Why Equity Matters in Physician Shift Distribution

When planning the schedule for a group of physicians, schedulers must take into account a tremendous number of factors. Because of this complexity, it’s not easy to ensure equity or fairness in shift distribution. Still, equity is an important part of any schedule. It can affect the dynamics of the physician group and even the overall effectiveness of the medical service.

After having collaborate with more than 2,500 medical planners to create and manage schedules, the PetalMD team would like to introduce you to the concept of equity and why it is crucial to a smooth and functional office.

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The Meaning of Equity in a Physician Scheduling Context

Equity is a fair distribution of the various scheduled shifts that takes into account the nature of the shift to be performed, the period of time when these shifts must be performed and exceptions that apply to certain physicians. 

In most schedules, there are always some shifts that are less desirable than others, such as night shifts and weekends. The same goes for certain types of shifts, which require more effort or specialization than others. For example, in an emergency department, the workload involved in a “major” emergency shift is not the same as for a “minor” emergency shift. But to be truly equitable, the scheduler must also take into account certain exceptions. Indeed, some physicians cannot perform certain shifts as often as others for various reasons (expertise, schedules in other health facilities, pre-existing contracts, etc.).

Since each group of physicians has a reality of its own, there is no perfect recipe for equity. Each group must agree on the equity factors they wish to consider for their schedule (period of time and types of shifts), and then determine their own equity targets, which is their idea of a fair distribution of shifts (e.g. everyone must work at least two weekends over a period of 3 months).

An Equitable Distribution of Shifts Does Not Necessarily Mean an Equal Distribution Among All Physicians 

For a schedule to be truly equitable, the scheduler needs to consider some exceptions when creating the schedule. After all, there’s a good chance that the equity targets decided by the group do not necessarily apply to every physician in the same way.

Indeed, exceptions may apply to either a specific physician (pre-existing contract with a hospital, schedules in another health institution, pregnancy, etc.) or to a team (full-time or part-time, specialties, etc.). Due to these exceptions, a fair distribution of shifts does not necessarily mean an equal distribution among all physicians.

Examples of exceptions that equity could take into account

• Dr. Aubé has a contract with the hospital so that he must provide a minimum coverage.
• Dr. Pelbois is the only scheduled physician who prefers to work during weekends because her husband also works weekends.
• Dr. Kelly is pregnant and should not perform certain shift types, also she should temporarily have a lower workload.

Why is Equity Important in a Physician Schedule

When a physician’s schedule does not sufficiently take into account the notion of equity or fairness, the distribution of shifts can create feelings of injustice and affect the dynamics of the group. For example, it is possible that some physicians believe that they are being assigned more on-call duties than their colleagues, which leads to feelings that there is favoritism in the schedule. This situation puts pressure on the scheduler, who might have a hard time justifying the distribution choices.

In some cases, lack of equity can have effects that go beyond mere perception. For example, when the most demanding or unpleasant shifts are always assigned to the same physicians, it is possible that the lack of equity in the schedule indirectly pushes these physicians to burnout.

Respect for equity in physicians’ schedules is therefore crucial for both efficiency and creating positive working conditions.

Choose a Planning Tool that Considers Equity

The more physicians there are, the more equity factors need to be taken into account, and the more difficult it is to respect all the equity targets effectively without a specialized solution. Some solutions, such as Petal Scheduling, the physician scheduling solution developed by PetalMD, can automatically include equity factors in the creation of shift distributions.

For more information, do not hesitate to contact us or request a personalized demo.