Sick call

[Belleza156]

My residency is implementing a new sick call policy. There doesn't seem to be much agreement in terms of the best way to implement it. Does anyone have a sick call policy in EM which they think works really well?

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[link2swim06]

Our policy is just that you have to be within 1 hr of the hospital and sober. Intern year they try put your call on your 'easy' months.

Also if you do have to go in for call then they 'owe' you a shift at some point.

Sick call isn't a big deal. You almost never get called in. Just don't get drunk or go on vacation for your call weeks.

 

[Fiddlergirl]

Ours is similar. You only take backup call on months you're scheduled to work in the ED. You have to be 30 minutes from the hospital. If someone calls in sick (which is rare), they don't owe you anything later. Sometimes people are too sick to safely work and that isn't their fault.

 

[deleted547339]

Our policy is just that you have to be within 1 hr of the hospital and sober. Intern year they try put your call on your 'easy' months.

Also if you do have to go in for call then they 'owe' you a shift at some point.

Sick call isn't a big deal. You almost never get called in. Just don't get drunk or go on vacation for your call weeks.

+1

 

[dotcb]

Have to be within an hour, have to be sober. If you call in sick, you owe a shift. Without the last part, people have lower thresholds for calling in sick.

 

[TooMuchResearch]

Similar to those posted above. No payback system in place, and our system is rarely used.

 

[The Buff]

Gotta have a payback system. Too easy for one bad apple to ruin the system and piss everyone off without it. Plus, it is only fair if you call out you owe the person who had to waste on of their easy days on you. It is not their fault they are sick, but it definitely is not the sick call person's fault either. It makes it more tenable to be called in on a day off if you know you are going to get it back. Plus, as said above, it keeps the bar high for calling out, just like it is in the real world.

 

[DocEspana]

We are only on sick call when we are off service. Seniors get sick call priority over juniors/interns. If you call out sick you don't owe a shift (AFAIK), but our director would probably make your life very tough if there was any whiff of you abusing the system.

If you pick up the day 1) you get an extra day off your next ER month and 2) you get a small bonus in your paycheck, ends up being like $140 I was told.

 

[sylvanthus]

Ours is similar. You only take backup call on months you're scheduled to work in the ED. You have to be 30 minutes from the hospital. If someone calls in sick (which is rare), they don't owe you anything later. Sometimes people are too sick to safely work and that isn't their fault.

Maybe it is where I am at, but every time we are on sick call for the month it is guaranteed we will get called in at some point. We have one particular 2nd year who has called in at least 9 times over the past 15 months.

 

[Fiddlergirl]

Wow. My program has a strong "Don't abuse sick call" culture. I've been called on once for someone on paternity leave, but that was the only time I've been called in over the past 2 years.

 

[e30ftw]

have never been called in and have never heard of anyone calling in sick at our program.

have had unexpected funerals etc that move the schedule around but never anyone calling in sick.

 

[Arcan57]

Maybe it is where I am at, but every time we are on sick call for the month it is guaranteed we will get called in at some point. We have one particular 2nd year who has called in at least 9 times over the past 15 months.

They're going to be in for some unpleasant conversations as an attending if that trend continues.
We had 3rd years take 1 backup per month and 4 yrs take two backups per month. Because of the hierarchical nature of the program (PGY1's couldn't cover for PGY4s, etc), I don't think there was a payback. We had residents working in wheelchairs after femur fractures, severe back injuries, etc. so the internal ethos was pretty much if you weren't admitted (or possible having intractable vomiting) then you showed up for your shift.

 

[turkeyjerky]

I would posit that any policy that has people working in wheelchairs or in which a single resident gets called in 9 times in a year is not working well. In addition, people should not be working w/ severe communicable disease that they can spread to their patients (gastro, influenza, Ebola, etc.-- uri's don't count).

 

[Fiddlergirl]

What's wrong with working from a wheelchair? Not going in the flu, severe vomiting, pmeumonia, that just makes sense. But we had a resident with a severe acl tear who was in crutches for months. He couldn't call out sick for the whole time, so we all helped him on shift.

 

[Mad Jack]

What's wrong with working from a wheelchair? Not going in the flu, severe vomiting, pmeumonia, that just makes sense. But we had a resident with a severe acl tear who was in crutches for months. He couldn't call out sick for the whole time, so we all helped him on shift.

They had special ortho setups for people with broken legs or whatever at our hospital. Break a leg? You get one of these:

Or these:

Back on your feet (or wheels, or whatever) soldier!

 

[Dane07MD]

One person from each class is on back up call for their class during non-busy off service months where getting pulled away has no negative impact on the rotation you are on. There is no formal payback system, though my particular class has never abused the system and routinely works as a team to try and cover people ahead of time for any reason. No one has ever actually been not sick when they call out. (For me, called in a couple times, one was for a pregnant resident who showed up two hours early because she had been consistently vomiting, tried to sneakily get zofran and a few liters IV before her shift. PD walked by, saw her, and said you're out for this one. Other time was a fellow resident had to be admitted for 2 nights...hard to fake that one.)

Other classes have been thought to abuse the system to some degree though. A payback system is smart, but in my class' case, we haven't needed one (or people will offer to payback anyway).

 

[DoctorMedic]

Our residency has a jeopardy call policy. Basically if you are truly sick you repay 1 shift. If you miss your shift, you repay 2 shifts for each 1. I have never been called in and have been here almost 1.5 years. Only once has this system been activated and that was last year.

 

[deleted547339]

I'm a second year and I've called in one time for a family emergency. I think one of my classmates has called in because of a sick child. That's it.

There have been a few times when people messed up reading their schedule and didn't realize they were working, i.e. got a 7AM call....."hey buddy, whatchya doin?" This happens maybe once every few months. That doesn't result in any repercussions other than probably buying the person who had to stay 30 mins late a beer.

 

[GoBuckeyes913]

Maybe it is where I am at, but every time we are on sick call for the month it is guaranteed we will get called in at some point. We have one particular 2nd year who has called in at least 9 times over the past 15 months.

Unless said resident has a significant medical problem. Like cancer.

 

[The White Coat Investor]

We were expected to be in the ER when our shift started, either as a doctor or a patient. If you're sick enough not to work, you're sick enough to be seen.

 

[gman33]

We were expected to be in the ER when our shift started, either as a doctor or a patient. If you're sick enough not to work, you're sick enough to be seen.

I agree with the above sentiment.

I also strongly agree that all shifts missed should be paid back.
This will minimize the BS callouts by some people.
It's amazing how many people are sick on a weekend shift.

 

[deleted307836]

We were expected to be in the ER when our shift started, either as a doctor or a patient. If you're sick enough not to work, you're sick enough to be seen.

What about something like food poisoning, where you need to be near a toilet but a ED visit is (often) unwarranted?

 

[Modafinil]

Our policy is just that you have to be within 1 hr of the hospital and sober. Intern year they try put your call on your 'easy' months.

Also if you do have to go in for call then they 'owe' you a shift at some point.

Sick call isn't a big deal. You almost never get called in. Just don't get drunk or go on vacation for your call weeks.

Exactly how it works for us.

 

[The White Coat Investor]

What about something like food poisoning, where you need to be near a toilet but a ED visit is (often) unwarranted?

There aren't toilets in your ED? If all you need is a toilet, go to work!

Seriously though, I got sick once in residnecy while on shift. When I could no longer stand to take a history and examine the patient, the nurses took me in another room, and put an IV in me. I then rode my bike home, collapsed in bed, missed my shift the next day (only one I missed in residency) and got out of bed for the first time a few minutes before my shift the day after that. I later made up the shift for whoever covered for me.

I'm not nearly as hard-core about this issue as I sound, but in a small group it is a major inconvenience to cover for someone else, so we try to minimize how often that occurs by working the shift ourself whenever possible

You don't need a policy for something that occurs 2 or 3 times a year. You just suck it up and cover for your colleagues. If it's rare, no one minds.

 

[DeadCactus]

Ad hoc jeopardy system. E-mail goes out asking someone to come in and cover when needed and people volunteer. Shifts are paid back later. Works well. No jeopardy which means more true days off. Wanting to keep the system as well as the shift pay-back motivates people both to avoid calling in and to volunteer...