“Can’t come in; I am sick”

[deleted836128]

We have a doc in our group that has “called out” for things like a gastroenteritis and pneumonia. As horrible as it is I have found it annoying at times because it puts everyone under a lot of stress to cover her. It seems to be an unspoken rule in my group that you don’t just “call out” because you’re sick. “In the hospital” type of sick is different (although one of my coworkers did work through appendicitis and then admitted himself after his shift, but I digress). I am talking about cold symptoms or a “stomach bug.” In my group if you have a minor, self limited illness, no matter how bad you feel, you try to find coverage (it’s not the ED director’s problem to figure it out for you... totally different with true emergencies though). If you can’t find coverage you suck it up and go to work. I have worked through the worst migraine of my life, a bad case of gastroenteritis (vomiting in between seeing patients), and influenza (wore a mask all day and felt like dying). Not bitter about it - it’s a reality and it shouldn’t be “admin’s problem” - they can’t pull a provider out of thin air, and when you don’t show up, patients and your coworkers suffer. Again I am NOT talking about more serious illnesses. How does it work for you in your group if you’re sick? Do you go to work sick or do you refuse to do it and just “call off”?

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[Apollyon]

When my mother died, I called my boss. I said I needed tomorrow off (on Monday night). He said that I would need Friday, also. I said, "No, I don't think so". He told me that I did. He was right. I didn't have to do a thing to cover my shifts.

So, I don't know what is going on with your shop.

 

[hello1234!]

do you not have a backup system?
I’m not an ER doc, but I thought having backup was pretty standard

 

[deuist]

do you not have a backup system?
I’m not an ER doc, but I thought having backup was pretty standard

Depends on the site. Some do, and even pay their docs to take home call by decreasing the shift load by one shift, but paying them for the hours. My group does not have a backup. Physicians calling out will contact either the medical director or scheduler to find coverage.

 

[OneTwoThreeFour]

We have a doc in our group that has “called out” for things like a gastroenteritis and pneumonia. As horrible as it is I have found it annoying at times because it puts everyone under a lot of stress to cover her. It seems to be an unspoken rule in my group that you don’t just “call out” because you’re sick. “In the hospital” type of sick is different (although one of my coworkers did work through appendicitis and then admitted himself after his shift, but I digress). I am talking about cold symptoms or a “stomach bug.” In my group if you have a minor, self limited illness, no matter how bad you feel, you try to find coverage (it’s not the ED director’s problem to figure it out for you... totally different with true emergencies though). If you can’t find coverage you suck it up and go to work. I have worked through the worst migraine of my life, a bad case of gastroenteritis (vomiting in between seeing patients), and influenza (wore a mask all day and felt like dying). Not bitter about it - it’s a reality and it shouldn’t be “admin’s problem” - they can’t pull a provider out of thin air, and when you don’t show up, patients and your coworkers suffer. Again I am NOT talking about more serious illnesses. How does it work for you in your group if you’re sick? Do you go to work sick or do you refuse to do it and just “call off”?

Most groups have someone getting paid for being "on call" in case someone gets sick who then gets paid more if they are called in. If you are true sick you should not go into work. Pneumonia is not typically minor and true gastroenteritis is contagious so I would rather that colleague not be at work. If we're talking sniffles or a cold that's one thing, but if you're going to get me sick? No thanks.
I'd be more concerned with a group culture that rolls their eyes when someone who is there 95% of the time is out of commission for the other 5%

 

[deleted836128]

When my mother died, I called my boss. I said I needed tomorrow off (on Monday night). He said that I would need Friday, also. I said, "No, I don't think so". He told me that I did. He was right. I didn't have to do a thing to cover my shifts.

So, I don't know what is going on with your shop.

I thought I was clear I was talking for call outs regarding minor illnesses. Not talking about serious illnesses or family emergencies. Our group would do the same thing in the event of a death in the family.

 

[ShockIndex]

I’ve worked at groups that do, don’t, and went through the process of establishing an on-call provider. A lot of it has to do with the size of the group since it seems to be a lot more palatable to groups that can spread the on-call days across a large spread of docs. While having an on-call doc probably increases the number of call-outs by a little, I think it makes a lot of sense for most groups. Having someone work with influenza is probably not very patient-centered...

 

[deleted836128]

Depends on the site. Some do, and even pay their docs to take home call by decreasing the shift load by one shift, but paying them for the hours. My group does not have a backup. Physicians calling out will contact either the medical director or scheduler to find coverage.

We should probably have a call system. No one wants to do this because we are a group of just eight PAs so we would be on call 3-4 days a month. But maybe we should.

So when you’re sick you are not required to text / call and find your coverage? You just call the ED director? Somehow I think people should really try to find their own coverage and not make it the ED director problem every time unless absolutely necessary. Just trying to figure out how different groups do this. But our ER director said we are responsible for finding coverage if we need it. They will help us if it’s for an emergency but beyond that it’s our problem.

 

[deleted836128]

Most groups have someone getting paid for being "on call" in case someone gets sick who then gets paid more if they are called in. If you are true sick you should not go into work. Pneumonia is not typically minor and true gastroenteritis is contagious so I would rather that colleague not be at work. If we're talking sniffles or a cold that's one thing, but if you're going to get me sick? No thanks.
I'd be more concerned with a group culture that rolls their eyes when someone who is there 95% of the time is out of commission for the other 5%

I think must be the culture of my group. I assumed everyone else’s was that way too. That if you can’t find coverage you show up to work unless you’re dying or someone else is dying (not literally... but just for serious stuff). I called out sick once when I first started with the group (I had influenza) and later on heard the ED director complaining about someone calling out for an ACL tear and how he had to scramble to get coverage. Therefore I vowed to never call out again. We’ve had meetings about setting up a call system but no one really wants to do it because “we got into EM because we don’t want to be on call” and so the problem exists because we can’t have it both ways.

 

[ShockIndex]

We should probably have a call system. No one wants to do this because we are a group of just eight PAs so we would be on call 3-4 days a month. But maybe we should.

So when you’re sick you are not required to text / call and find your coverage? You just call the ED director? Somehow I think people should really try to find their own coverage and not make it the ED director problem every time unless absolutely necessary. Just trying to figure out how different groups do this. But our ER director said we are responsible for finding coverage if we need it. They will help us if it’s for an emergency but beyond that it’s our problem.

My last EM job was a very large academic site with more than 30 faculty. We had an call system where the on-call doc was responsible for rounding in the CDU and psych boarders. However, every effort was made to find voluntary coverage whenever possible before activating the call doc. I got called in maybe 4 or 5 times over 7 years for things ranging from funerals to the flu.

 

[deleted109597]

I've had a few places where the MLPs will simply call out, and if we can't find someone to cover, we are short. ED docs aren't given the ability to just not "show up".
Of course, if coverage is found, then you can swap out.



I don't think people should intentionally bring infectious diseases to work. But at the same time, somebody has to be there. This is a lot like the discussion where your relief doesn't show.

 

[deleted836128]

I've had a few places where the MLPs will simply call out, and if we can't find someone to cover, we are short. ED docs aren't given the ability to just not "show up".
Of course, if coverage is found, then you can swap out.



I don't think people should intentionally bring infectious diseases to work. But at the same time, somebody has to be there. This is a lot like the discussion where your relief doesn't show.

Yep. That’s the kind of thing with us. In our group we PAs seem to be considered essential because it would never be an option to just call out. We have heard the ED director use the term “patient abandonment” when one of the PAs called out several years ago. So yeah - SOMEONE has to be there. And I hate to be the harsh person to enforce this.

 

[erdoc00]

I just want to point out how ****ed up it is that people feel guilty about calling out for acute gastro or influenza. This is not normal.

 

[deleted109597]

I just want to point out how ****ed up it is that people feel guilty about calling out for acute gastro or influenza. This is not normal.

Nobody should feel guilty. If you can call in sick, do so.
But somebody has to work. It's not like the bank, or a restaurant. You can't just close the shop. If nobody is available, then you've got to go in.

Just like snow days. Or hurricanes. Or any of the other **** we have to work through.

 

[ShockIndex]

Yep. That’s the kind of thing with us. In our group we PAs seem to be considered essential because it would never be an option to just call out. We have heard the ED director use the term “patient abandonment” when one of the PAs called out several years ago. So yeah - SOMEONE has to be there. And I hate to be the harsh person to enforce this.

So, it sounds like you need to create a call system because I promise you that call outs are not going to completely stop. There will always be illnesses of various acuity and family tragedies.

 

[ShockIndex]

Nobody should feel guilty. If you can call in sick, do so.
But somebody has to work. It's not like the bank, or a restaurant. You can't just close the shop. If nobody is available, then you've got to go in.

Just like snow days. Or hurricanes. Or any of the other **** we have to work through.

Nah, just call the CMO and tell them that you are closing down the ED.

I kid, I kid.

 

[thegenius]

We should probably have a call system. No one wants to do this because we are a group of just eight PAs so we would be on call 3-4 days a month. But maybe we should.

So when you’re sick you are not required to text / call and find your coverage? You just call the ED director? Somehow I think people should really try to find their own coverage and not make it the ED director problem every time unless absolutely necessary. Just trying to figure out how different groups do this. But our ER director said we are responsible for finding coverage if we need it. They will help us if it’s for an emergency but beyond that it’s our problem.

If your sick that day, then you can send out a mass email to the entire group but I would also contact the ER director.

 

[thegenius]

We have a doc in our group that has “called out” for things like a gastroenteritis and pneumonia. As horrible as it is I have found it annoying at times because it puts everyone under a lot of stress to cover her. It seems to be an unspoken rule in my group that you don’t just “call out” because you’re sick. “In the hospital” type of sick is different (although one of my coworkers did work through appendicitis and then admitted himself after his shift, but I digress). I am talking about cold symptoms or a “stomach bug.” In my group if you have a minor, self limited illness, no matter how bad you feel, you try to find coverage (it’s not the ED director’s problem to figure it out for you... totally different with true emergencies though). If you can’t find coverage you suck it up and go to work. I have worked through the worst migraine of my life, a bad case of gastroenteritis (vomiting in between seeing patients), and influenza (wore a mask all day and felt like dying). Not bitter about it - it’s a reality and it shouldn’t be “admin’s problem” - they can’t pull a provider out of thin air, and when you don’t show up, patients and your coworkers suffer. Again I am NOT talking about more serious illnesses. How does it work for you in your group if you’re sick? Do you go to work sick or do you refuse to do it and just “call off”?

Sounds like you are! LOL

 

[thegenius]

I've called out sick once in 5 years, although I've been sick with flu-like symptoms every year. At those times I've just gotten lucky it hasn't overlapped with work.

I will occasionally, like 1-2 times a year, get these horrible headaches that last 8-12 hours. I'm pretty much incapacitated. I take full dose Tylenol/motrin/reglan/drink water, sleep and they go away all the time.

About a month ago I had one of those and I was scheduled to work a night shift solo in the next 4 hours. I was screwed. I could barely see / think and I couldn't work...but I knew it would get better. I actually told my group and they found coverage for me.

Every now and then, **** happens. If I call out once every 5 years, I'll take that.

 

[deleted836128]

Sounds like you are! LOL

No. Truly not bitter about it... I get it. It’s a necessary evil. I really just wonder if I am being a tyrant for having to enforce this standard as the lead of my group of PAs.

 

[ShockIndex]

No. Truly not bitter about it... I get it. It’s a necessary evil. I really just wonder if I am being a tyrant for having to enforce this standard as the lead of my group of PAs.

Not bitter - yet.

I’m totally waiting for one of your PAs to tell you they can’t make it and have a doctor’s note...

 

[deleted109597]

Nah, just call the CMO and tell them that you are closing down the ED.

I kid, I kid.

I mean, if the oncoming doc calls me and tells me they're dying of manflu, and we ramp up the machine to get someone to cover, that's one thing. I'll do a couple more hours if need be. But if nobody shows, and you're on later that night? Yeah, I'm not in charge. That guy/girl can show up. Peace, I'm out. Close the doors if you have to.

 

[Groove]

So, med school (actually, probably residency) hard codes this culture of self flagellation, martyrdom and sacrifice of your personal best interests in order to benefit the pt (more like the group practice). On one hand, we're certainly not factory workers or coffee baristas, so you expect a certain degree of work ethic beyond what you would expect from someone who has little invested in their job. After all, how often do fortune 500 CEOs call in sick? I'd wager Tim Cook doesn't stay home sick very often. Steve Jobs was dying of pancreatic cancer and was still working from his hospital bed. Regardless, I don't think the practice is entirely fair, nor very good for the physician (or pt for that matter). If you've got the flu, do you really think it's a great idea to expose all your patients to it and/or your co-workers? The problem is that it's difficult to get anybody to cover ER shifts at the last minute. Technically, the AFMD and FMD are paid stipends to handle this sort of thing anytime there's a call in or gap in coverage. I get paid about 2 shifts as AFMD for very few "real" responsibilities, but when there is a sudden gap in coverage, I'm expected to come in and fill it and let's face it, it doesn't happen very often. Personally, I think calling in sick should be tolerated with greater frequency among physicians and less judgement from your peers. That being said, it's a difficult culture to change and it's even more difficult to re-wire old conditioning. Case in point, I've had the flu and been horribly sick many times since residency but the only time I called in over 10 years was to give several days advance notice for about 3 night shifts and that was because I had a traumatic pneumothorax. Working was 100% not an option. Honestly though, for most other "common illnesses...URI's, etc.. 1g of tylenol and/or 800mg ibuprofen dramatically improves my symptoms +/- anti-tussive. I can get through just about any shift on those three alone.

 

[miacomet]

We have a doc in our group that has “called out” for things like a gastroenteritis and pneumonia. As horrible as it is I have found it annoying at times because it puts everyone under a lot of stress to cover her. It seems to be an unspoken rule in my group that you don’t just “call out” because you’re sick. “In the hospital” type of sick is different (although one of my coworkers did work through appendicitis and then admitted himself after his shift, but I digress). I am talking about cold symptoms or a “stomach bug.” In my group if you have a minor, self limited illness, no matter how bad you feel, you try to find coverage (it’s not the ED director’s problem to figure it out for you... totally different with true emergencies though). If you can’t find coverage you suck it up and go to work. I have worked through the worst migraine of my life, a bad case of gastroenteritis (vomiting in between seeing patients), and influenza (wore a mask all day and felt like dying). Not bitter about it - it’s a reality and it shouldn’t be “admin’s problem” - they can’t pull a provider out of thin air, and when you don’t show up, patients and your coworkers suffer. Again I am NOT talking about more serious illnesses. How does it work for you in your group if you’re sick? Do you go to work sick or do you refuse to do it and just “call off”?

This is a systems issue. I work all the time when sick; it's not great for us or the patients. The group should come up with a paid sick-call system. It's still stress on the group if someone calls out dead, after all. You need to fix the system.

 

[TooMuchResearch]

We always have a backup/on call physician. Heck, when someone is about to go out on parental leave or has some other expected absence that might happen at a variable time, we add a second backup doc. Our PAs have a similar system, but if they still end up short, our physician backup will cover. We get paid some for being on call. We get 1.5x pay if called in. Generally the person who can't work will text/email the scheduler, medical director, and on call person to make sure someone knows of the gap. The system is used infrequently. Anything with 1-2 days advance notice we'll generally just put the shift up and send a mass email, if no one wants it the on call person still takes it.

 

[Brigade4Radiant]

You should have some docs who are credentialed who can pic up shifts on occasion

 

[rokshana]

I thought I was clear I was talking for call outs regarding minor illnesses. Not talking about serious illnesses or family emergencies. Our group would do the same thing in the event of a death in the family.

Your definition of “minor” seems skewed...influenza isn’t minor in that you are putting the patients at risk.
If you are infectious, you really have no business being around pts.
And why do you think that the ED director shouldn’t be “ bothered “ with staffing issues...isn’t that part of their job?

 

[Brigade4Radiant]

Your definition of “minor” seems skewed...influenza isn’t minor in that you are putting the patients at risk.
If you are infectious, you really have no business being around pts.
And why do you think that the ED director shouldn’t be “ bothered “ with staffing issues...isn’t that part of their job?

yeah that’s strange influenza you look terrible and patients might complain. Staffing is the ED directors responsibility. Does the ED director not control their schedule?

 

[RustedFox]

This whole thread makes me ill.

I got a phone call last January letting me know that my good buddy and roommate of 2-3 years hung himself.
Needless to say, I was a sobbing, emotional mess. I "called out" that day.
I spent the whole day crying.
What was going thru his head? Did he have a terminal disease that he chose not to reveal to his friends/family and just wanted to "not see the end"?
Did he have a psychotic break?

No idea.

Just a dead buddy. Would'a picked him up off of his floor and resuscitated him.

Life happens to us all.

I have a dad.

I love my dad. He is 69. He will die some day. Probably soon, given how poor his health is.

When he dies, I'm going to have to fly to PA, bury him, take care of his affairs, etc, etc, etc.

Its not going to be fun.

The fact that the "culture" of EM implies that "if you're not in the hospital, then you're supposed to make your shift" sickens me.

Nobody else does that. The office workers? The bankers? The paper-pushers?

Nope.

I have come in at 4AM to "help out the night doc".

Excuse me if I need to have a day to cry and be a human being.

 

[EM Junkie]

I'd be more concerned with a group culture that rolls their eyes when someone who is there 95% of the time is out of commission for the other 5%

Most docs in Houston right now are getting 1-2 less shifts than their ideal, so are happy to cover anyone that wants to give up a shift last minute.

While I agree that our culture of “show up unless you’re in the hospital” is not healthy, the example given of 5% out of commission rate could equate to a doc calling out for 8-9 shifts a year if working 14 shifts a month. I think I’d cast an eye at a doc that called in for 8-9 shifts a year.

 

[deleted547339]

I would disagree that it isn’t the medical directors job. It’s exactly the medical directors job.

I think there is a line, and everyone’s line is different. There is a “minor illness” where you feel crappy but can work. If you can find a swap, you do, otherwise, you show up. I have a minor illness right now, but I’ll be at work tomorrow.

Then there is a “major illness” - sometimes gastro or the flu can be this if severe. I’ve had the flu and not been able to get out of bed. It can also be hospitalization or major illness in a spouse or child. Or death in direct family. I think this is when it falls on the medical director. Your kid in the icu isn’t the time you need to be making calls to find a swap.

The problem is that everyone’s line is a little different and everyone assumes that everyone else’s line should be exactly where there line is. Should anyone ever call in for a sprained ankle? No. Get some crutches and Motrin and suck it the hell up. Do this enough times and you should be fired. But should anyone have to worry about finding coverage when their wife dies? No.
Show me a place that does that and I’ll show you a dysfunctional group where I wouldn’t work.

There’s no honor in working through undue suffering and it is the medical directors job to help manage that. But there’s also no place for snowflakes who run at the first sign of difficulty, either.

 

[ShockIndex]

I ran into a difficult problem about 4 years ago that illustrates how good co-workers can really help a guy out. Ahead of a 3-midnight shift, I decided to take my dogs out for 1.5 mile walk down our country road at 1PM - 1 Great Dane, 2 GSDs. We get to the half-way point and turn around to head back when the 9.5-year old Great Dane suddenly collapse DRT SOL. For a second I thought that he just stumbled, then I realized that he was dead. So, I sat down on the side of the road with him until the agonal breathing stoped and try to keep the GSDs calm since they were distressed sniffing and whining around him.

Now, I’ve got a couple of big problems: 1) I’m on a country road out in the stix with a dead giant dog, 2) I don’t want to tell my wife over the phone that he is dead, and 3) I’m supposed to be at work in an hour.

Luckily, a neighbor happened to drive down the road and saw me sitting next to my dead dog. They graciously sat next with him on the road while I ran home with the other two, gathered my family, and made some calls.

I quickly called work and asked if the AM doc could cover 2 hours of my shift so that I could make my dogs arrangements and console my wife (we got this dog while engaged, they hung out during all my Army and Bureau deployments, and he was my son’s best friend).

I went into work that day a couple hours late and got though the shift. Fortunately, the night doc heard what had happened and came in THREE HOURS early on his own accord to help me out after hearing through the grapevine what had happened. It turns out that the CNO of the hospital who I barely knew texted my partner when she heard what happened. I didn’t ask, he just came in out of kindness when he got the news.

So, I’ve said this before in other threads - there are a lot of problems with EM that caused me to leave the field. However, the work ethic and integrity of my coworkers, employers, and administrators was never one of them.

 

[deleted109597]

Nobody else does that. The office workers? The bankers? The paper-pushers?

That's the thing. Each of those jobs is accessory. We do just fine without them. Sure, maybe a little inconvenient, but so what.
Some jobs have to be covered 24/7. Yes, there should absolutely be a sick call system. I implore each of you to create one at your job if you don't have one. But somebody has to be there. You can't just have no coverage.

 

[WilcoWorld]

Even indispensables like EM docs should be able to call in sick when they're sick. If this is "frowned upon" to the point of being essentially forbidden, what's really going on is that those impacted by the failure of admin to come up with a solution are inadvertently aiding and abetting a delinquent admin policy. I've worked in both types of set ups, and I prefer to have a backup system in place. Fortunately, I've always seen docs take calling another in very seriously and never seen it abused. It is precisely because we're indispensable that we should have back up systems in place.

Stated otherwise - we should definitely have backup plans in place, but if someone is an outlier and is activating that system statistically significantly more often than everyone else, that person is the problem, not the system.

So, I wonder if @ERCAT is less concerned about the possibility that someone is a real crisis would call in, and more bothered by this particular coworker who seems to take calling in too lightly?

 

[GeneralVeers]

We don't get paid sick leave like a lot of other specialties, so I think it's entirely reasonable to call out for ANY reason. No one calls out at my main job. Why? Because a lost day of work means you lose ~$3000 in income. That's a big hit just for the man flu. If someone does call out, we can almost always get someone to pick up the shift, get people to come in a few hours to help, or just have the director do their job and come in.

Also being on RVU pay if someone calls out, or comes in late, guess what? More tasty RVUs for me.

 

[Janders]

Being a small group (we need about 9FTE to cover our shifts), making a true call schedule is rough. Everyone would need to work their 14-15 shifts a month, and have 3 more days off where they are dedicated call. People don't like that.

But it can get hairy covering shifts when someone calls out. We have to beg. I've gone in to work 16hr double more that once. Work the 7-3 then come back and work the overnight. Switch everyone to 12hr shifts to cover the same hours with less docs.

So our culture is you don't call out for minor things. But death in a family? Birth of a kid (we always make extensive baby-call schedules since that typically happens in a couple week window..)? Diarrhea everywhere? Stay home. We'll sort it out. It might be me texting and email and calling for hours, but we'll figure it out.

I don't want someone with real norovirus working...

We are open to other ideas. We've thought of adding bonus money for covering a shift last minute, but that has to come from somewhere (don't want to punish the sick person). So that means a little group tax that gets hit everyone time an unexpected call-out happens. If any genius has solved this issue, feel free to let me know.

 

[Xerxes1729]

If you actually have influenza, I don't think you should be working. I know you'd wear a mask and wash your hands, but if I would not want you to take care of me, especially if I were immunocompromised or had some sort of baseline pulmonary disease. Flu can kill, especially if you have end-stage lung disease.

 

[ShockIndex]

Being a small group (we need about 9FTE to cover our shifts), making a true call schedule is rough. Everyone would need to work their 14-15 shifts a month, and have 3 more days off where they are dedicated call. People don't like that.

But it can get hairy covering shifts when someone calls out. We have to beg. I've gone in to work 16hr double more that once. Work the 7-3 then come back and work the overnight. Switch everyone to 12hr shifts to cover the same hours with less docs.

So our culture is you don't call out for minor things. But death in a family? Birth of a kid (we always make extensive baby-call schedules since that typically happens in a couple week window..)? Diarrhea everywhere? Stay home. We'll sort it out. It might be me texting and email and calling for hours, but we'll figure it out.

I don't want someone with real norovirus working...

We are open to other ideas. We've thought of adding bonus money for covering a shift last minute, but that has to come from somewhere (don't want to punish the sick person). So that means a little group tax that gets hit everyone time an unexpected call-out happens. If any genius has solved this issue, feel free to let me know.

A few options:
1) Create a call schedule where all of your partners share it equally.
2) Pay your director to take all or most of the call.
3) Shorten a shift to 4 hours and that person is on call. They can flex up to 8 hours if nobody calls-in and volumes demand it. This may require that other shift lengths be adjusted.

There is no way to create a painless call schedule. Someone will have to sacrifice.

 

[emergentmd]

family emergencies and real medical issues, yes. call the director and they usually find coverage or docs just extend their hours.

If you call in for something the majority would go in for, then Don't do it.

I have never called in sick since my first job at age 15. Alot of luck but many days when I didn't feel the best but if I can do a competent job, I go in.

 

[Brigade4Radiant]

If calling out is rare why make a call schedule? If you make a call schedule then those docs need to be paid. What happens if you are sick on call or also have a family emergency?

Just have a few docs credential pick up one or two shifts or prn at places which is what I do.

 

[TooMuchResearch]

Because then you know it's covered. If our on call doc is sick, they let people know and someone else picks up the call day or we go unprotected for a day. The odds of having two people needing a non-scheduled off day on the same day are pretty low. If we're unprotected, we'll get an email/text/or other chat service in advance to let us know a backup plan, which is generally group chat and someone will pick it up.

We don't have any interest in having doctors we don't know cover us.

.

If calling out is rare why make a call schedule? If you make a call schedule then those docs need to be paid. What happens if you are sick on call or also have a family emergency?

Just have a few docs credential pick up one or two shifts or prn at places which is what I do.

If calling out is rare why make a call schedule? If you make a call schedule then those docs need to be paid. What happens if you are sick on call or also have a family emergency?

Just have a few docs credential pick up one or two shifts or prn at places which is what I do.

 

[betamale]

We have a doc in our group that has “called out” for things like a gastroenteritis and pneumonia. As horrible as it is I have found it annoying at times because it puts everyone under a lot of stress to cover her. It seems to be an unspoken rule in my group that you don’t just “call out” because you’re sick. “In the hospital” type of sick is different (although one of my coworkers did work through appendicitis and then admitted himself after his shift, but I digress). I am talking about cold symptoms or a “stomach bug.” In my group if you have a minor, self limited illness, no matter how bad you feel, you try to find coverage (it’s not the ED director’s problem to figure it out for you... totally different with true emergencies though). If you can’t find coverage you suck it up and go to work. I have worked through the worst migraine of my life, a bad case of gastroenteritis (vomiting in between seeing patients), and influenza (wore a mask all day and felt like dying). Not bitter about it - it’s a reality and it shouldn’t be “admin’s problem” - they can’t pull a provider out of thin air, and when you don’t show up, patients and your coworkers suffer. Again I am NOT talking about more serious illnesses. How does it work for you in your group if you’re sick? Do you go to work sick or do you refuse to do it and just “call off”?

Had 3 missing docs past 4 days. Seems like first week of January is a block I need to avoid from now on.

 

[DeadCactus]

Not having a call schedule is mismanagement. The end. You have a critical function with no back-up plan? We train to have like 5 back-up airway plans but the back-up plan for the entire cohort of emergencies that might come in over a shift is to wing it? Ridiculous. You can still have a culture where voluntarily coverage is looked for rather than jumping straight to the call person, but having no call person requires a lot of mental gymnastics. I know a lot of places run without one and I'm sure it's adequate the majority of the time but it's nonsense coming from people in a specialty like emergency medicine.

And the barrier to calling in sick should be your desire to not spend a day off ill and have to pick up someone else's shift. It shouldn't be external pressures to not inconvenience the system with your stupid human body. Problem providers should be dealt with individually not through a malignant culture that harms patients and physicians.

 

[deleted497653]

Backup plans should be infrequently used. This is a personal call as to what qualifies as an emergency to call out. There is no criteria for what people can call out for. Just have to trust people have a good work ethic. Being on call could be as simple as being asked to come in earlier than scheduled. If you ask people to come in early too often, it ruffles feathers. I wouldn’t mind once a year but would not be happy if I’m called in once a month. Again, it’s a personal call.

 

[TheSingularity]

I just love the CMG approach to this.

At any of their shops I've been at, there is no person on call and the FMD usually just throws up their hands and the shift goes uncovered. Maybe they come in, maybe they don't. It's hilarious...unless you're the poor sucker that is working in the pit when this happens.

Yah, you signed up to be FMD or AFMD, it's your responsibility to show up and work the shift.

Shocker...most of the rank and file don't wanna work another overnight unless being offered a shift bonus!

Sent from my Pixel 3 using SDN mobile

 

[Dr Mantis Toboggan]

There’s no doubt having a system in place increases call outs for lame, minor illnesses.

Backup plans should be infrequently used. This is a personal call as to what qualifies as an emergency to call out. There is no criteria for what people can call out for. Just have to trust people have a good work ethic. Being on call could be as simple as being asked to come in earlier than scheduled. If you ask people to come in early too often, it ruffles feathers. I wouldn’t mind once a year but would not be happy if I’m called in once a month. Again, it’s a personal call.

 

[RustedFox]

There’s no doubt having a system in place increases call outs for lame, minor illnesses.

Call outs for being a human being?
Made of flesh and blood?
That has emotions?

Your statement just reinforces a culture of toxicity.

 

[TooMuchResearch]

Not in our group. We don't want people working if they a) feel terrible and b) are at risk of spraying patients and co-workers with vomit and feces.

There’s no doubt having a system in place increases call outs for lame, minor illnesses.

 

[TheSingularity]

Why would you not have a call out system ? Makes absolutely no sense not to.

Call outs for being a human being?
Made of flesh and blood?
That has emotions?

Your statement just reinforces a culture of toxicity.

Sent from my Pixel 3 using SDN mobile

 

[RustedFox]

Why would you not have a call out system ? Makes absolutely no sense not to.

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Buddy of mine called out a day last year.
His daughter was in SVT.
He didn't come to work.

That was okay.

Another buddy of mine had a kidney stone and was out for 3 days.
He didn't come to work.

That was okay.

People get sick.
Life happens.
You get calls that make you stop and say: "Life?"

Your bank teller can call out sick.
They have "sick days" built into their schedule.

Your kid's Algebra teacher can call out sick.
They have "sick days" built into their schedule.

We should be no different.