This article has attempted to address a contentious issue regarding on-call duty allocation in hospitals. Let us consider a hospital scenario with 20 clinical specialist assistant candidates (MACCS), consisting of 10 juniors in their core year of general internal medicine and 10 seniors specializing in areas like cardiology, gastroenterology, pneumology, etc. These MACCS are distributed across various departments, each comprising 1 to 5 MACCS, with varying proportions of juniors and seniors. Every night or weekend, one of these doctors had to be on call to provide permanent hospital patient care that was followed by a recuperation day. A discussion is currently underway as to whether senior MACCS should participate as much as junior MACCS in on-call duty. These senior MACCS receive 12% higher remuneration than younger staff, while they assist doctors in carrying out technical examinations during the day as part of their training. Will it cost more to the institution if the 10 senior staff members take part in general on-call duty? How will their absence during recuperation affect their work and training? Would departments with more senior staff face disadvantages? How would you address these questions? Some might be rather pessimistic, but how does it actually look reality?
What is already known about this topic?
- The structuring of on-call duty in a hospital poses ongoing challenges in terms of team coordination and cost efficiency. This issue is increasingly under discussion, particularly as limiting working hours has become an imperative for specialist clinical assistant candidates.
- Several misconceptions complicate this organization. Among these is the notion that doctors nearing the end of their training, with higher salaries and more specific training, should have limited involvement in on-call duties.
What does this article bring up for us?
The problem of on-call distributions can be analyzed in a purely mathematical way, enabling predictions of cost variations for hospitals or departments, as well as assessing training benefits. Primarily, it helps dismantle certain misconceptions or intuitive assumptions.
Keywords
Training, medical specialties, hospital organization, economics