My sister is in charge of scheduling physicians for shifts and on call for a large hospital and she has a really hard time. She does it manually with the help of a spreadsheet. She engaged with some software company to help and after many hours of work she still uses the spreadsheet.

Part of the problem is that some senior physicians do whatever they want and aren't interested in playing fair. They'll call her the day before a holiday and tell her they're not coming in, and my sister is left trying to figure out the least shitty way to cover the gap.