When best-intentioned providers try to come up with scheduling methods to meet their needs, but they cannot (or will not) change those ideas when confronted with the reality of generating a repeatable schedule… you can be sure the scheduler will hear about someone “gaming the system”, favoritism or other grumblings regarding perceived unfairness.
Fairness is in the eye of the beholder. It is therefore likely that when confronted with a problem, providers have the tendency to evaluate those situations as “fair” that happen to benefit themselves… it’s human nature.
Tally ‘em up! Three expectations make it difficult for software to help you create a “fair” on-call schedule.
Do these issues sound familiar to you? If so, your internal processes and or rules may be keeping your group from benefiting from using scheduling software efficiently.
The scheduler used in these example conversations is a physician, but in many cases, the scheduler may be an assistant who has even less authorization to question the process or consider any type of change.
Physician Scheduler: It’s not fair! He has more Thursdays than me! He automatically gets a three-day weekend as a consequence of that! That’s not fair!
Trainer: So, how about scheduling Fridays, Saturdays, and Sundays first? That way everyone will have the same amount of calls on the weekends, and therefore the same number of three-day weekend opportunities?
Physician Scheduler: Because we always schedule Thursdays first. That’s our process.
Trainer thinking “Huh . . .”
Suggestion: Scheduling some jobs in a slightly different order may give better results.
Physician Scheduler: It’s not fair! I have more Saturdays than he does!
Trainer: What date-range are you using for tallies?
Physician Scheduler: Just this month.
Trainer: Is anyone on vacation?
Physician Scheduler: He is.
Trainer: How do the tallies look over a 3 month period of time? Do things even out when there is time to “catch up” when someone is gone?
Physician Scheduler: That doesn’t matter. Each month has to balance individually. If there is a fraction, we use a pay-back method. That’s the way we’ve always done it and it’s what they expect. This tally is not fair!
Trainer thinking “Um . . .?”
Suggestion: Agree on a date-range everyone will use as a “target” and make sure it’s long enough for all providers to serve at least 2 weekends. A longer time-frame generally allows for a better spread of assignments throughout the year.
Physician Scheduler: It’s not fair! He always gets the weekends he wants for a call! He’s never available to spread things evenly between us!
Trainer: Do you have a method of allowing Providers to ask off or volunteer for certain weekends?
Physician Scheduler: Well, yes.
Trainer: Is it first come, first serve, or “random draw” at a certain date? Or maybe they are processed by seniority?
Physician Scheduler: Well, it’s “first come, first serve”. But he always puts his stuff in the way before all of us.
Trainer: Do you all have the same opportunity to submit your stuff? Is there any limit on how many can be gone on a day, or how far in advance they can make requests?
Physician Scheduler: No, you don’t understand. We don’t want to limit our staff! We can submit our stuff at any time, right up to a week before the calendar is due out. We want to be as flexible as possible so they will be happy.
Trainer: So, the Provider is using the system to get his stuff in the right way so when it is approved, he can plan his weekends well in advance. Why don’t the rest of you do the same thing? Have you considered limits on how many “off” requests will be accepted on any day or perhaps schedule far enough out so Providers can swap if they need a weekend off?
Scheduler: No. That is not our process. We need to be as flexible as possible, so we don’t want to schedule calls for more than a month or two. We don’t want to get into pay-back situations with swaps. But what he is doing isn’t fair!
Trainer thinking “So when the process is used, it isn’t perceived as fair?”
Suggestion: Once a process is in place, reward those who use it well and as intended. “Catch” them doing “good”, and the behavior will most likely increase. Keep enabling “undesirable” behavior and you will continue to have it occur.
When internal processes conflict with your scheduling expectations, something has to give! Usually, updating your scheduling process will open opportunities to get your schedule “done right” but only if everyone perceives the new process as fair, abides by it, and rewards those who use it consistently.
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