Canadian doctors spend millions of hours on unnecessary paperwork each year: report
dr Leisha Hawker sets aside a full day each week just for paperwork. She sees no patients and works through form after form to get home in time to put her daughter to bed.
She is not alone in this routine.
The Halifax GP, who is also president of Doctors Nova Scotia, said most doctors in the province spend an estimated 10 hours a week on unnecessary paperwork.
This means someone else could do it, or it doesn’t need to be done at all. She said that work accounts for about 500,000 hours of medical work each year in Nova Scotia and often falls on nights and weekends.
“A lot of younger doctors who have families work two shifts,” Hawker said. “You go home and take your kid to judo or swimming or whatever, put them to bed and then log back in and do more work and then go to bed late at night.”
In 2019, the provincial government partnered with Doctors Nova Scotia to study administrative burdens on doctors and how to reduce them. A new report released Monday builds on that research and draws conclusions that apply across the country.
The Canadian Federation of Independent Business’s Patients Before Paperwork report shows that Canadian physicians spend 18.5 million hours a year on unnecessary paperwork — the equivalent of 55.6 million patient visits.
“Ministries of health across Canada face many complex challenges,” the report states. “A chronic shortage of health workers, an aging population and capacity constraints have put pressure on the health care system and the doctors who support it.”
The aim is to reduce the administrative burden
A September 2022 survey by Angus Reid found that half of Canadians either cannot see their GP within a week or cannot find a doctor at all.
Monday’s CFIB report concludes that if governments across Canada set a goal of reducing the administrative burden on physicians by 10 percent, they will reduce fatigue and burnout, improve the quality of patient care and achieve the equivalent of 5, 5 million patient visits per year.
“We know that all prime ministers are working with the federal government to negotiate a new deal on the health front, which is very important,” said Ryan Mallough, CFIB’s vice president of legislative affairs.
“But we want to make sure we don’t forget about the other things we can do in the system … if it eliminates a form that doesn’t need to be filled out by a doctor, or if it reduces a 12-page form to a three-page form.” . It adds up and it will save doctors time seeing their patients.”
Leanne Hachey said even if her office meets the 10 percent reduction target, they will continue the work. (Brian MacKay/CBC) Nova Scotia is moving forward
Since 2019, Nova Scotia has been working to reduce the administrative burden on physicians.
Mallough said this is groundbreaking work and he hopes other provinces will follow suit.
“We know medical associations have reported this to 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 Regulatory Affairs and Service Effectiveness took the lead on the project and outlined 15 actions that would reduce unnecessary administrative burden by 10 percent by 2024.
Leanne Hachey, the office’s executive director, said 500 doctors in Nova Scotia were interviewed.
“We’ve heard that stress looks like many different things. It looks like too much paperwork, duplicate forms, different agencies asking for the same information, things they need to do on paper instead of doing digitally. Processes that just don’t work make no sense.”
Hachey said her office has acted as a liaison between doctors and provincial authorities to help them collaborate and make changes.
dr Joe Gillis said if he doesn’t keep a handle on the paperwork, it can get out of control. (CBC)
Joe Gillis, a doctor in Yarmouth, NS, said his desk is often full of forms that he will “pick up later in the day.”
But he said if he doesn’t stay up to date, things like insurance and income support forms, medical exams for drivers and tax credits for the disabled “could spiral out of control”.
He said he’s pleased the government has committed to reducing this type of extra work, but the province still has a long way to go.
“Healthcare is difficult right now, both as a patient and as a provider,” Gillis said. “And I think anything we can do to alleviate this difficulty is just a step in the right direction for everyone.”
He said he’s already heard that some notoriously long and cumbersome forms have been trimmed, but he hopes more technology will be used in doctors’ offices to further reduce the work.
“Take a fork and knock off an iceberg”
The provincial Office of Regulatory Affairs and Service Effectiveness has less than a year to meet its goal of a 10 percent reduction.
Hachey said the office’s physician impact assessment tool shows they are halfway there, but she believes they will meet or even exceed the goal.
“Sometimes it feels like you’re going to take a fork and pick at an iceberg because there’s so much,” Hachey said. “What we need to do is start showing results, get doctors to feel the effects, and then start doing more.”
She said the focus is on saving every doctor minutes of work.
“But when you extrapolate that to 2,500 doctors doing it maybe 50 times a year, those minutes add up to huge hours and annual patient visits.”
Hawker said the 10 percent reduction target equates to about 150,000 patient visits per year. There are currently nearly 130,000 Nova Scotians on the waiting list for basic services.
“That would be a visit for every single person who would be on the waiting list,” Hawker said. “Even a 10 percent reduction in administrative burden could have a significant impact on patient care and the healthcare system.”
Hachey said her office has heard about reduction efforts from the British Columbia and Manitoba governments and hopes more will come forward.