Creating a Fair Call Schedule Begins with a Policy

When On Call policies are under review, here are some issues to consider

Belonging to a group medical practice has many advantages such as one physician not having to manage and regulate the office, the schedule, and the employees. Instead, everyone helps out and shares responsibilities, including on-call duties. The practice can set up a schedule so that providers have the ability to take a personal vacation or CME days and also have more flexible time for family or business affairs.

However, differing expectations can mar the working experience. How can you avoid conflicts?

Creating a Fair Call Schedule Begins with a Policy
To avoid conflicts between partners, Group physicians must have a strong business arrangement in place that includes defining policies that will affect the management of the on-call schedule: how it is created, maintained, and published, various issues regarding how it is structured, and who will be involved in the approval/denial of various Provider Requests.

On-Call Scheduling Policy Issues to Consider

Holiday Policies

    • What are your Primary Holidays? How about handling secondary Holidays?
    • Are Holidays scheduled differently in general?
    • Who decides the Holiday coverage rotation year to year?

Day Off Type Policies

    • How do you collect and document your Day-off Requests?
    • How will they be approved? First-in/ first-out? By seniority? By random draw? Settings.
    • How many Providers are allowed OFF on any day (cannot take the call)
    • How far out do you schedule OFF information in advance?
    • Do you schedule Call first and take vacation requests after it is done, okaying vacation around Call already in place?

Swap Policies

    • How do you collect and document your Job-Swap requests?
    • Do both swap-parties need to “okay” the swap before it is approved?

Weekend Policies

    • Do you schedule weekends out further than weekdays?
    • Is there always a minimum number of Fridays (weekends) OFF after doing a weekend of call?
    • Are there any “If Friday then not previous Monday” rules

Length of Schedule Rotation, Spread, and Tally Policies

    • How many weeks do you schedule at a time? Be sure to consider the number of Providers you are scheduling so your expected tally is mathematically reasonable for the period of time you have in mind.
        • Example: A tally of 27 weeks for 9 providers instead of 6 months will give better results.
    • Do your On-Call tallies have to be equal for everyone on weekends? Does this include part-timers? How about the total tallies (weekdays plus weekends)?
    • How are weekends scheduled? For example, are weekends always Fri/Sat/Sunday for everyone? If not, why not?
    • Are there any part-time or pre-scheduled patterns for an individual provider? Ex. Dr. Smith always takes a call every third
    • Wednesday unless on a vacation.
    • Are Templates for weekends okay? Are Templates okay for any part of the schedule?

A simple worksheet may assist in documenting the discussion about the changes your group is considering. Be sure to look into why the change is desired so the On-Call schedule addresses multiple points of view.

TODAY it is… WISH it was … Why?
1. 1. 1.
2. 2. 2.
3. 3. 3.

Key Takeaway: The advantages of belonging to an on-call scheduling group are optimized when a defined fair Call Schedule Policy is part of the formal business arrangement. This list helps identify some issues to consider.


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