Dr. Leisha Hawker reserves┬аa full work day each week just to do┬аpaperwork.┬аShe sees no patients and works through form after form, so she can get home in time to put her┬аdaughter to bed.
She’s not alone in this routine.
The Halifax family doctor, who is also the president of Doctors Nova Scotia, said it’s estimated that most physicians in the province spend about 10 hours a week dealing with unnecessary paperwork.
This means someone else could do it, or it doesn’t need to be done at all.┬аShe said this work accounts for about 500,000 hours of physician work per year in Nova Scotia, and often falls on nights and weekends.
“A lot of younger physicians that have a family will do two shifts,” Hawker said.┬а“You’ll go home and take your kid to judo or swimming or whatever it is, put them to bed and then log back in and┬аdo more work and then go to bed late at night.”
In 2019, the provincial government┬аpartnered with Doctors Nova Scotia to research physician administrative burden┬аand how to reduce it. A new report released Monday builds on this research and draws conclusions that apply to the whole country.┬а
The Canadian Federation of Independent Business’s report, Patients Before Paperwork, shows Canadian doctors spend 18.5 million hours annually on unnecessary administrative work тАФ┬аthe equivalent of 55.6 million patient visits.┬а
“Health ministries across Canada are facing many complex challenges,” the report said.┬а“A┬аchronic shortage of health professionals, an aging population and capacity constraints all have put pressure on the health-care system and the physicians who support it.”
- Have a question or something to say? Email: ask@cbc.ca or join us live in the comments now.
Target to reduce administrative burden
An Angus Reid poll┬аfrom September 2022 found┬аhalf of Canadians are either unable to see┬аtheir family doctor┬аwithin a week,┬аor they can’t┬аfind a doctor at all.
Monday’s CFIB report concludes that if governments across Canada set a target to reduce physician administrative burden┬аby 10 per cent, they could reduce fatigue and burnout, improve the quality of patient care┬аand open the equivalent of 5.5 million patient visits a year.
“We know that all of the premiers are working with the federal government on hashing out a new deal on the health-care side, that is very important,” said Ryan Mallough, CFIB’s vice-president of legislative affairs.
“But we want to make sure that we’re not forgetting about the other things that we can do in the system … if it’s eliminating a┬аform that doesn’t need to be filled out by a doctor or if it’s reducing a 12-page form to a three-page form.┬аThat adds up and it is going to free up doctors’ time to see their patients.”
Nova Scotia leading the way
Nova Scotia has been working on reducing physician administrative burden┬аsince 2019.
Mallough said this is trailblazing work, and he hopes other provinces will follow suit.
“We know that medical associations have been flagging this with their provincial governments, but as far as we know, no one has come out and done anything as robust as what Nova Scotia has done,” he said.
The provincial Office of┬аRegulatory Affairs and Service Effectiveness took the lead on the project and outlined 15 actions that would reduce┬аunnecessary┬аadministrative burden┬аby 10 per cent┬аby 2024.
Leanne Hachey, the executive director of the office, said 500 physicians were surveyed in Nova Scotia.
“We heard┬аthat burden looks like many different things. It looks like paperwork that’s too long, forms that are duplicative, different bodies asking for the same information, things that they have to do on paper as opposed to doing digitally. Processes that just don’t make sense.”
Hachey said her office has acted as a liaison between doctors and provincial departments to help them work together and┬аmake changes.┬а
Joe Gillis, a physician in Yarmouth, N.S., said his desk is often piled with forms, which he’ll “pick at it┬аduring the course of the day.”
But he said if he doesn’t keep on top of it, things like┬аinsurance and income assistance forms, medical reviews for drivers and disability tax credits┬аcan “get out of control.”
He said he’s happy to see the government committing to reducing this type of extra work, but the province has a long way to go.
“Health care is difficult right now, both as a patient and provider,” Gillis said. “And I think anything we can do to alleviate that difficulty is┬аjust a step in the right direction for everybody.”
He said he’s already heard about┬аsome notoriously long and cumbersome forms being shortened, but he hopes more technology will be used in doctor’s offices to further reduce the work.
‘Taking a fork and chipping away at an iceberg’
The provincial Office of┬аRegulatory Affairs and Service Effectiveness has less than a year to complete their goal of a 10 per cent reduction.
Hachey said the office’s physician impact assessment tool shows they’re halfway there, but she┬аbelieves they’ll meet the target, or even surpass it.
“Sometimes it does feel like you’re taking a fork and chipping away at an iceberg because there is so much,” Hachey said.┬а“What we have to do is start, show some success,┬аmake sure that physicians feel the impact and then start to do more.”
She said the focus is saving minutes of work for each physician.┬а
“But when you build that up to 2,500 physicians that may be doing it 50 times a year, those minutes┬аstart to add up to big hours and to annual patient visits.”
Hawker said the 10 per cent reduction target is the equivalent to about 150,000 patient visits per year. Currently, there are nearly 130,000 Nova Scotians on the primary-care wait list.┬а
“That would be a visit for every single person that would be┬аon the wait list,” Hawker said.┬а“So even a 10 per cent┬аreduction in administrative burden could have significant impacts on patient care and the health-care system.”
Hachey said her office has already heard from the British Columbia and Manitoba governments about reduction efforts, and hopes more will come forward.
