Doctors want to practice medicine. Instead, we are buried in paperwork
Posted on September 30, 2024 in Health Delivery System
Source: TheStar.com — Authors: Adrianna Schamp
TheStar.com – Opinion/Contributors
Sept. 30, 2024. By Dr. Adrianna Schamp, Contributor
A recent survey from the Ontario College of Family Physicians found that on average, a family doctor spends 19 hours per week on administrative and clerical tasks.
Two-and-a-half million people living in Ontario do not have a family doctor, according to the Ontario College of Family Physicians. In fact, it is estimated that by 2026 a quarter of people living in Ontario will be in this predicament.
Unfortunately, many family doctors are giving up their practices and fewer medical students are choosing family medicine.
When I trained to become a family doctor in Ontario almost two decades ago, the atmosphere surrounding the job was very different. During medical school, I was taught to use science to solve medical problems, to work in partnership with specialists, and to provide support to the patients under my care. None of my training focused on how to deal with the mountain of paperwork, administrative tasks and clerical responsibilities that I find myself responsible for daily. This growing administrative burden is destroying family medicine.
Administrative burden is a catch-all term to describe all the work a family physician does each day that does not include seeing patients. I complete this work before or after my clinic hours and in the few moments between seeing patients, but often it is done after hours. On a typical day, forms littering my desk include work notes, requests for massage therapy, home care forms, test requisitions, travel grants and special medication applications; the list goes on and on.
My ancient fax machine never stops spewing out medication refill requests from pharmacies. I shudder when I see the 16-page disability tax credit application land on my desk. Onerous disability insurance forms are different for each insurance company with anywhere from 20 to 100 questions. Lawyer’s requests for letters often require scouring years of medical documentation. It is critical that I fill out these forms but they take more and more time each year, time I would rather spend seeing patients in the clinic.
The administrative burden doesn’t end with all this paperwork.
To take care of patients, I have to order tests and follow up on each of them. This job should be manageable, but as a family doctor I am sent the results of every test I order, and every test any other doctor orders for a patient. Everything gets copied to me either electronically or by fax. The pile of results gets larger each year due to the increasing age of my patient population and the growing complexity of their care. Unfortunately, it is not always clear why a given test was ordered by another physician or whether a patient was even notified about the result.
As the gatekeeper of a patient’s medical record, the task lies on my shoulders to sort out abnormal tests and assure proper follow-up for these patients. Electronic medical records should simplify this task but they do not. Many physicians in Ontario do not share electronic medical records and without the support of the provincial government to amalgamate all of these electronic patient charts, caring for patients is a complex and difficult task.
The Ontario College of Family Physicians recently surveyed family doctors and found that on average, a family doctor spends 19 hours per week on administrative and clerical tasks. Is it any wonder that recent reports state that medical students don’t want to be family doctors? In fact, 94 per cent of family doctors report feeling overwhelmed with this burden and as a result, some even close their practices. In my hometown of Sault Ste. Marie, Ont., 10,000 patients recently found themselves without a family doctor and now 40 per cent of community members are without a primary health care provider.
The medical colleges and associations are trying to advocate for changes that lessen administrative burden, but more must be done and quickly. The provincial and federal governments must take a more active role in addressing this issue. As our population ages and grows, it is going to take a concerted effort to make family medicine a job in which doctors are able to see more patients and do less paperwork.
Dr. Adrianna Schamp (Malicki) grew up in Mississauga, studied in Toronto, and now practices family and palliative medicine in Sault Ste. Marie, Ont.
Opinion articles are based on the author’s interpretations and judgments of facts, data and events.
https://www.thestar.com/opinion/contributors/doctors-want-to-practice-medicine-instead-we-are-buried-in-paperwork/article_b3e9e2b2-7147-11ef-9856-73c0f79efb5d.html
Tags: Health, ideology, jurisdiction
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