Few of us look forward to administrative tasks. For physicians, however, relentless paperwork is actively eroding wellbeing and feeding into the ongoing health care crisis.
According to the Canadian Medical Association’s (CMA) most recent physician wellness survey, 60 per cent of respondents said that administrative burden was a direct contributor to burnout and worsening mental health.
Admin burden is not a single activity, but rather the culmination of system inefficiencies, complexities and a lack of interoperability between record-keeping systems. Together, they chip away at physicians’ time with patients, sap our energy and take away the focus on care – the reason we chose medicine.
Some administrative work will always be required in health care. Physicians need to document care provided and integrate results from specialists or clinic consultations into patients’ care plans.
But a report from the Canadian Federation of Independent Business (CFIB) found that 38 per cent of the 48 million hours physicians spend on administrative tasks is, in fact, unnecessary. Worse, red tape can delay patient care and contribute to moral injury as well as burnout among care providers.
Electronic Medical Records (EMRs) are one pain point. I was an early adopter, believing technology would reduce and streamline reporting. Instead, information duplication and redundancy has increased exponentially.
A task force on hospital report management in Ontario found that notifications of admissions, discharges and transfers, COVID-19 assessments and other test results add up to millions of records every year. At the same time, the lack of interoperability between EMRs means doctors still have to chase information outside their own health authorities or specific areas of treatment, at times with a direct, negative consequence on patient outcomes.
Sorting through all of this comes at the cost of decreasing face-to-face time with patients during clinical hours, eroding access to care, or taking work home at the end of the day to complete on your own time, so-called “pajama time.”
Some physicians, tired of busy work and sacrificing their personal lives on the altar of medicine, are substantially reducing the number of hours they practise, or leaving the profession altogether.
Nearly half of physicians polled by the CMA said they were likely or very likely to reduce clinical hours – with those suffering psychological distress, not surprisingly, 1.4 times more inclined to do so.
Canada’s health care crisis is multifaceted. System reform will take time. But reducing onerous, needless administrative tasks that are harming physicians is something we can do right now.
This work is underway in some provinces and territories. In Nova Scotia, a report that physicians were spending 100,000 hours writing sick notes prompted legislation prohibiting employers from requesting them.
Change is achievable on a national scale. The CMA’s working group on administrative burden is collaborating with regional medical associations and partner organizations to identify potential improvements and advocate for reform.
In partnership with MD Financial Management and Scotiabank, the CMA has also launched a $10-million Healthcare Unburdened Grant for projects to improve physician wellness by reducing their administrative burden. Recipients will be announced this spring.
Physicians enter medicine because we want to use our knowledge to care for others, not to get bogged down in paperwork. No one should feel they have no choice but to abandon the sector because of it. By naming the high toll admin burden takes on physicians and patient care, targeting solutions and collaborating to pull in the same direction, we can build efficiency into our health care system to give physicians the time they need with patients, as well as the time they need to take care of themselves.
By Dr. Kathleen Ross
Dr. Kathleen Ross is a family physician in Coquitlam and New Westminster, B.C., and the president of the Canadian Medical Association.
