Finding Solutions to the Hospitalist’s Scheduling Problem

Hospitalist work is increasingly attractive among doctors who have no desire to open their own practices or work for a group. Even locum tenens doctors are increasingly looking at hospitalist contracts as opposed to some of the other alternatives. Yet as attractive as hospitalist work is, there is one nagging problem that a lot of doctors feel they just have to live with: the hospitalist schedule.

Ever since hospitalist jobs became recognized as a legitimate option for working as a doctor, the majority of American hospitals have employed the 7/7 schedule – doctors work seven days on and then have seven days off. No one really knows the origin of the schedule. It has been suggested that it is based on the understanding that the average patient stay is between four and five days.

Alongside the 7/7 rotation are shifts that typically run from 12 to 14 hours. That means your average hospitalist is working 84 hours in a single week; more in some cases. This can be terribly disruptive to a doctor’s personal life. Perhaps that explains why veteran doctors would prefer shorter work days and weeks while new doctors just out of residency are fine with the 7-day, 12-hour arrangement.

Do the Research

For the employed doctor and locum alike, the first part of the scheduling solution is to do the research. It pays to know how a facility schedules its hospitalists before a job application is ever made. Why? Because of the tendency to take a job once offered – even if it is not ideal. If you never apply for a job with a schedule you do not approve of, you will never take that job.

It is true that the majority of U.S. hospitals still follow the 7/7 schedule. Still, there are some that have adopted 14/14 and 5/5 schedules. They are out there, you just have to dig around until you find them. Pay attention to shifts in your research as well. Otherwise, you might find yourself looking for the day shift at a hospital only offering nights.

Continuity Is Key

Note that the next part of the solution is continuity. Nothing is worse for the doctor’s personal life than a schedule constantly in flux. Even hospitalists need to know that their schedules will remain constant over an extended amount of time. That is the only way they can make time for family and outside activities.

If you work as a locum, don’t sacrifice continuity based on the false assumption that it’s only temporary. One assignment without continuity easily leads to another.

Finding the Right Balance

There is a temptation to look out for your own interests with a vigilance that scares potential employers away. Do not present that kind of attitude. Yes, you do want to look out for yourself and try to find a schedule that suits your needs. At the same time though, some flexibility is required. Try to balance your own needs against the needs of the hospital in question.

On that same note, there is no such thing as a perfect schedule for hospitalists. You are going to have to compromise on some points. So be willing to find the best way to balance your needs against those of the employer. You will find job hunting a bit easier that way.

Hospitalist scheduling is unlike scheduling in most other professions. Because of the unique nature of what they do, hospitalists are expected to keep schedules that most of us would find too demanding. So keep the tips you read here in the back of your mind if you are hospitalist looking for work.

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