It’s 9 PM, my phone rings. Instinctively, I pick it up. The nurse practitioner from the ER starts asking me about a patient with right lower quadrant abdominal pain. There is only one problem. I am not on call. I switched my call day with Dr. King. I don’t know this patient, but even if I did, the on-call surgeon’s job is to manage it. Ironically, I still answered because that is what we are trained to do. Pick up the phone.
But here is what no one tells you in residency. Being reachable and being available are not necessarily the same thing. One means your phone works; the other means you are the physician who is actually supposed to be taking this call. Too often in my career, I found out the hard way. Even this far into my practice, I still get roped in. A schedule can say one thing, and reality can say another, and the gap between them lands on whoever picks up that phone. Today, it just happened to be me.
Welcome back. I am Dr. Kevin Halow, cofounder and Chief Medical Officer of Clinician Core. Today I want to talk to you about something we all know too well. The call schedule. But today I want to focus on the difference between a static schedule and a smart schedule, and why the former fuels burnout and the latter relieves it.
Unfortunately, we have all been there and know too well. That if you are fresh out of training, you are the most likely person in your group to get a misrouted call. It is not because anyone is targeting you. Maybe it is just because they want to give you a sympathy consult. But really, more likely, you are new to the rotation, you do not have the standing to question a schedule, and you have not built the workarounds that senior partners have developed over the years.
Physician work weeks are running pretty close to 58 hours on average. And a meaningful chunk of that is pure administrative drag. A late night call for coverage that isn’t yours is not just annoying. It is a withdrawal from an account that is already overdrawn. You are tired, but now you cannot go back to sleep. It is an energy drain that just burns you out.
When it happens to you, it is not a sign you are bad at managing call. If your group’s routing runs off a static list, a swap that you made yesterday might not register in the system until the call schedule coordinator processes it. Who knows when that might be. You did nothing wrong. The schedule was just behind reality once again. A static scheduling system does not ask questions. It simply lists who the person is to contact. Whether that is right or wrong does not matter to that system. It is just a name on a calendar day that fills the checkbox.
On the other hand, a schedule aware system asks questions. For example, who is actually on call right now for this coverage area at this moment. The difference between those two systems is the difference between another night of harassment and a good night sleep.
So ask your practice manager this. Today, not after it costs you another bad night. When I swap a call with a colleague, how fast does that change actually show up on our static call schedule. What happens if the person who is supposed to make that change is out of the office or not available. How do I know that the change has been made. If the answer is that the change is not automatic and instantaneous, then that just represents another phone call that will go to the wrong person at the wrong time, and that includes you.
If you want to know the real energy drain of a static call schedule, try this exercise. First, go back and confirm all of your scheduled days on the call schedule. Including those swaps that you have made, and see how long it takes you to jump through all of those hoops. Next, make a mental note of how much time it takes you to recheck and reconfirm the call schedule weekly. Especially when you make a last minute swap. Then, think about how many times the wrong call went to you. Does your static call schedule scheduling system really work, or is it hit and miss. How often does your static schedule get the call schedule wrong. Finally, add it all up and track the pattern. If you are catching coverage that isn’t yours more than once, that is not noise. That is a signal worth naming out loud to your group and to your practice manager.
The difference between reachable and available all depends upon a name, on a date, on a calendar. However, that difference also defines a very important boundary that marks an enjoyable practice from an unpleasant one. Enjoyable practices are sustainable for an entire career. Unpleasant practices just lead to more burnout and an early end to that career.
Static scheduling systems do not ask questions, they just represent another box that was checked by someone. Take a moment and ask the people who run your schedule if the system knows who is actually on call, or just who was on call the last time someone remembered to update a list. The difference is way too important to ignore anymore.
Okay, that is it for today’s video podcast. Do not forget to check out our website, cliniciancore.com, to learn about on call schedule aware routing as well as the many other features that Clinician Core provides. While you are there, sign up for our waitlist to take part in our soft launch and our upcoming release. You can also follow us on LinkedIn, YouTube, Spotify, Instagram, Facebook, and Reddit. There is no excuse not to check out Clinician Core.
I am Dr. Kevin Halow, cofounder and Chief Medical Officer of Clinician Core. Thanks for watching.