Monday through Friday, your patient’s attending and consulting physicians should round on your patient, write a progress note and enter orders if needed. They usually do this between the hours of 0800-1700. After and before this time, it’s the on-call physicians and midlevel providers that you’ll be dealing with.
Doctors within their group or practice will rotate who takes call. It will not be the same physician or midlevel every time. Rarely are they in-house, typically they are at home. Keep in mind when speaking to these providers that they probably aren’t the patient’s primary physician and may not be familiar with them at all.
Ideally, you need to have the patient’s primary and consulting physicians address all issues. The on-call doctors/midlevels are available for issues as they arise and not for routine things that can wait for rounds.
So, if’ it’s Tuesday at 0730, and your patient’s blood pressure is suddenly 72/45, you will call your on-call doctor.
Similarly, if it’s Tuesday at 0730 and your patient has an 0800 dose of Coreg due that you’re not sure if they want held prior to their 1000 surgery, you will wait until after 0800 and call the attending (or consulting if more appropriate) doctor and ask. It is not an emergency (even though to you it may seem like it because you have 700 things to do now!) and it can wait for the patient’s primary doctor to be on again.
Therefore, it makes everyone’s lives easier if we get all of our questions/concerns/clarification done before 1700 on weekdays.
Now, if a doctor was on-call all weekend, then Monday will be their post-call day. So they were on-call for all of their partners over the weekend, therefore they get a day off where they are not on-call and one of their partners rounds on their patients. Keep that in mind if you work Sunday and Monday. If your patient’s primary doctor is Dr. Smith but he was on call all weekend, one of his partners will cover his patients on Monday.. so you’ll have to either wait and see who rounds or call the office to see who is covering Dr. Smith’s patients. Don’t page Smith!
You should know where their call schedule is or how to access it. Most departments post the call-schedule for their discipline and/or most frequently used service line.
I hope this makes sense! It took me way longer than it should have to understand this because this was something it was assumed everyone just knew.. and alas, I did not.