Team management · 8 min read · 2026-08-19

8 moments that wreck your FMG schedule.

In a Family Medicine Group, the schedule does not break just anywhere. It is almost always the same situations that come back, and a schedule that held up on Friday ends up half wrong by Tuesday. Here are eight of them, what actually goes on when they hit, and what to change so it stops.

By Kamel Gorieze

Co-founder · product and user experience

In short

Six of the eight moments happen after the schedule is published, when a change does not reach the rest of the team.
The same three things show up every time: the office, the walk-in block and the on-call shift.
A fairness argument costs more than a scheduling error, because it comes back every month for as long as nobody produces numbers.
The real cost gets paid on Sunday evening, at the manager's kitchen table, and shows up in no budget.

Why it is always the same ones

An FMG week has its forced passages: Monday opening, the start of walk-in blocks, the Friday call handover, the hours when everyone needs an office at once. Every FMG already has to cover a minimum of 68 hours of services a week spread over seven days, and an accès-réseau FMG adds 28 to 84 hours on top depending on its designation level, which multiplies the hands passing the baton.

On top of that, the schedule is built once a month but read every day by fifteen or so people who were not there when it was built. Everything that changes in between has to reach them.

The eight moments

1. Monday morning, after a weekend that moved things

The manager walks in and three messages are already waiting. A physician has a stomach bug, a specialized nurse practitioner will be at the satellite site rather than the main one, and someone wants to know who has office 4 today. None of it is in the schedule published on Friday, because all three changes were settled by text between two people. By 8:00 the sheet posted at reception is already wrong.

What is missing is a place where a change reaches the rest of the team without anyone having to think about it.

2. Two physicians, one office

An FMG almost always has more professionals than rooms, especially when part of the team works part-time. The room plan, meanwhile, is kept separately from the schedule, and it has been out of date since the first replacement of the month. So it gets settled standing in the hallway, between two colleagues who are both right, while a patient waits.

A schedule that places rooms at the same time as people refuses the double booking when it is made, instead of letting it surface on Monday morning.

3. The walk-in block nobody is covering

The 13:00 block opens in five minutes and nobody is covering it. The withdrawal had been approved two weeks earlier. It never triggered the next question, the one about who takes the block back, and the appointments stayed open in the EMR, because Ofys or Omnimed display a block without knowing who holds it. The patients, meanwhile, have arrived.

Approving a withdrawal and reassigning the block should be the same operation. A block carries a name or an uncovered flag, never a blank, all the more so since those hours count toward the accessibility obligations of the GMF program.

4. The constraint left in an email

A physician stops by the administrative office. He announced back in March that he would be away all of October, and he is right: the email exists, it is clear, and it is buried under eight months of messages.

An inbox makes a poor registry. It does not reread itself when the schedule is being built, it does not say that one request contradicts another, and it mixes what was approved with what was merely mentioned. Constraints need to be written somewhere that belongs to the schedule, by the physician, in thirty seconds.

5. Five shifts each, and one physician still unhappy

Two physicians compare their call in the parking lot. They have five shifts each and one of them still finds it unfair. He is not wrong: two of his fall on a Friday evening and another on 24 December, while his colleague inherited three Tuesdays.

Counting shifts is not enough, they have to be given a value. Once the FMG has agreed on what an evening, a weekend and a statutory holiday are worth, the discussion happens once a year about the numbers instead of every month about people.

6. The Friday afternoon withdrawal

A withdrawal on the weekend shift, an hour and a half before everyone leaves. The manager takes her list and starts dialing. Two voicemails, one physician in consultation, another who would say yes if someone swapped his Tuesday. Nine calls and forty minutes later the shift is covered, but the official schedule still shows the name of the person who withdrew.

Offering the shift to every eligible physician at once takes care of the forty minutes. Updating the schedule right after takes care of the rest, because a schedule known to be wrong stops being consulted at all.

7. The hospital list that lands after the FMG schedule

The email lands at the end of the day, with next month's hospital call and AMP obligations. Three of the FMG's physicians have some falling on days they are already supposed to be at the clinic. The FMG schedule was published ten days ago, the appointments are booked, and it is the clinic that will give way.

Nobody at the FMG controls the hospital calendar. What can be controlled is speed: the faster the schedule is corrected, the fewer patients have to be called back.

8. Sunday evening, in Excel, at the kitchen table

The manager builds the next period at home, because it is her only two uninterrupted hours of the week. She re-enters the week's seven snags by hand, the ones she settled from memory, and she is the only person in the FMG who can do it.

That is where the real cost of the schedule gets paid, in the evening, without showing up anywhere in a budget. It is also the FMG's most concrete risk: when she takes two weeks of vacation, nobody can replace her.

What these eight moments have in common

Six of the eight happen after the schedule is published. Building it is done calmly, with all the information in view, and it works well enough even in Excel. It is the changes that hurt, for lack of one place where they become visible to the fifteen people concerned. And every time, the same three things come back: the office, the walk-in block and the on-call shift.

There is also the fact that an FMG manager schedules physicians who are not her employees. Everything gets settled by discussion, and a discussion drags on when the numbers are vague.

Where to start next Monday

Pull up your last ten post-publication changes. Who asked for what, how it got settled, and how many people knew about it the same day. That is the list that shows where your schedule loses the thread.
Date your schedule. The version and the last-modified time, visible to everyone. A team that knows when the document changed stops working from last week's screenshot.
Put the offices in the schedule. As long as the room plan lives elsewhere, it will create conflicts you find out about too late.
Produce the on-call numbers before the next discussion, not during it.

Where Synchro fits

Synchro builds the schedule for Quebec medical teams: walk-in blocks, weighted call, offices, constraints written in plain French by each physician, transfers between colleagues with a record of who accepted and when. When someone changes something, the whole team sees it immediately, which targets the six moments that happen after publication.

Frequently asked questions

Why does an FMG schedule always break at the same moments?

Because an FMG week has its forced passages: Monday opening, the start of walk-in blocks, the Friday call handover, the hours when everyone needs an office at once. Pull up your last ten post-publication changes and the same handful of situations will come back.

How much time does it take to manage an FMG schedule?

In our pilot FMG in Saint-Hyacinthe, a team of about thirty people managed in Excel took roughly 30 hours a month, post-publication fixes included. With a dedicated tool it came down to around one hour. The calculation is detailed in the article on Excel. These are our own measurements, not a network average.

How do you split evening and weekend call without reopening the subject every month?

By giving shifts a value instead of just counting them. The FMG agrees once on what an evening, a weekend and a statutory holiday are worth, then everyone can see their own running total. The discussion is then about the numbers once a year, rather than about people every month.

What should you do when a physician withdraws on a Friday afternoon?

Offer the shift to every eligible physician at once instead of calling them one by one, give it to the first who accepts, and update the schedule right away. The round of calls takes thirty to forty minutes and leaves an official schedule that no longer tells the truth. That is what shift transfer handles.

Do you need software, or is a better method enough?

A small, stable team with one site and little call does fine with a shared file and some discipline. The threshold is crossed when post-publication fixes take longer than building the schedule in the first place, when only one person knows how to do it, or when the same fairness discussion comes back every month for lack of numbers.

Sources: Programme de financement et de soutien professionnel pour les GMF, MSSS, in force from 1 April 2026, section 4.6.1.1 for the 68 hours spread over seven days and section 5.8.1 for the accès-réseau mission hours. The management hours cited come from our own measurements in a pilot FMG and are not a network average. Product names belong to their respective owners.

About the author

Kamel Gorieze