Our previous post discussed how a full-time equivalent equals 2,080 work hours annually. To further clarify, we would like to explain how work hours during federal holidays can be calculated. One approach is to offer employees an incentive by counting each work hour after-hours as 1.5 and each work hour during federal holidays as two during the calculation of payable annual work hours. This can encourage employers to expect coverage for emergency work during these times rather than elective work.
An alternative approach is to adopt the “Seven-Day Hospital Model,” which equals all days, including weekends and federal holidays during the calculation of payable annual work hours. This approach can have negative effects on the employee.
First, employers and workplaces can identify all the federal holidays and corresponding extended weekends for the coming year, excluding normal weekends. For example, in 2027, employers and workplaces may plan to observe New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth National Independence Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. In this scenario, employees would be expected to cover after-hours shifts for four days (Thursday to Sunday or Friday to Monday) during the seven corresponding extended weekends. Additionally, they would be expected to cover after-hours shifts for five days (Wednesday to Sunday) during Thanksgiving Day. Therefore, 33 days of after-hours coverage would be needed during federal holidays and corresponding extended weekends in 2027.
Suppose a group of 33 full-time equivalent (FTE) employees is expected to provide after-hours coverage on the 33 days mentioned above in 2027, with only one employee per day needed to cover. In this case, the employer of the 33-person group can withhold 8 work hours pay from each FTE employee’s annual 2,080 work hours pay. Subsequently, each FTE employee can earn back this withheld 8 work hours pay by providing after-hours coverage on any of the aforementioned 33 days in 2027. Suppose any FTE employees cannot provide after-hours coverage on any of these 33 days. In that case, they will not earn back their withheld 8 work hours pay as it will be paid to other FTE employees who have provided after-hours coverage for more than one of the above-mentioned 33 days in 2027. By doing so, the FTE employees are incentivized to earn back their withheld 8 work hours pay and potentially earn multiple incentives of 8 work hours pay if they provide more than their annual share of after-hours coverage during federal holidays and corresponding extended weekends.
However, if the number of FTE employees is too low, such as only 3 FTEs to cover 33 days in the above-mentioned example, none of them gain or lose 8 work hours pay when each provides after-hours coverage for 11 days. But if one of them chooses to cover ten days, they will have a deduction of 8 work hours pay, which will be given to the one providing after-hours coverage for 12 days.
If the number of FTE employees is high, such as 99 FTE covering 33 days, each FTE can be assigned a unique number between 1 and 99. A computer-generated random number generator, with no repeats, can then determine which employee will provide after-hours coverage for each of the 33 days. Any employee who is selected but does not want to provide after-hours coverage on their assigned day will have 8 hours of pay deducted. This pay can be given to the employee providing coverage on that day.
Suppose only 32 FTE employees are covering 33 days. In that case, the computer-generated random number generator can select one employee to provide after-hours coverage on the 33rd day, and this employee will receive extra pay of 8 hours. All 32 employees will have 0.25 hours of pay deducted to cover this extra pay, which will be assimilated in this way. This will mean one of the 32 employees chosen by computer will receive extra pay of 7.75 hours. If that employee does not want to provide after-hours coverage for the 33rd day, they will have to pay the extra 7.75 hours to the employee who provides coverage on that day.
If 34 FTE employees cover 33 days, the computer-generated random number generator can select one employee not to provide after-hours coverage on any of the 33 days.
The bottom line is that although employers and workplaces may be free to choose whether or not to expect elective work from their employees during federal holidays and corresponding extended weekends, they must evolve approaches to how they can equalize the distribution of work among their employees providing after-hours coverage during federal holidays and corresponding extended weekends.
Deepak Gupta is an anesthesiologist. Sarwan Kumar is an internal medicine physician. Shushovan Chakrabortty is a pain physician.
