Better Hospital On-Call Scheduling Begins with a Sound Policy

Administrative staff working in hospitals with on-call physicians know the challenges of arranging on-call coverage all too well. Patient demand is already high; even if you're using the most advanced hospital on-call scheduling software, you never seem to have enough physicians. And that isn’t expected to change anytime soon. 

• According to the Association of American Medical Colleges, the U.S. could see a shortage of 54,100 to 139,000 physicians by 2033, spanning both primary and specialty care fields. This shortage is expected to lead to delays in access to primary care, putting additional strain on emergency departments (EDs) — a care setting that depends heavily on on-call physicians. 
• Meanwhile, urgent care centers have been growing in popularity at roughly 7% per year. The aforementioned physician shortage, however, will likely decrease the effectiveness of urgent care centers to meet the needs of their communities. 
• By 2034, the U.S. population is expected to grow by 10% with more than 42% of the population being aged 65 and above — a demographic “sweet spot” for EDs.

Work Smarter, Not Harder

In working with over 1,000 hospital-based physician groups throughout my 20-year career developing hospital on-call scheduling software, I’ve had the opportunity to meet a lot of healthcare professionals, including many administrators and others in charge of physician scheduling. And some feel downright helpless about the aging patient population, the physician “retirement cliff,” and the limited number of physicians entering the profession. 

But I’ve also been impressed by some pretty forward-thinking hospitals who are finding ways to work smarter, not harder in achieving their “no-patient-waiting” approach. In particular, those who leverage on-call physician scheduling software to effectively balance demand and available resources appear to be gaining a significant competitive edge.

But all that starts with having a solid on-call strategy in place. So, in part 1 of this blog series, I’d like to share a few observations I’ve gathered over the years.

Start with Policy

As with most administrative processes and procedures, consistent on-call scheduling is built on a foundation of sound organizational policy. While those at the top of the org chart must lead the charge, administrative staff are responsible for operationalizing that policy and therefore have a valuable role to play. 

Wherever you find yourself within the organization, use this checklist to ensure your hospital on-call scheduling strategy is comprehensive, has high predictability, and ensures patient safety.   

• Outline the core and ancillary obligations of medical staff to participate in on-call duties.
• Explain the criteria and process for obtaining exemptions.
• Specify under which circumstances (if any) non-physician practitioners can respond to calls. 
• Provide guidance regarding whether simultaneous on-call is permitted and, if so, under what circumstances. 
• Establish processes to ensure contact information is updated regularly.
• Set expectations for the timeframe by which an on-call shift is scheduled or changed. 
• Specify the length of time for which each physician’s physical presence is required.
• Outline consequences should a physician not fulfill their responsibilities or violate the policy.
• Ensure your scheduling software helps you meet all your compliance and reporting requirements. 
• Make sure all stakeholders have access to your policy through a mobile device.

As you introduce or update your existing policy, remember that change can be difficult, especially for physicians already well established in their careers. If you find yourself updating your hospital's on-call policy, remember to convey that this is just a natural part of ensuring your business runs as smoothly as possible.

Learn More

This blog includes excerpts from our recently published e-book, 5 Tips for Meeting On-Call Physician Demand. In it, you’ll find best practices informed by healthcare professionals from across the U.S. for maximizing today’s advanced on-demand scheduling software and developing a strategy that works best for your practice and market.

Future posts in this blog series will help you think differently about:

• The importance of flexibility in physician scheduling
• How to improve transparency with scheduling changes
• Ensuring that your approach to scheduling is equitable and fair
• How to reduce manual processes so you can focus more on your patients

*Brad Goldsmith is a serial entrepreneur and the CEO of MDsyncNET. He has more than 20 years of experience helping hospitals achieve their no-patient-waiting goals.