Call schedule

[Ogliodendrocyte]

What does your call schedule look like? How many times per wk/yr and how does it change as you proceed? How busy are you when you are on call?

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[lejeunesage]

Technically, I'm on call every night, for my own patients. The only times I'm really off are on my off weekends.
I don't have to come in, ever. If a patient needs to be transferred out, they get transferred out.

When I'm called, I just give verbal orders over the phone. On a typical day, I don't get called. I only got called on one night this week. Sometimes, the pharmacist will text me if they have a question. That's pretty much how it goes.

There's the occasional night where I'll get called 3 or 4 times, but that's truly the exception.

Currently, I'm on call every other weekend. That will change to 1:3 starting next month.
On weekend call, I'm just there to do admissions, although I may opt to round on my patients if I feel like it.

 

[RangerBob]

I essentially have lejunesage's setup as well. Call 1:2 weekends, covering my own patients during the week, but I need to round on everyone at least once over the weekend. We have hospitalists as consultants, so just about every overnight issue that comes up will go to them. I've probably been woken up once in the last month.

 

[lejeunesage]

I essentially have lejunesage's setup as well. Call 1:2 weekends, covering my own patients during the week, but I need to round on everyone at least once over the weekend. We have hospitalists as consultants, so just about every overnight issue that comes up will go to them. I've probably been woken up once in the last month.

I still get more calls than I should about things that should be handled by the hospitalists overnight.
Why do you have to round on everyone over the weekend?

 

[RangerBob]

I still get more calls than I should about things that should be handled by the hospitalists overnight.
Why do you have to round on everyone over the weekend?

Hospital bylaws. Patients have to be seen at least every other weekend by a physician at my hospital.

Edit: I meant to say patients have to be seen every other day

 

[lejeunesage]

Hospital bylaws. Patients have to be seen at least every other weekend by a physician at my hospital.

And that can't be IM?

 

[RangerBob]

And that can't be IM?

I fixed an error-I meant a physician has to see the patient at least every other day.

To answer your question- yes, it can be IM, but our hospitalists can only see so many per day because they’re understaffed as well (we’re in a rural area). They can’t see the entire unit over the weekend, so I have to come in anyway to see at least half the unit.

If I’m alone I see everyone since I don’t feel right choosing half of my patients to not see for two whole days. But if my partner is here and I only have half the census, when I cover on the weekend then I’ll ask the hospitalists to see my partner’s patients at least once over the weekend, so I only need to see their patients if there’s a specific rehab issue to follow up on.

 

[PMR2018]

Technically, I'm on call every night, for my own patients. The only times I'm really off are on my off weekends.
I don't have to come in, ever. If a patient needs to be transferred out, they get transferred out.

When I'm called, I just give verbal orders over the phone. On a typical day, I don't get called. I only got called on one night this week. Sometimes, the pharmacist will text me if they have a question. That's pretty much how it goes.

There's the occasional night where I'll get called 3 or 4 times, but that's truly the exception.

Currently, I'm on call every other weekend. That will change to 1:3 starting next month.
On weekend call, I'm just there to do admissions, although I may opt to round on my patients if I feel like it.

This is probably a very naive question, but does this mean that you can't go out for drinks during the week after normal work hours? Having home call every day of the week, despite the low likelihood of anything critical, just seems super restrictive on lifestyle. Am I missing something?

 

[lejeunesage]

This is probably a very naive question, but does this mean that you can't go out for drinks during the week after normal work hours? Having home call every day of the week, despite the low likelihood of anything critical, just seems super restrictive on lifestyle. Am I missing something?

Well, yes and no.
I don't drink all that often, so it's a moot point for me anyway.
But you never have to come in. If something is bad enough that the patient needs emergent care, they get transferred out. Almost my calls revolve around some medication that the patient wants, and all I have to do is give a verbal order.

The last two times I was called:
1. I screwed up when entering the admission orders. The patient arrived without any meds on board. They called me so I could fix my mistake.

2. A femur x-ray I had ordered came back positive for a fracture. I told them to send the patient to the ED across the street, so she could get Ortho evaluation and decision of cast vs surgery.

You could have a drink and respond to things like that.

 

[Gauss]

This is probably a very naive question, but does this mean that you can't go out for drinks during the week after normal work hours? Having home call every day of the week, despite the low likelihood of anything critical, just seems super restrictive on lifestyle. Am I missing something?

if you are oncall then you are working, so you shouldn't do anything that puts your job and med license at risk