Readers Write: Ten Ways to Avoid Making the List

Ten Ways to Avoid Making the List
By Ryan Secan, MD, MPH

In honor of the Year of the Hospitalist, I would like to share some hard-earned wisdom with those just entering our profession.

There are many unique things about hospitalist medicine – the seven on/seven off schedule (don’t get me started on this one – that’s another post), the exclusive inpatient focus, and the unfortunate administrative tasks that always seem to fall on our shoulders. Since we don’t have appointments, our patient assignments are determined early each morning at about 7:00 a.m. And often, ‘making the list’ is a job that falls to one of the hospitalists (despite hospital administrators consistently talking about everyone practicing at the top of their license). This remains a manual process that is time-consuming, painful, and delays everyone’s start to the day.

In my 15+ years of experience as a practicing hospitalist, I’ve never run into anyone who enjoys this process, and in fact have seen lots of creative ways that folks have been able to avoid the job. At one of my prior programs, the first doc who arrived in the morning made the list, so everyone started coming in later and later to avoid it. When you feel like you aren’t up for the task, feel free to borrow from:

The Top Ten Ways to Avoid Making the List

1. Refuse to shovel your driveway. Even if the hospital sends someone out to get you, the list should be done by then (this will only work in Boston through April).
2. Delete Waze and just accept that traffic will make you late.
3. Make the list really badly once. They’ll never ask you again.
4. Keep handy a picture of your car with a flat tire. Send to your program director in the morning as needed (but remember, you have four tires).
5. Hide in your car until everyone else has gone in.
6. Park really far away to get those 10,000 steps.
7. Schedule 7:00 a.m. family meetings.
8. Fake an emergency page.
9. Become a nocturnist.
10. Talk to IT. Isn’t there an app for that?

Ryan Secan, MD, MPH is chief medical officer of MedAptus of Boston, MA.