Tales From the Call Room – Medaholic’s Hierarchy of Needs on Call

If you’re familiar with Maslow’s Hierarchy of Needs, there is a pyramid structure of man’s needs. The most fundamental necessities are at the bottom with the need for self-actualization at the top.

I want to propose a similar model – Medaholic’s Hierarchy of Needs on Call

HierarchyLevel 1 – At the most basic level – you have to do your job on call. Look after patients, return your pages and get the work done. On busy nights, you’re happy with just the bottom rung.

Level 2 – On better nights, you might have the chance to eat a meal and maybe even get some sleep. A 30 minute nap, not bad. 2 hours of sleep, now we are getting somewhere. 4 hours – your post-call day is starting to look productive. 6 hours without interruptions – you might as well just have slept at home!

Level 3 – Being on call is all about presentation. Normal bladder and bowel movements, fresh breath and getting along with your colleagues. Call’s not so bad.

Level 4 – Now we’re getting somewhere. You feel great looking after your patients  and you get a lot of satisfaction out of it. You’re doing a good job and you’re happy you can provide quality patient care.

Level 5 – This is now getting to the realm of self-actualization. You’re learning, you’re teaching, you’re finding time to look up the evidence behind the treatments we prescribe. What a great educational experience, an hour on call is worth several hours studying. Finally you are learning some real medicine.

Level 6 – You get to take a shower. You feel refreshed. It’s a total game-changer.

Tonight’s call has been pretty good. I’m hovering somewhere in levels 4 and 5. I even wrote a blog post! Might even attempt level 6 and hope there are no codes.

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