A Physicians Guide to On-Demand Telemedicine Staffing Models

On-demand staffing is very similar to how companies like Uber or Lyft operate their driver staffing. Telemedicine companies will manage a large pool of contracted doctors or nurse practitioners that consult with patients. Those medical care providers come online, log into the telemedicine platform and make themselves available to patients whenever they want, then log off at any time. They then access the queue of patients in the virtual waiting room and claim the ones they want to see at that time for as long as they want.

The organizations typically only pay the physician per visit, so there is little risk for them if they overstaff to ensure they have care coverage at all times. This type of model is advantageous to telemedicine organizations because scheduling and staffing is much easier to manage. 

Similarly, care providers themselves can benefit from the on-demand staffing model in several ways. 

Benefits of On-Demand Scheduling for Telemedicine Care Providers

• True workplace flexibility – It goes without saying, but being able to work whenever and wherever you want is a highly appealing benefit in any workplace. It’s also one of the primary reasons why physicians enter into a telemedicine career in the first place. It doesn’t get any more flexible than in an on-demand staffing model. Physicians make their own schedules, pick the patients they want to see and, for all intents and purposes, act as their own boss.
• Float Wherever You Want – With on-demand staffing, physicians have the luxury to float between multiple telemedicine platforms more freely, which ultimately increases their chances to secure more consults and make more money. They are not beholden to meeting a certain quota or being 100% present for a specific set of hours. They can leave one platform and jump into another as they please without the worry of leaving patients or telemedicine employers hanging. In many cases, they can be on more than one platform during the time they have set aside to perform telemedicine consults.
• Selectiveness in Consultations – If you’re a savvy virtual care physician spread across a few different telemed clinics, on-demand scheduling allows you to cherry-pick the patients you do want to see, and avoid the ones you don’t. Once you work on a few platforms that will become apparent, and you may become more comfortable with one platform in terms of the workflow, charting, EMR, etc. Otherwise, if you are scheduled to work during a certain time on one specific platform, you can only select from the pool of patients seeking consults on that particular date, time, and platform. You might want to take on consults without video chat, or only see those with ailments that are within your strongest area of expertise. With on-demand scheduling, you can do this with the luxury of a bit more selective freedom.

On-demand staffing can also introduce a host of new issues if not properly managed by both the telemedicine operations managers and the physicians themselves.

Disadvantages of On-Demand Scheduling in Telemedicine

• Competitive Pressures – With a strictly on-demand staffing model, telehealth clinics typically overstaff a specific type of physician since they understand that each additional staff member increases the chances that a patient’s on-demand care request is received and responded to quickly. This creates a competitive free-for-all where doctors and nurse practitioners are waiting in the wings, monitoring a queue of patients. For many, this may not be the most comfortable working environment, especially if you’re paid per consult exclusively.
• Less Consults (and Less Money) – On-demand physicians that are paid per consult might not be able to secure the number of appointments they’d prefer because there is no guarantee that:
  A) there will be patients ready and waiting, and
  B) they will be the care provider to actually “claim” the patient appointment as their own.
• Unpredictable Demand – You might need to stay logged in longer to get the patients you need if you want to meet a personal quota or reach certain financial goals, especially if the patient volume is low. This type of unpredictability may lead to fewer consults for each logged-on physician, as they are all competing for what little patients are ready to be seen.
• Licensing Limitations – Moving into an on-demand staffing model, physicians with multi-state licenses have a greater advantage to reap the benefits of this type of scheduling (or lack thereof). For physicians licensed in only one or two states, which is much more common than multi-state, this type of telemedicine position may not be as fruitful as it could be due to limitations of only being able to treat patients from one or two states.

Scheduled Staffing Model vs. On-Demand

Just like most jobs, where working days and hours are established in advance, telemed physicians working in a scheduled staffing environment will experience more predictable and stable day-to-day workloads.

Similar to the on-demand model, the traditional scheduling model has some advantages and disadvantages to physicians.

Benefits of Traditional Scheduling Models in Telemedicine

• Guaranteed Money – Usually, scheduled physicians will receive some sort of guaranteed pay, even when the patient volume is low. For the most part, scheduled physicians are more likely to be guaranteed some sort of minimum pay per shift, whether that’s because they are paid hourly on top of their consults, or because tight scheduling ensures they’ll reach a certain number of consults each shift. 
• Preset Schedules – Having a predetermined, clearly defined schedule can be advantageous for busy physicians who juggle multiple positions, whether online or in brick and mortar clinics. Not all employers leverage an on-demand model, so advanced scheduling is certainly a benefit for doctors who want to conduct visits at specific dates and times or already have scheduled shifts elsewhere. 
• Off Hour Guarantees – Most platforms operate until 10:00 or 11:00 PM, however, there are some “Virtual ER” platforms that operate 24/7. For those who prefer working through the later night-time hours instead of the standard day shift, a telemedicine platform that does shift scheduling is probably going to be more lucrative. Late-night hours aren’t the most popular time of day for people to seek medical care overall. Therefore, in an on-demand delivery model, medical care professionals preferring exclusively nighttime consultations could have more difficulty reaching the workload or pay they expect simply because there aren’t as many patients to see on the fly. However, if you’re scheduled in advance for these night shifts, you get to not only work at your preferred time but also ensure you make a minimum and are likely to conduct more patient consults. Clinics are unlikely to overstaff during these hours, so it’s less competitive if there are only a few physicians logged in.

Disadvantages of Traditional Scheduling Models in Telemedicine

On the flip side, many of the aforementioned benefits of being in an on-demand staffing model aren’t typically associated with working in a scheduled staffing setting. Thus, the obvious disadvantages of being employed in a scheduled staffing model might include:

• Less workplace flexibility
• Less selectiveness in consults
• Less potential to work across several platforms

Tips for Telemedicine Physicians

Whether you are seeking employment or currently working in an on-demand or tightly scheduled capacity, there are certain ways physicians and nurse practitioners can better ensure they see the patients they want to see at the times they want to see them. 

1. Obtain Licenses across multiple states – Interstate Licensure Compacts offer a unique opportunity for physicians to obtain (and maintain) medical licenses across several states without clearing as many hurdles as they would have to when seeking individual state licenses one by one otherwise. Licensing compacts will group states together based on the similarities in their licensing processes and requirements, and then physicians can leverage the compact to gain licensure in states that are most similar to their primary states’ statutory requirements. Online clinics tend to favor employing and scheduling medical professionals with licensing in multiple states. 
2. Join Multiple Platforms – Especially for physicians who are new to telehealth, joining multiple platforms might seem like overkill or a lot to manage. This is becoming a more common practice for physicians because it better ensures they’re able to meet their personal patient-per-hour sweet spot, which is typically 3 to 5 patients per hour for asynchronous telemedicine visits. Juggling multiple platforms and monitoring several different virtual waiting rooms is an effective way for physicians to not only be more selective in the patients they choose to interact with, but also improve their chances of actually picking up a consultative visit at all, especially in on-demand staffing. 
3. Get Savvy – Learning the tools of telemedicine, asynchronous versus synchronous, video visits, chat-based, etc., and being able to quickly toggle between various platforms, waiting rooms, and patients can improve your efficiency as a virtual care professional. To increase your chances of thriving in telemedicine settings, get the right equipment and take the time to learn the tools and processes. This goes without saying, but computer savviness goes a long way in telehealth.
4. Contact Medlink – Whether you’re a telemedicine employer looking for clinical staff, or a physician seeking telemedicine employment, MedLink specializes in staffing for the telemedicine industry. Our massive pool of doctors and nurse practitioners have familiarity with various staffing models and represent some of the best virtual care providers in the country. We are regularly connecting physicians with platforms and vice versa.