How To Share On-Call with Another Group & Avoid Hassles

6 potential trouble spots to monitor when sharing on-call coverage with another Clinic.

With the changing dynamics in the composition of physician groups and increasing Providers’ expectations for life/work balance, it is has become more common to share the on-call duty with another compatible Clinic or Group. In well-run groups, there is a shared culture that resonates with the Partner-Group. However, even the best situations can have simmering coverage disputes and sore spots. Here are a few things for the Scheduler in charge of the shared On-Call calendar to look out for.

Shared on-call Coverage Problems:

  1. The schedule that the Other Group hands to you reflecting their share of coverage isn’t exactly what they “told” you, it would be. Now you have duplicate coverage or “holes” in call coverage because the dates you-all supposedly agreed on are not exactly the same.
  2. The Other Group is supposed to cover a certain percentage of calls, but you suspect they are NOT. Everyone is feeling put out. How can you prove or disprove if each Group is pulling its fair share?
  3. The Other Group adds or loses a Provider and weekends are already particularly contentious. The Shared On-Call schedule has a meticulous plan for weekend coverage that does not conveniently repeat in six months. How long will it take to re-jigger the shared-call pattern between the two Groups so each party is again represented fairly?
  4. Your docs want to know who is on-call from either Group in a convenient way. They don’t want to bother calling the ED or the Other Clinic, so you usually keep a printed copy of the Other Group’s most available current schedule. But what your Providers really need is a simple, reliable way to have accurate information regarding the unified schedule… ideally “in their pocket”, on their Smartphone.
  5. The Other Group changes their schedule and informs the ED, but doesn’t tell you, so your copy is always out of date. Your docs are not directly affected unless they want a consult and (embarrassingly) call the wrong person from the Other Group.
  6. One of your physician’s assignments got accidentally changed and the wrong provider got called. Now what? Both Group-schedulers have access to the same online calendar because it was cheaper and easier that way (a la: Google calendars). How can you have a shared schedule that the Other Group cannot mess up?

Shared Group on-call, Shared Solutions

I believe the first step in solving many of these problems is to have both Groups using the same physician call scheduling software. Simply put, paper or Word, or Excel were not designed to build medical on-call schedules. Those methods do not track tallies, allow for rules (and their exceptions), nor provider requests. And if a shared document IS put online, you are still spending time making a format do something it simply was not designed to do.

The larger the group, the more fallible a manual system becomes. Add consideration of the foibles of Shared on-call Group scheduling, and… well I think you can see where that will go.

There is no magic formula that will solve ALL call problems; it’s really up to the Groups to resolve their own problems through negotiation and goodwill. Once the dust is settled, and a written on-call policy is in place, physician scheduling software can maximize the benefits of sharing the workload and coverage schedule with another local Group.

Using online physician scheduling software to start your scheduling, you can put in the percent “load” for each Group that has determined to be fair during your joint Partner-Group meetings. Let the software turn out a scheduling “template” for each party to fill with the appropriate individual Provider from each particular Group. Such a “template” can be viewed online for easy reference, or exported for each Group to fill with their portion with their own individual Providers. Once the schedules are filled (whether manual or imported), the unified Call schedule calendars can be viewed online by authorized persons such as staff, providers, and the ED at the hospital. Updates are available to all parties whenever they are needed.

Don’t want the “Other Groups” Providers listed directly on your calendar? If you are both using TigerSchedule, have them populate their own calendar according to your shared template, and the software will automatically merge your two calendars together. The resulting merged-view schedule will accurately reflect the exact Provider on-call coverage from each Group while maintaining only authorized access to each of the individual schedules for changes and requests. No more surprise changes!

What if the Other Group is not using the same online software you are? Export a “sign-up” sheet for the Other Group to use. They can fill their spots and the form can be imported to automatically fill the Other Group’s shifts with their appropriate providers directly into your schedule.

Sharing on-call responsibilities in this manner not only helps with Providers’ satisfaction and sense of fairness but helps with EMTALA compliance as to which individual physician is on-call from each Group, rather than vaguely listing “Other Group” and a generic phone number on your schedule.

BONUS: With online schedules, the providers can have accurate schedules “in their pocket” (Smartphone) and authorized personnel can view the schedules without you having to update everyone each time, including the ED.

Key Takeaway:

Prevent disputes and improve EMTALA compliance when sharing on-call providers with another Group by using online, shared merged-views of the Call schedules. Let call scheduling software generate a fair “template” for each party to fill with Providers from each Group.

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