Designing a fair call policy
Most call policies are a page long, were written to settle one argument, and do not answer the question that comes up next. This is what a policy has to decide in order to be usable by a person building a schedule.
Decide what is being counted
"Call" is not one thing. A policy has to name the units it measures:
- Call periods, regardless of length? Then a 72-hour weekend equals a weekday night.
- Call hours? Then the weekend counts as three times the night, which may overstate it if most of a weekend is quiet.
- Weighted periods, with a weekend worth more than a weekday but less than three? Then the weights need writing down.
There is no correct answer. There is only a stated one and an unstated one, and the unstated one is applied differently by each person who builds a schedule.
Decide over what period
This is the omission that causes the most trouble.
A policy requiring equal call with no window is technically satisfied by almost any schedule and emotionally satisfied by none, because the complaint people bring is "I have had the last three Thanksgivings" — a claim about three years, against a policy measuring one quarter.
Pick the horizon you actually care about. For holidays it is years. For nights and weekends, a year. For routine weekday call, a quarter is usually enough.
A window longer than one schedule period implies carried balances: someone who took more than their share last period takes less this one. That is the mechanism that makes long-run fairness happen rather than being aspired to.
Decide who is in which pool
A policy that says "the department shares call equally" is wrong in every department with a subspecialty. Name the pools, name who is in them, and say what happens to someone in two.
Also say explicitly who is not in a pool and why — a reduced share for a clinical lead, an exemption on medical grounds, a phased return. Unstated exemptions are read as favouritism by everyone who has not been told.
Decide how a reduced share is counted
Someone at 0.6 taking 60 per cent of a full share is being treated equally. A policy that does not say this invites the comparison of raw counts, which makes every part-time colleague look under-burdened.
State it as a proportion of a full share, and state what the full share is measured against.
Decide what happens when it cannot be met
Sometimes the schedule cannot be fair. A pool of four with one person ineligible for nights has an unavoidable imbalance; a month with three people on leave has another.
A policy that only describes the good case is silent exactly when it is needed. Say what gives way first: is an uneven month acceptable if the year evens out? Does the department cover with locums? Does a service close?
Decide who decides
Finally, name the person or group who resolves a case the policy does not cover, and say that their decision is recorded. Most of the perceived unfairness in scheduling is not about outcomes but about opacity — a decision nobody can see looks like a decision taken for reasons nobody will state.
Writing it so software can run it
A policy in these terms translates almost directly into configuration: counted burdens, per-person shares, weights, a window, pools by eligibility, and hard rules for the things that must not happen.
That is not a coincidence, and it is a useful test of a policy. If it cannot be expressed as rules and counts, it is not specific enough for a person to apply consistently either.
How fair call distribution works in KarmaSchedule
Common questions
What is the most common mistake in a call policy?
Not saying over what period fairness is measured. A policy that requires equal call without naming a window is satisfied by any schedule and contradicted by every complaint, because the complaint is almost always about a longer period than the schedule covers.
Should a policy weight undesirable shifts?
If the department believes some call is worse than other call — and it usually does — then yes, because otherwise the weighting happens informally and inconsistently. Writing the weights down converts a recurring argument into a one-time one.