Physician Burdens

The Physician Burdens engagement is now closed. Your input will be used to inform policy development at Doctors of BC. The results from this engagement have been included in a What we Heard report distributed to members.

Help us understand how we can advocate for you

We know physicians are frustrated by mounting demands. For many, the volume and pace of these demands has become burdensome, and this can have serious consequences for physicians and the health care system.

A dedicated, long-term approach that focuses on systemic change is needed. Doctors of BC is committed to advocating for this change.

A literature review and early member engagement revealed 10 key burden areas. We now need your input to understand if and how these impact you. Scroll down to the three blue tabs below to share your thoughts.

Your input will help inform policy recommendations specific to the BC context and enable Doctors of BC to advocate for solutions that reflect your experience and meet your needs.



Have your say

Take 10 to 15 minutes to share your input on this online engagement platform:

  • Go to Step 1 to help us Identify the burdens
  • Go to Step 2 to help us Understand their impacts
  • Go to Step 3 to Inform our solutions


Navigate through this online platform by clicking the three blue tabs below.

Help us understand how we can advocate for you

We know physicians are frustrated by mounting demands. For many, the volume and pace of these demands has become burdensome, and this can have serious consequences for physicians and the health care system.

A dedicated, long-term approach that focuses on systemic change is needed. Doctors of BC is committed to advocating for this change.

A literature review and early member engagement revealed 10 key burden areas. We now need your input to understand if and how these impact you. Scroll down to the three blue tabs below to share your thoughts.

Your input will help inform policy recommendations specific to the BC context and enable Doctors of BC to advocate for solutions that reflect your experience and meet your needs.



Have your say

Take 10 to 15 minutes to share your input on this online engagement platform:

  • Go to Step 1 to help us Identify the burdens
  • Go to Step 2 to help us Understand their impacts
  • Go to Step 3 to Inform our solutions


Navigate through this online platform by clicking the three blue tabs below.

Tell us what specific demands are burdening you or your practice.

Share as many specific examples as you'd like in the comment box below. Comments will be displayed below and can be viewed by other physicians.

Your input will provide further insight into if and how the burden areas identified in the literature and early member engagement impact physicians across BC.

Click the Submit button to publish your comment.

Administrative work and paperwork. Not being able to take "sick days" easily. Increasing demands, both clinical and administrative, from the health authority. Losing autonomy in clinical decision making to the health authority. Contract negotiations. I find it absurd that recently physicians and nurse practitioners separately negotiated contracts for new government-sponsored urgent care clinics and that the NPs ended up with a far better deal!

user765 4 months ago

LACK OF ADEQUATE PAYMENT FOR MY TIME AND KNOWLEDGE.

robert 4 months ago

I am nearing the end of my career. I own and run a walk in clinic, which I acquired a few years ago, when it was a profitable business. I am finding it increasingly difficult to staff it with medical personnel. I am about to renew my lease and I am very reticent to do so. The local health authority has opened 2 urgent care facilities, which I regard as nothing more than glorified walk in clinics, in our region and is about to do something similar in the downtown core. They will provide a working environment and compensation that is more appealing than anything I can offer. I won’t be able to compete with these entities for the scarce physician resource. Nor can I compete with those clinics fortunate enough to be aligned with pharmacies. The business will likely have to close. I have invested a lot of money in the last 5 years that is likely to be lost. I don’t think that the thinkers in the system appreciate the role of the physician entrepreneur and the huge (collective) investment we make to provide an infrastructure for practice. It is very difficult to manage the physician staffing when there is no requirement for any sort of commitment or contract. The walk in segment relies on mostly casual part time workers who come and go as they please. It’s nearly impossible to maintain consistent staffing level and hours of service. College requirements that we follow patients who attend repeatedly allows no control over workload. Unlike our colleagues in a traditional practice, it’s not so easy for us to say that we aren’t taking new patients. I am seriously considering shutting it down and walking away. 500 patients a week may end up in the ER.

Notyourdocinabox 4 months ago

-Form is a 4 letter F word. SO much uncompensated work. My current biggest pet peeve is BC Cancer agency clinical follow-up forms. I am not their research assistant, they can either pay for these forms or go on careconnect to find this info themselves. I refuse to do them anymore.-complete lack of drug pricing transparency/formulary info on EMRs. Full formulary and cost info should be readily available to pre-empt the fax/phone call from the pharmacist to apply for special authority, etc. We really need to understand costs if we have any hope of patients following our recommendations -College is completely ineffective to enforce their own rules that actually matter (eg there is a physician in our rural area who won't see own patients in hospital and routinely goes on 1-2 week vacations with no coverage)--BUT they will undertake costly, time consuming evaluations of our office sterilization procedures. In a small town we know our name is on the line and we would never knowingly do a poor job of sterilizing equipment for the simple fact that it's bad patient care and it will ruin our reputation which in the end is all we have to stand on.

Knitttingbiddy 4 months ago

THERE IS CONSTANT PRESSURE BY PATIENTS TO DO MORE AND MORE IN A MORE EXPEDITED TIME FRAME. I AM EXPECTED TO COMPLETE HOARDS OF FORMS FOR EVERYTHING AND HAVE VERY MINIMAL REIMBURSEMENT. I AM EXPECTED TO REVIEW AND COLLATE INFORMATION FROM SPECIALISTS WITH NO FINANCIAL REIMBURSEMENT. I REVIEW COPIOUS TESTS AND XRAYS AND COMMUNICATE TO PATIENTS WITH MINIMAL REIMBURSEMENT. WE ARE NOT PAID ADEQUATELY AT ALL FOR OUR EXPERTISE AND OUR SKILL IN ORGANIZING PATIENTS CARE.

robert 4 months ago

Work is complex and patients have expectations and we meet those demands in a happy way. I run a 5 physician Family Practice group practice and have specialists as well. The main burden is the gross incompetence of the CPSBC committees and the lack of available options when they are sloppy and inaccurate with their work. We all should be held to high standards and the CPSBC is not. The CPSBC committees should be held accountable and individuals at the CPSBC must be held accountable to some type of reasonable standard.The Health Review Board is not reasonable to call out the CPSBC errors as it would take up too much time that practicing physicians don't have and committee type people have in abundance. I see the CPSBC affect many excellent colleagues while not bothering incompetent colleagues

satisfiedwith practice 4 months ago

1. Struggling to pay off my enormous student debt2. Lack of pension/financial security for the future3. Working 24-48 hrs in a row. Being on call for no additional compensation. How are these working conditions ok?4. Lack of overtime/sick days/5. 10-15 min appointments do not address the complexity needs of majority of patient population but due to insane overhead costs are the only way to do business. 6. For every hour of seeing patients I have 40 min of paperwork -unpaid work. In a job where extensive paperwork is required, there should be compensation for it.

Db14 4 months ago

I am in rural practice and also practice in the ER at our local hospital.Within the office context the burdens that contribute to a sense of frustration and burnout are technology - fighting with the EMR to accomplish tasks such as referrals and investigations. I also believe that patient expectations to some degree contribute to this scenario. The biggest contributor though is the wait lists that patients are expected to endure due to lack of access to specialist care in the rural setting. We are left managing situations in the office that could be resolved quickly if our patients could see the appropriate specialist and/or get the appropriate investigations. Within the context of the emergency room, the biggest contributor to burnout is transportation. Continual issues with transferring patients to higher level of care contributes to physician stress and burnout. Understaffing of both nurses and physicians contributes to long wait times for patients which further stresses physicians.

TaraGut3 4 months ago

I am a full time emergency physician and I do a small amount of family practice. I believe poor patient flow through the hospital and understaffing of both physicians and nursing staff impacts negatively upon patient care and cause burnout amongst physicians (and nurses). It is a a complex problem but I believe varying your practice is one way to help fend off burnout. I believe more should be done from a College and DOBC perspective to encourage physicians to move around and practice in different areas of the country. I have recently done locums in BC and NWT but in places, have been met with a tremendous amount of resistance and red tape. I believe doing so allows you to break your routine, meet other people, learn what others are doing, and provides an opportunity to see parts of this beautiful country that you would not otherwise see. I would like to see formal exchanges set up and I believe that from a College point of view this improves patient care facilitating a healthier work force of physicians.

Martin 4 months ago

Health system frustrations, program/silo focused care vs patient centered careCompassion fatigue with emr's (bidirectional and office and hospital)College of Physicians and Surgeons of BC has become over-confident and paternalistic while turning a blind eye to the big MD professional issues facing the public.Lack of ability to innovate to high value care. Too much resource focused on low value care.

highvalueFM 4 months ago

I have a small practice but also work in a walk in clinic. I am overwhelmed by the number of patients without family doctors who have complex needs. We need more physicians who speak languages other than English as well, because translation services do not always work well, especially with the elderly.

User24 4 months ago

The opiate addiction crisis is straining the system. There are inadequate resources for treatment- voluntary or otherwise, inadequate housing. It’s hard to watch your clients die.

lm1959 4 months ago

1. Lack of useful EMR in hospital with upgrades that don’t improve clinical usefulness2. Lack of true support for family practice work in hospital: we are the only physicians on call not remunerated to be available for response with increasing expectations and care responsibilities 3. Too many patients not enough time

Melanie 4 months ago

1. Requests for forms of various types/kinds. These are time consuming and mainly are fruitless. The specific example that is rather onerous is that of the disability tax credit. I've seen a massive increase in the demand for this form, despite the bulk of the patients not qualifying. This leads to time consuming conversations OR a wasted application process.2. Social work: The availability of services to help patients navigate the complex world of social assistance is lacking locally so often I end up spending time trying to help patients sort this out. Time consuming and not something I know a lot about.3. Meetings: there are typically 1-3 meetings a week for various committees/groups. They usually happen in my 'off' hours such as lunchtime or immediately after office. This adds hours to my work, and limits time to do 'catch up'.

UserName16 4 months ago

My practice has been limited to addiction medicine for the last 20 years. I was the first physician in BC to complete fellowship training in addiction medicine (Cleveland 1999). A big part of my practice in the first ten years was to act as a community based consultant (as well as doing hospital, treatment centre, jail, OAT, occupational etc. work). I probably did 5000 consults with short term follow up in my first ten years and stopped acting in this role when other areas of work got to busy. I noticed that when I stopped this work, people I was seeing in my private office started turning up in hospital. To me, this meant their care was transferred from a low cost environment to a high cost setting and the disease was more advanced. Currently, the only doctor doing comprehensive, office based, addiction medicine consults by referral is my office partner. His wait list is four months. I've advised him to close it for medical legal reasons. The people he sees are the same patient population I saw more than a decade ago. These are not people needing OAT. They are alcohol, cannabis and stimulant dependent people. The OAT people he sees in his OAT clinic. The same practice I had. To date, he bills the same fee code I billed, which pays about the same as it did a decade ago, but markedly less actual dollars with overhead etc factored in. My office partner and other physicians interested in community based addiction medicine care would be drawn to the work if there was a well remunerated dedicated fee item. Doing this work in a private office, referral based setting, as opposed to a publicly financed clinic is more ideal. It ties the doctor to the setting and hence to the patient.

Paul W. Sobey 4 months ago

Patient and family expectations regarding care are a challenge as what is acceptable versus real time frames for tests and treatment are not always the same. Paperwork is an ongoing challenge. Also planning transition of practice with difficulty finding coverage and replacements

user4550 4 months ago

The increasing amount of initiatives, quality improvement and specific programs. It's hard to be familiar with everything. There's such a wide availability of programs, there's no central repository for figuring out what's locally available vs. further afield.

UserName16 4 months ago

Paperwork like pharmacare forms and a lack of understanding especially from pharmacare that specific drugs are actually better for patients (like LAMAs should be first line therapy and why in the world do they advocate SAMA/SABAs for COPD patients and make life awful for family doctors to fill out ridiculous paperwork. AND specialists who expect the family doctor or referring specialist to fill out a 1-5 page referral form to get their patients seen basically doing the entire consult for the specialist; rising costs of running an office and the complexity of finding competent front staff in smaller communities;

sunshine 4 months ago

I have been a full service solo GP for last 17 years and approaching 50. I relate to various issues mentioned in other comments . I have decided to drop obstetrics end of the year and reduce work hours and do less call to find balance . The paperwork ( i am on EMR ) is endless and it seems like I have been on call for last 2 decades , I am making changes before it is too late , at the moment I enjoy good health and hope to keep it that way as long as I can . I am planning to switch to alternate payment model and am interested in team work approach . Thanks

Satishmann 4 months ago

I find that the people that the health authority places in lead positions often lack the ability to lead, and subsequently, care suffers all the way down the chain. It seems that often these people are chosen perhaps for their degrees, etc, rather than their abilities. Then when issues arise, they are poor at improving the situation, because they lack the practical abilities to problem solve. They also do not take well to efforts to improve care because they lack the confidence to take criticism, or feel that suggestions from physicians are somehow threatening. I have seen this situation in several different entities, and find it rather scary in the field of medicine. Patients are becoming more complex and more ill, requiring a team that is on the ball.

ramier 4 months ago