LLM-Enhanced, Data-Driven Personalized and Equitable Clinician Scheduling: A Predict-then-Optimize Approach

Clinician scheduling remains a persistent challenge due to limited clinical resources and fluctuating demands. This complexity is especially acute in large academic anesthesiology departments as physicians balance responsibilities across multiple clinical sites with conflicting priorities. Further, scheduling must account for individual clinical and lifestyle preferences to ensure job satisfaction and well-being. Traditional approaches, often based on statistical or rule-based optimization models, rely on structured data and explicit domain knowledge. However, these methods often overlook unstructured information, e.g., free-text notes from routinely administered clinician well-being surveys and scheduling platforms. These notes may reveal implicit and underutilized clinical resources. Neglecting such information can lead to misaligned schedules, increased burnout, overlooked staffing flexibility, and suboptimal utilization of available resources. To address this gap, we propose a predict-then-optimize framework that integrates classification-based clinician availability predictions with a mixed-integer programming schedule optimization model. Large language models (LLMs) are employed to extract actionable preferences and implicit constraints from unstructured schedule notes, enhancing the reliability of availability predictions. These predictions then inform the schedule optimization considering four objectives: first, ensuring clinical full-time equivalent compliance, second, reducing workload imbalances by enforcing equitable proportions of shift types, third, maximizing clinician availability for assigned shifts, and fourth, schedule consistency. By combining the interpretive power of LLMs with the rigor of mathematical optimization, our framework provides a robust, data-driven solution that enhances operational efficiency while supporting equity and clinician well-being.