The laboratory on-call model has been inherited more than it has been designed. Most labs run some version of the same arrangement whether it’s a rotating list, a phone that gets passed, or an expectation that whoever is on call will respond when needed. This is often because that is how it has always worked, not necessarily because anyone sat down and determined it was the best way to ensure coverage while protecting the staff providing it.
That distinction matters more now than it used to. The ASCP found that 85.3% of laboratory professionals have experienced burnout, with lack of adequate staffing and heavy workload identified as the leading contributors. On-call obligations sit at the intersection of both. They extend the workload of staff who are already stretched, and they fall most heavily on the staff whose experience makes them most valuable and hardest to replace.
The Willingness Problem
On-call lists in most laboratories are built around who will take the call, not who should.
The consequence is a coverage model structurally dependent on the most committed staff, offering them in return an accelerated path to the exhaustion that precedes departure. A 2020 ASCP vacancy survey found that 44% of laboratory professionals experiencing burnout were considering leaving the field entirely. On-call obligations don’t cause burnout in isolation, but they reliably accelerate it in the staff already most at risk of leaving.
What Redesigning On-Call Requires
Redesigning an on-call system from scratch is something most laboratory managers resist because the current model, whatever its costs, is known. It functions well enough to avoid a crisis. The staff who carry it are still there. The case for changing something that hasn’t visibly failed is a hard one to make, at least until it fails.
The labs that have moved past inherited on-call models share a few characteristics.
- They track on-call frequency as a retention variable, monitoring concentration rather than waiting for someone to raise it as a concern.
- They build compensation and recovery time into the on-call structure explicitly, rather than treating call-ins as a normal extension of the working week.
- And they distinguish between on-call availability and on-call response, which carries a meaningfully different physical and cognitive burden and should be accounted for differently in the schedule.
The Expertise Concentration Risk
There is a compliance dimension to on-call burnout that extends beyond retention. In specialized disciplines like blood bank, microbiology, and molecular diagnostics, on-call coverage requires specific expertise that is not broadly distributed across the staff. When the pool of qualified staff for overnight blood bank coverage is small, the burden concentrates among them by necessity. When those staff members burn out and leave, the coverage model loses not just people but the qualification depth that made coverage possible.
The ADLM whitepaper on laboratory staffing shortages notes that stress from high vacancy rates and overtime likely leads to greater dissatisfaction and burnout, a cycle particularly acute in specialized roles where vacancy rates are already elevated and on-call burden is already concentrated. An on-call model that depletes the specialists who make it viable is not a sustainable coverage strategy. It is, instead, a slow drawdown of a resource that is genuinely difficult to rebuild.
The Conversation Worth Having Before It Becomes Necessary
The staff who take call most often are also, typically, the staff with the least formal input into how the on-call system works. They inherit the model the same way the lab did, because it was there when they arrived and changing it requires a conversation that has not been prioritized.
That conversation is worth having before the departure that makes it necessary. The on-call model most laboratories are running was not designed for current workforce conditions: elevated vacancy rates, an aging professional population, and a generational shift in expectations around work-life balance. Redesigning it is not a minor scheduling adjustment. It is a retention strategy that happens to require a scheduling solution, and the distinction shapes how seriously the problem gets taken.
On-call scheduling that protects your most experienced staff is a retention strategy as much as a coverage one. Schedule a 30-minute walkthrough with our team to see how StaffReady makes your scheduling and competency tracking challenges tangible, visible, and solvable.
I’m not as familiar with industry grammar, so unclear if this is correct phrasing.
