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

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Waiting for the perfect doctor scheduling software solution?


AnneIndecisiveLet me tell you a story about a Cardiology group on the east coast.  Back in 2004 they contacted Adjuvant looking for a call scheduling software for their 21 Cardiologists.  We did a full dog-and-pony show to illustrate how useful our software or any call scheduling software could be to help them create, maintain and publish the schedule. With 21 providers assuming 5-7 jobs (both call and work), the person creating, maintaining and publishing this call schedule would be spending on average 46 hours every 6 months or 92 hours per year.  The group made no decision in 2004.

In 2005 they came back and asked for another software demo, in addition asking for references.  They spend another 92 hours that year and did not make a decision. 

In 2006 if you can believe it, they called back as well as in 2007, 2008 and 2009.  Each year still not making a decision, and yet spending another 92 hours creating, maintaining and publishing the call schedule.  At this time I was certain that they had chosen another solution, which although is not good for my company, is good for the group and hopefully they were saving time and money.  Nope!

In late 2010 I received another call asking to go through the same process.  I was not even sure what to say.  With a smile on my face I agreed to take them through the entire process from the beginning only to have them give us another lame excuse as to why they did not want to get help.

In the past 7 years the scheduler would have spent approximately 644 hours or approximately $19,000, and were not satisfied with the results.  What were they waiting for?

The only thing I can think of is that this cardiology group is waiting for the perfect doctor scheduling software.  What would have been perfect in their eyes was full automation at no cost.  Let me tell you a little secret...IT DOSENT EXIST!  While waiting for perfection this group has missed out on automated tally reports, rules, scheduling engines, vacation and time off request areas, easy swaps, and the doctors having the ability to see their schedule on their smart phone.  This has lead to the wrong doctor getting called in this group and I’m certain that there has been physician dissatisfaction regarding this issue.

The long and the short of my point is that a good plan executed today is better than a great plan tomorrow, because tomorrow may never come.  Take advantage of the tools that exist today and trust the people who are trying to help you.

P.S.  Any comments or suggestions on what I should say to this group when they come back in 2012?

Can you view your on call schedule on your phone?


feature smart phoneIs my phone smarter than yours?  It might be depending on what you’re using.  My current cell phone is a Motorola Droid 2 running the Google Android operating system.  I have been using phones like this for about the past 5-6 years when the first Palm phones came out.  Although I would be considered an early adopter, I immediately found value in having access to my email, calendar and the Internet on my phone.  And for around $200 investment up-front and $100 per month I think it is worth every penny.  It costs me about $3.29 per day for "access", by access I mean access to the world through the Internet.

In 2011 having an iPhone or Android phone is like having a Facebook page.  I am not here to convince you to buy one (or to use Facebook), if you don't see the value or understand why people use them, the chance of you reading this blog are almost zero.  "27% of 5.3 billion cell phone users have a smart phone" according to the International Telecommunications Union. 

Over 300,000 mobile apps have been developed in three years. Apps have been downloaded 10.9 billion times with demand expected to continue to rise.  While most downloaded apps are only used a few times, the quality of the apps is beginning to grow, especially in the field of medicine.

Here is a list of the top 5 medical apps that are available for Android and iPhone.

  1. Medscape:  7,000+ drug references, 3,500+ disease clinical references, 2,500+ clinical images and procedure videos, robust drug interaction tool checker, CME activities, and more.
  2. Epocrates:  essential drug reference tool.
  3. Skyscape :  offers health care professionals and students access to a robust selection of medical calculators (Archimedes), periodically updated medical news alerts, select practice guidelines, access to paid textbooks (like Netter‘s), and solid drug reference (RxDrugs) and disease monographs (Outlines in Clinical Medicine).
  4.  Evernote:  allows you to access and read your PDF documents on the go.  Other tools, such as notes and image capture allow you to record atypical disease pathology encountered while practicing for your own reference — possibly even a future presentation.
  5. Calculate:  The collection of medical calculators

I would be remised if I didn't mention that one of the coolest features for our customers that use Call Scheduler Lite or Call Scheduler Classic, is that via an "iCal" link you can have a live feed of your on-call schedule in your smart phones calendar.  When the schedule at the office changes your phone will automatically update with the current information.

Ask not what you WISH your on-call software could do for you...


But what you're on-call software can do for you. 

doctor scheduling software expectationsAfter years of showing prospects demonstrations of our call scheduling software I have come to realize that there are two types of people; the ones who see what software can't do for them and the ones who see what it can do. 

When was the last time that you were shopping for a car and you asked the salesperson "why can't I stand up and drive this car?  I can do it when I'm on my peddle bike"?  Or have you been to Sears or Home Depot lately and asked the person selling washing machines why can’t the machine hang my clothes outside when it's nice, but dry them when it's cloudy?  I can do that today when I do my laundry.

Ok, so these may be extreme examples, but my point is that the old way and the new way are never the same.  If they were, there would not be a need for a new way.  When you are implementing new software, whether it is doctor scheduling software or word processing software; there will be things that are different.  You will have to change how you do some things on order to benefit from others. 

The users that benefit the most from any software implementation are the ones who will objectively look at all of the features that the software has to offer and figure out how to use as many as possible to achieve the most value, even if it means making some changes.

If I could give you one piece of advice that will help you have a positive experience every time you buy software is to have realistic expectations regarding what it will do and how it will do it.  Please note that most web-based SAS software was intentionally designed to solve a single problem.  For example, if you purchase doctor scheduling software and down the road get frustrated that it does not track shift hours that can be integrated into a payroll system you need to remember that it was not designed to do that.

One of the things that Adjuvant is trying to do when we welcome a new customer is to ask the new scheduler/customer to fill-out a brief form letting us know what their expectations are as a scheduler and what their Doctors expectations are for the software.  This is a way for our training staff to be sure that we meet the customers’ expectations; also we can be sure that the sales department did not accidently mis-communicate what the software can do.

You're managing my on-call schedule with a 3-ring-binder?


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Out of date hospitals manage on-call for the Doctors with binders whereas modern hospitals mange on-call for their Doctors customers using technology.

If you are a specialty provider such as a Cardiologist or OB/GYN Doctor, what type of service do your patients receive at 3:00am when they present in the ED?  How important is this to you?  This will depend on the type of Hospital that you affiliate with. 

What I have found is that US Hospitals that have not improved the process of managing on-call for their specialty physicians in the ED are doing a disservice to their specialty provider’s customers. 

Are you aware that every hospital ED, Telecom Department and Medical Staff Office that I have spoken with over the past 5 years still manages the on-call information with a 3-ring-binder?  Yes, a plastic $.90 binder.  To further explain this, when your office call schedule creator completes the call-schedule they will mail, fax or email a paper copy of the schedule over to the hospital.  This document will be 3-hole-punched and placed in a 3-ring plastic binder along with every other specialty in your medical community (usually15-20 schedules).  Someone’s job-duty at the hospital will be to manually transpose the information from your and other schedules in the binder and create a "daily call sheet" usually in Excel.  This is then faxed or delivered to critical areas of the hospital and medical community. 

25 years ago when physicians were on-call to build their practice and patient base, this worked well.  Doctors considered on-call as part of their medical community obligations.  Swaps were few and far between and Doctors helped each other out and were happy to communicate changes to the hospital.

Don't get me wrong; in 2011 Doctors still help each other out, but make no mistake that on-call is no longer desirable in helping a physician build his or her practice.  Now days most late night ER calls for a general surgeon will be stitching up a drunk-persons face that does not have insurance.  Not only will they not follow-up with the Surgeon at their office in 3 weeks to get there stitches out, but they will not pay for their ER visit.  This is a loose/loose for the Doctor.  This is a contributing factor for providers not wanting to be on-call.  This is also why many do everything they can to get out of call or try to pawn off the patient onto another service so they do not have to come in.

Although being on-call is not desirable, it is necessary for the community and part of most contracts physicians have with the hospitals that give them privileges.  With that said, how do you make the best of a rotten situation?  Remember that not all people who present in the ED are like the case I described above.  Many of them will be productive members of our community.  What type of service do they deserve?

In my opinion, they deserve the same level of service that I provide my customers, the best possible. The same level of service that you as a health care provider demand from your insurance agent, legal firm, cleaning company and other service providers, the best.

When was the last time that you went to visit your accountant during tax time and the front desk worker had to sift through a 3-ring binder to find out who you were there to see?  And what if it took then 30 minutes to figure that out?  Thank god it's not an emergency right?  That would seem ludicrous in 2011 with the type of technology available today.  How can your customers be getting the best service if the front line does not have access to accurate information.  The answer is, there not.

As a specialty physician you need to demand that your Hospital has an up-to-date on-call management system, to be sure that your customers are helped as efficiently and effectively as possible, every time. 

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