(My Personal) Rules for Call

March 12, 2024
hospital Starbucks: also permitted on call.
Oat milk cappuccinos are my jam.

It’s a call week! I am hoping I can continue the attitude I had in January — that was one of the busiest weeks I can remember but I did really well managing my energy and handling things calmly. I did not resort to scrolling-as-escape-mechanism and actually found this kept things feeling more manageable and less frenetic.

So, here goes round 2! Will try to just remain open to what comes, work-wise, and plan on handling things as they come up. Call is a “PUSH” productivity system (as opposed to “PULL”, where you have a task list and get to decide how to get things done). I guess in some ways outpatient clinic is “PUSH” too, but there’s more predictability and imposed structure there, so it feels different.

It has taken a lot of time but I do think I’ve gotten to so much more acceptance of the “PUSH” of call. Rather than hoping for some kind of outcome, it’s much better to just accept that I will be needed in random fits and spurts, and feel confident that I can deal with whatever comes up. Generally, I do not have to stick to an arbitrary end time in a given work day so there really is enough time to get things done.

And if I DO happen to have extra time? I can use it to finish other administrative-type work tasks (there is always SOME module due, right?) or I can read or do extra Headspace or things like that. I do NOT need to scroll frenetically. Honesty, it’s the wrong kind of energy for these weeks.


1- Get ahead when possible! If possible chart-prep outpatient notes the day prior or the day of. This is new for me but I am really obsessed with chart prep lately! This means reviewing the prior notes, or if it’s a new patient looking at all of the records from the PCP and starting a rough draft note based on the data available. This also helps identify where there might be missing pieces to a puzzle – perhaps a new patient is referred for elevated A1c but there are no lab results in our system. Better to alert the team in advance vs having to scramble once I’m already in there seeing the patient.
(Side note: Patients usually seem impressed/pleased with the pre-review, and the fact that I already have their results like growth charts, X ray images, and labs on my screen and organized so I can explain what I see so far. I feel like this is such a low bar — generally being prepared to see someone and gathering the data?! — but I guess not everyone has the time or desire to do this. To be fair, I DO practice a low-volume specialty and imagine it would be much trickier if I were seeing 40 patients/day!)

2- Use your takeout budget. Truthfully, I don’t have a separate takeout budget (it comes out of my allowance) but call weeks are a time that I don’t mind using said allowance to eat what I feel like eating. It may not be highbrow (today = Panera) but it’s nice to treat myself to delivery on these more stressful weeks. Generally I try to make healthy choices too but call weeks are also a nice time for saying ‘yes’ to adding a cookie or other treat to my order.

3- Defer non-urgent life admin stuff. It will still be there to do later. It helps if I earmark some catchup time in advance (usually the following Tuesday).

4- Sleep when possible. Go to bed early (9ish for me) when it is feasible – it’s actually sort of like having a newborn. Yes, you might have to wake up at 1 AM but that feels much easier if you’ve already slept for 4 hours. And if you DON’T happen get called, what an awesome bonus!

5- Don’t skip running. I know, controversial. And sometimes difficult after a night of interrupted sleep. I definitely allow myself exceptions to this — if I am truly exhausted to the point of feeling bad, this rule does not apply. But otherwise, just suck it up. (I feel calmer and just generally better after a run and I crave this stabilizing force on call days more than ever.)

All right – ending this call week dispatch here 🙂 I definitely have a pretty positive attitude so far. I hope everyone else is having a great week.


  • Reply Yet another Heather March 12, 2024 at 2:02 pm

    I love that you read the notes and look for labs! My PCP *never* looks at the notes ahead of time, drives me crazy. Even when I made an appt to follow up on physical therapy (bc I needed him to authorize additional sessions). He told me he literally never reads the notes and asked me to summarize the info my PT had put together for him. Infuriating, but he’s also so much better in other ways than the two drs I saw before him. I just ran out of energy to keep trying.

    • Reply Sarah Hart-Unger March 12, 2024 at 2:19 pm

      Primary care volume is sooo much higher than what I do that it’s probably really hard! But I hear what you’re saying!

  • Reply Kristin W March 12, 2024 at 3:58 pm

    Sounds like you’ve set yourself up for success! Thank you for sharing a peak into your work life! I have two questions: 1)As I’ve had little interaction with the medical field, can you share more about what “being on call” entails? Are these patients that come to your hospital that need help in your area of specialty? Do you see normal patients during this or do you only focus on this? Do you have to go into the hospital for each patient or can you make a recommendation from home/office? 2)You mentioned an “allowance”…how do you decide what goes in this category? My husband and I have tried this but always end up in the weeds about what comes out of allowance vs. another category. What if he gets food with kids? What if it’s something I’m buying for fun that’s also for the family’s use? If you’ve already covered either of these, please point me in the right direction! Thank you!

    • Reply Sarah Hart-Unger March 12, 2024 at 6:58 pm

      Will do a call post! As for allowance it’s only personal stuff and only if alone (ie taking a kid to a movie wouldn’t count!)

  • Reply jennystancampiano March 12, 2024 at 4:53 pm

    Like Kristin (above) I would love more details about what “call” entails. Maybe- when the week is over, not now!- you could do some sort of “day in the life of call week” post. I’m sure most of us would find it fascinating!
    Anyway- it sounds like you’ve set yourself up for success. Good luck with it!

    • Reply Sarah Hart-Unger March 12, 2024 at 6:57 pm

      Totally can do that!

  • Reply Lisa’s Yarns March 12, 2024 at 7:30 pm

    I feel like I might need to employ something similar for travel weeks? Or figure out some way to manage life better now that it includes travel? I thought of you this am when I used the flight time to Chicago to update my planner while listening to BOBW! It helped to get some of the stuff in my head down on paper! The challenge is that I’m traveling twice a month now so it’s getting so frequent but can really throw so much off. I know lag liv has some rules around travel related to workouts and not drinking so I probably need to employ some of those kinds of rules to my work travel.

    All that said I am glad you have a plan for call and that you have figured out ways to make it more manageable!!

  • Reply Gillian March 12, 2024 at 7:47 pm

    I am jealous that you get stuff in advance. I have patients who come into my office who don’t even know why they were referred!!!!

    Have a good week. Wishing you an easy call!

    • Reply Sarah Hart-Unger March 12, 2024 at 8:31 pm

      Oh my goodness that would drive me crazy! Thankfully our staff does do a great job requesting stuff in advance and we can usually pull old lab results from Labcorp or Quest if we need to

  • Reply Coco March 12, 2024 at 10:07 pm

    The more stress at work. The more I need to run too. 🙂 even at slower pace, I always feel better after running.

  • Reply Amanda Rogers March 13, 2024 at 6:31 am

    I hope I can get to this zen point during call weeks at some point in my career lol. I think I am realizing that what stresses me out the most is not actually the work itself but the feeling of having an end time (which isn’t totally true as my nanny can stay late if needed, and my husband is often home at a reasonable time) and the feeling of getting behind on other life/admin/outpatient stuff during the week. It just feels like it takes an extra week to recover once it’s over. I also have a really hard time exercising during my call weeks. I hope/expect some of this will get better as my kids get older (still 5 and 2 with one on the way), have more predictable sleep/wake up times (I.e. not randomly waking up at 5:30 am some days), etc. Good luck this week!

  • Reply Suzanne March 13, 2024 at 7:15 am

    Ooooh I love hearing about call week from the “other side”! (Wife of a doc, and I have call week rules, too.) I hope this week goes super smoothly for you and that all your efforts at streamlining pay off.

  • Reply Katie March 15, 2024 at 8:02 pm

    Also really helps mentally to put an “i’m on service, might be delayed in returning your email” message on your outlook. Takes away the pressure to respond to emails!

  • Reply Heather March 17, 2024 at 11:59 am

    I’m a primary care provider and prepping charts saves my life every week! Hope you had a good week:)

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