Here are a few things that you need to be aware of that comes along having the same provider create the schedule by hand.
  • There is a misconception that there is only one way of doing things, the current scheduler’s way.
  • The schedule can be seen as unfair if you are not as close to the scheduler as others.
  • Scheduling nights, weekends and holidays is a lot of power for one person to have.
  • Too much of the important information, namely rules, are contained in someone’s head.
  • There is a lack of documentation of the current process.
  • Lack of a back-up process.
  • Historical data may not be present or accurate.
 
Person –vs- Process
According to Wikipedia, Process describes “the act of taking something through an established and usually set of routine procedures to convert it from one form to another”.  For example, milk into cheese or processing provider requests and schedule history to create an on call schedule.  Typically when using a process you are able to predict the results.  With a person, you are not.  An example of this would be if you have a provider that has been creating the call schedule for years and suddenly a new person steps in while the original person is on an extended leave.  I will guarantee you that the new person will hear “…well that’s not the way so and so did it”.  It is very difficult to produce consistent results by chance.  We also observe prospect schedulers being challenged with honoring the groups scheduling policies via “rules”.  We see this clearly when people send us a copy of their current schedule accompanied by a list of their rules or policies.  80% of the time the rules are violated and we find out they are really strong preferences.  We also observe, mainly from physician schedulers, that if there is a discrepancy or hole in the schedule, they will often sacrifice themselves to work extra days as opposed to upsetting the apple cart. 
 
The not-so new way
Back in 1999 I saw my first ever computer based on-call scheduling system.  Granted it was DOS based, but it did the job.  Today, web-based on-call scheduling programs exist with the intent of solving the problem of having one person hold all of this important knowledge.  Outsource the knowledge to a database and you will quickly realize the benefits.
  • According to a 2006 article in Physicians Practice Magazine by Pamela Moore, PhD, there are approximately 5 “call models”, call scheduling software can run scenarios to show you the differences?
  • Let the software choose the best candidate to work, based on your groups rules and policies.
  • Prove fairness and transparency with automated tally reports.
  • The good call-scheduling companies will document and print out your unique process for you to use and keep.
  • Historical data such as provider requests and holiday history are archived indefinitely and available at your fingertips.
Software is the answer to solving the problem of having all of the on-call information trapped in someone’s head. Making the transition takes time and a willingness to change, but it’s worth it.
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