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How one medical center created their dream schedule

At Barnard Medical Center in Washington, DC, the staff and physicians worked together to create a schedule that meets of the patients, as well as the practice’s working parents. Melissa Gohacki, the practice manager, explains how the schedule was designed.

I work at a small primary care office- two physicians and two NPs. One of the physicians is married to one of the NPs, and they are expecting baby #2 any second now. When discussing how to handle their impending situation, there were a few challenges:

  • Childcare is ridiculously expensive here (DC Metro), and they’d be paying as much as a mortgage payment per month with two children in diapers in daycare.
  • Mom really wants to work part-time after the 2nd child is born.
  • Dad also wants to be able to spend more quality time with his family.
  • Our office is fairly new (not yet 2 years old) and when we opened, hours were limited to 8:30a-3:30p for patient appointments, and we are currently trying to figure out how to expand our service hours, not cut back.

What we decided to do was offer the NP two 10-hour days per week, and the physician 3 12-hour days per week, plus some admin time at home. This way there is always somebody available for childcare (dad works Mon, Tues, and Thurs, while mom works Wed and Fri), and we get 40 hours from the doctor and 20 hours from the NP per week.

We thought staffing would be a challenge, since this would mean having earlier opening and later closing times than previously. 

To solve the staffing problem, what I said to the staff was that we needed their help and were hoping to expand our clinic hours to better accommodate both our providers AND patients, and I asked them to give me their “dream schedules.” I told them to tell me when they’d like to work, and to give me what a 4-day week would look like, and what a 5-day week would look like. 

For example, one person might want to work 4 10-hour days, with Friday off, or work 5 8-hour days, starting later in the day and staying until the last patient leaves, or they might want to work 4 9-hour days plus a half day at the beginning or end of the week. I told them I was open to reviewing any schedule which gave them 40 hours in the week and met our patients’ needs.

Because I engaged them and asked them to help me solve the problem, it was much easier to solve the staffing issue than if I had simply dictated a new schedule to everyone. Our new schedule is on the books and everybody is happy with what they’ve got. Better for patients, better for providers, and better for staff.

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