How smarter systems and clear boundaries can protect frontline workers and improve outcomes
In an era of relentless demand, on-call duty has emerged as one of the most unsustainable stressors in healthcare. Doctors, nurses, and frontline specialists are increasingly expected to be available at all hours, sacrificing sleep, work-life balance, and mental clarity in the name of responsiveness. However, as burnout reaches crisis levels across the industry, healthcare leaders are rethinking how on-call responsibilities are managed, not just for performance, but for survival.
The statistics paint a stark picture. Nearly half of physicians reported at least one symptom of burnout in 2023, according to the American Medical Association. A 2024 Medscape survey puts that number even higher, with 49% of physicians reporting burnout, and emergency medicine professionals topping out at 63%.
The old way of treating burnout as an unfortunate byproduct of the job is no longer tenable. Instead, progressive healthcare organizations are shifting toward a human-centered model for on-call work, one that emphasizes clarity, fairness, and recovery.
Below are seven strategies to make that shift and protect your workforce.
1. Prioritize Alert Urgency: Not Every Ping Deserves a Page
In many healthcare settings, alerts arrive with the same level of urgency, whether it’s a life-threatening emergency or a routine administrative update. That’s a recipe for alert fatigue, especially during overnight shifts. Implementing a priority-based alerting system can help staff focus on what truly matters. Critical messages get escalated immediately, while lower-priority notifications are deferred or batched for regular hours. This reduces the “cry wolf” effect, allowing healthcare professionals to conserve their energy for real emergencies.
2. Automate Escalation Protocols to Reduce Chaos
When the first on-call staffer doesn’t respond, what happens next should not be a guessing game. Automated escalation policies ensure that alerts are routed to the right clinician, at the right time, without requiring human intervention in the heat of the moment. These built-in workflows prevent delays, reduce anxiety among staff, and minimize the number of people who get woken up for the same issue. This structure also ensures patients receive timely care without overburdening individual team members.
3. Centralize Communication Channels
Fragmented communication, which involves a mix of pagers, calls, secure messaging apps, and emails, creates friction, confusion, and duplication. Healthcare workers often waste precious minutes figuring out who is responsible for what or chasing down the correct contact method. The solution is a single, unified platform that consolidates all critical communication, securely. When every team member has one source of truth, response times improve, stress goes down, and accountability is easier to manage.
4. Schedule Smart and Fairly
Unpredictable or inequitable schedules are a direct contributor to burnout. Many healthcare professionals report being blindsided by last-minute on-call shifts or trapped in cycles where a small subset of staff carries most of the burden. Use digital tools to rotate shifts equitably and publish schedules well in advance. This allows providers to plan personal time, attend to family needs, and mentally prepare for demanding rotations. Fairness builds trust, and trust helps teams perform better under pressure.
5. Make Recovery Time Non-Negotiable
Burnout doesn’t just come from hours worked. It results from a lack of recovery between periods of intense demand. A clinician who spends the night triaging cases shouldn’t be expected to perform routine duties the next morning without rest. Build recovery into the schedule. Even a half-day off after an overnight shift can dramatically improve alertness, morale, and long-term retention. Some organizations also offer comp time, mental health days, or sleep pods for short breaks. These small investments pay dividends in performance and satisfaction.
6. Educate Teams on Healthy Boundaries
Always-on culture doesn’t just arise from policy. It’s also a product of workplace norms. If staff are praised for responding to messages while off-duty or penalized for setting boundaries, burnout becomes inevitable. Healthcare leaders must take a stand: Respect downtime. Clarify expectations. Encourage disconnection. Normalize not replying to non-emergency messages outside of shift hours. The more clearly teams understand when it’s okay to step back, the more resilient and present they’ll be when they’re on.
7. Leverage Analytics to Catch Burnout Early
You can’t fix what you don’t track. Use real-time reporting and historical analytics to monitor alert volumes, response times, and contact frequency across staff. These patterns often reveal hidden burnout risks, such as one provider shouldering a disproportionate load or specific alerts spiking during off-hours.
A Better Model for Everyone
Burnout isn’t just a workforce issue. It’s a patient safety issue. Fatigued clinicians are more prone to errors, slower to respond, and more likely to leave the profession entirely. The good news is that these outcomes are preventable.
It’s time to stop accepting burnout as a byproduct of commitment. With the right tools and mindset, on-call can be managed, not endured.
Judit Sharon
Judit Sharon is CEO & Founder of OnPage.
