Reachable vs. Available: Why Static Call Schedules Are Quietly Burning Out Physicians

Dr. Kevin Halow, MD MBA, breaks down why a static call schedule and a schedule-aware one produce two very different physician experiences, and two very different burnout outcomes.

At 9 PM, Dr. Kevin Halow's phone rang. He was not on call. He'd swapped that day with a colleague. He answered anyway, because that's what physicians are trained to do.

In this episode, Dr. Halow breaks down the difference between being reachable and being available, and why a static call schedule can't tell the two apart. He covers why physicians early in a rotation absorb the most misrouted calls, what a roughly 58-hour physician workweek does to the recovery time clinicians need, and why a swap made yesterday can still be invisible to the system routing today's calls.

He also offers a simple self-audit: track every misrouted call for a few weeks, note how long it takes to reconfirm the schedule after each swap, and see whether the pattern is noise or signal worth naming to your group.

About the ClinicianCore Podcast

Hosted by Dr. Kevin Halow, the ClinicianCore Podcast explores unified clinical communication, physician burnout reduction, HIPAA-compliant collaboration, and the real impact of AI in healthcare.

New episodes are released every Monday at 1 PM EST.

If you’re a healthcare leader, physician, administrator, or innovator committed to improving clinical efficiency and restoring clarity to care delivery, this podcast is for you.

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Learn more about ClinicianCore and our mission to strengthen clinician collaboration at:
https://cliniciancore.com/

Connect with Dr. Kevin Halow
LinkedIn: https://www.linkedin.com/in/kevin-halow-md/

Transcript

SPEAKER_00 0:00

It's 9 p.m., 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's only one problem. I'm 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 answer because that's what we're trained to do: pick up the phone. But here's 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're the physician who's 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. The 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'm Dr. Kevin Hallow, co-founder and chief medical officer of Clinician Corps. 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 leaves it. Unfortunately, we've all been there and know too well that if you're fresh out of training, you are the most likely person in your group to get a misrouted call. It's not because anyone is targeting you. Maybe it's just because they want to give you a sympathy consult. But really, more likely, you're new to the rotation, you don't have the standing to question a schedule, and you've 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's a withdrawal from an account that's already overdrawn. You're tired, but now you can't go back to sleep. It's an energy drain that just burns you out. When it happens to you, it's 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 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's just a name on a calendar day that fills a 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's 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've 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 this call schedule wrong? Finally, add it all up and track the pattern. If you're catching coverage that isn't yours more than once, that's not noise. That's 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 of 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's actually on call, or just who's on call the last time someone remembered to update a list. The difference is way too important to ignore anymore. Okay, that's it for today's video podcast. Don't forget to check out our website, cliniciancore.com, to learn about on-call scheduled aware routing, as well as the many other features that Clinician Core provides. While you're there, sign up for our wait list 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's no excuse not to check out Clinici. I'm Dr. Kevin Hallow, co founder and chief medical officer of Clinician Core.