- Make sure you know your schedule- No one likes surprises. So make sure you know when you are on call. If there are conflicts take care of them with enough time to get someone to cover for you. Ideally you want the schedule made far in advance with easy access to view it on a shared calendar. Many practices use google calendar or something similar.
- Don’t make big plans- Depending on your practice, being on call may be extremely busy or pretty slow. However, you need to be available for urgent and emergent patient issues that arise. Trying to make it to a concert or take a family vacation while you are covering your practice after hours is a recipe for disaster. You may be setting yourself up for medical liability and certainly making it difficult to enjoy your time off. Instead, swap calls with a partner or develop a relationship with a friendly competitor in your area to help cross-cover your practices.
- Ensure that patients can get through easily- At the beginning of call review the process that patients take to reach you. For some it may be checking that your phones are being forwarded properly and the call center knows your contact preferences. Ideally they should have your cell phone, home phone and email. Make sure they know how you want to be contacted.
- Try not to get angry or grumpy- It’s not always easy to sound enthusiastic when you get awoken in the middle of the night or disturbed during dinner to speak to a patient for an issue that doesn’t seem very important. Try to remember that the patient is not as knowledgeable as you are about health issues and wouldn’t be bothering you unless they were very concerned. Even if the call turns out to be non-urgent be sure to be polite and reassure the patient; you will both sleep better if the tone is pleasant.
- Educate your patients- Tell your patients to call if they are having difficulties or have questions about their care; try to be specific about the type of symptoms to look for. This is especially important for patients who have had recent surgery or are taking new medications. By explaining what serious post-operative symptoms or potential medication side effects may be will reduce potential problems for you and the patient.
- Have a process to document calls- Your job is not done when you are finished speaking to the patient. Find an easy and reliable way to document the call and your recommendations. Some practices have a voicemail system that they call into to tell staff members about patients that called. You can also keep notes and fax back to the office. We don’t suggest email or texting your office staff since this is likely to be in violation of HIPAA regulations. The easiest way to document is with an app based on-call service which allows for immediate documentation that is sent to the office staff as well as into your EHR.
- Designate staff to follow up after hour issues- No matter how you document the calls you need to designate someone in your office to handle the follow-up and charting of after hours calls. Ideally that person gets in early so they can call patients that need urgent appointments. Make sure you have a way to track which calls were reviewed and charted by your staff. Signature and time/date stamp is helpful.
David Rhee, M.D. – Retinal Specialist and Co-Founder of Connect On Call
David graduated from Harvard University with a BA in Biology, and obtained his MD from UC-San Diego. He then completed a residency in ophthalmology at Tufts University and a vitreoretinal Surgery Fellowship at Wills Eye Hospital in Philadelphia. David has a keen interest in the Android platform and other open source platforms and designed the wireframe layout of the mobile web app for ConnectOnCall.