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.

- Increasing health demands and complexity of patients (not necessarily them demanding but their health care needs being demanding) but the system is not able to match their needs. This leads to gap in the patient's care and physicians having to do more work and/or work that is not satisfying to help patients. - The system is forever surveying and asking how they can help but doesn't seem to make much headway in creating the change.- With increased burden on physicians (And to the overall health care system), self-care is even more neglected leading to burnout which then can lead to poor patient outcomes.- BC is becoming very expensive to live in but physicians are not getting appropriate increase in pay like other health care professionals (Nursing) to continue to be able to work and live in BC.- System not financially renumerating physicians especially re: MOCAP. They make it mandatory to provide 24h call coverage and yet do not allow for appropriate financial compensation. Our patients, especially those with medical complexity need a 24h line support instead of visiting the ER so frequently.- There needs to be better education for physicians and all health care professionals to have conversations dealing with serious illness / palliative care as our population is aging.

deardeer 4 months ago

1). Patient load and care burden which consists of• increasing patient numbers,• increasing complexity of care• increasing complexity of psychiatric care required• increasing age of population• increasing expectations from patients• increasing "false" science claims and demands from patients and their alternative practitioners• multiple, and often conflicting guidelines and protocols and prevention screening• lack of resources for patients with poor and untimely access to specialist care and investigations unless emergent.2). Financial problems not being kept up to buy wage increases which consists of• increasing office costs caused by increasing utility bills, wage bills, technology bills, rental etc.• increasingly complex billing with MSP often not knowing what they're talking about.• The prospect of retirement receding into the future as savings are eroded by political and financial instability• increasing cost of EMR with no financial support from the government3). Paperwork• increasing burden of unpaid paperwork/computer work• increasing expectation of patients and employers for form filling• the increasing burden of paperwork means cutting back on patient contact time in order to get home before bedtime

dbeaver 4 months ago

Conflicting demands. Huge pressure to deliver more services, attach more patients. At the same time incentives for visits like Complex Care, Diabetes, Mental Health, CHF, etc. result in more time per patient (and sometimes better care) but net result is a reduction in number of patient services per day. Family doctor participation in clinics for obstetrics, pain management, hospitalist services, OAT, etc. take doctors out of full service family medicine but these doctors are performing services that would have to done by full service docs if the specialist family docs were not doing it. Is a push to have more of our new doctors do full service family medicine but the services they perform as specialty docs will have to be done out of an office by those of us less skilled in the services they provide.Paperwork, Paperwork, Paperwork! This is aggravated by poor and/or inadequate technology. We need ability to share critical information with other doctors and our allied care partners. Especially need on line Care Plans, Immunization records, ability to communicate urgent needs between care partners. Medical care is highly technologically advanced but our information technology remains far behind.

merd4 4 months ago

Fee for service compensation, which does not compare to other provinces like our neighbours in AB who have more compensation for the time they spend with their patients Excessive paperwork for which there is no pay, and forms to complete and often not covered by MSP forcing patients to pay and complain about the charges (or for the MD to do the work for free).Inadequate resources for patients: long wait time for specialist consultations, procedures, patients in dire need of counseling services but cannot afford to pay

Cap2 4 months ago

- Little to no assistance for practice management despite GPs generally having zero background in business administration- Highest overhead in the country with the 3rd worst GP fee schedule. - GP fee schedule does not include any codes for 2nd/3rd/4th complaints being addressed (look to eg. Alberta or Yukon fee schedules) leading to revolving-door care- No fee schedule bonus for after-hours office services which disincentivizes evening + weekend work (see Ontario fee schedule)

kittymeow 4 months ago

The huge increase over the last 10 years or so in paperwork and forms and 2 or 3 page forms that need to be filled out to refer to many subspecialty clinics is overwhelming. I have many medically complex paediatric patients and one visit generates several forms as well as dictating the follow-up letter and referral letters to subspecialists. In the hospital, there is now a huge amount of paperwork to fill out to satisfy health authority and/or accreditation requirements (eg med rec forms and the med rec forms that serve as discharge prescriptions, an over-abundance of pre-printed orders), most of which is irrelevant to patient care, especially paediatric patients.

Paed 4 months ago

Lack of Nephrology services in suburban areas when there are so many Nephrologists who are unemployed with many patients who need these servicesSurgeons without jobs when demand is so high like ENT, ortho All this is not because of lack of OR time or resources but rather our colleagues not wanting to let go of some billings. Fee for service creates an environment of maintaining high volume low quality care. This brings about lack of employment.

User1234 4 months ago

Technology (or lack of)Constantly having to do the same work twice. Writing pages of orders, signing multiple times, paperwork that requires multiple entries of same information. Forms, forms and more forms

User1234 4 months ago

culture of medicine.Lots of bullying and disrespect amongst sub specialties. Several instances of people being jerks when I ask them for help. Makes me never ask or feel fearful to ask

User1234 4 months ago

1. Staggering amounts of soul destroying paperwork, much of which has to be done after office hours at home: time loss and disability forms, insurance forms, ICBC reports, WorkSafe requests, medical legal, CPP forms, income tax disability, pharmacare special authority forms, referral letters etc etc. This comes up as a "burden" frequently in many of the entries on this site. The paperwork has been a problem for family practice for many years, and continues to get worse. It will continue to drive doctors away from family practice when more and more are needed for an aging population with multiple complex problems. 2. Increasing over regulation by licensing bodies such as the College will drive many capable physicians to an earlier retirement. This will lead to further loss of manpower. Many older doctors feel discriminated against.

jb49 4 months ago

Document review /paperworkOverhead costs Fee for service- rewards rushed medical interactionsFamily doctors are grossly underpaid.

Matdoc 4 months ago

1. Technology - lack of technology is still a burden - continue to have paperwork landing on our desk when it could be directly downloaded onto our EMRs; The Technology is there that would enable us to directly link to pharmacies and specialist offices instead of faxing scripts and referrals. From health authority to health authority - systems don't community - separate grids for radiology and lab - which leads to unnecessary extra costs and some information not being available 2. Paperwork is becoming impossibly burdensome. Doctors are expected to complete reports and return-to-work forms that are becoming more complex - taking time away from patients and possible free time. Paperwork also involves going over patients' labs and forms and reports - all unpaid for. 3. Work environment - health authorities - supported by expectations from the College - can have unreasonable expectations; In rural areas, doctors are expected to be on emergency calls, or work in urgent care centers - attend a plethora of meetings - unpaid for during lunch and other "free" times; Doctors in rural areas do ward rounds, home visits, maternity care, geriatrics, without access in many instances to specialist help. When we as physicians seek to have a work- life balance - we are harassed or shamed into complying with unreasonable demands. Meeting after meeting is held to showcase inter-professional team work - only to find that the health authorities don't have staff to back up the promises of said teams. Hospitals are crowded and physicians are faced with unrealistic demands to discharge patients who are not ready to go home. 4. Clinical complexityChronic Pain - The problem of the opioid crisis is being laid at the door of the physician, instead of the problem of the chronic pain being recognized. Not only are physicians faced daily with uncontrolled pain, there is an increasing number of patients struggling with mental health disease. In our rural area, we have a critical shortage of mental health workers. Wait lists for surgeries are one to two years for knee and hip replacements due to lack of infrastructure., meanwhile 1 in 5 recently trained specialists can't find work. With all the work we are expected to do, we still have to keep up with rapid changes in the medical field. As a family physician I have to manage increasingly complex cases with increasingly less support. I am now doing courses to manage PTSD and Pain because there simply aren't resources available to my patients in the rural areas. More strain. More stress. Less time for me.5. Documentation - The College demands personal information and expects us to complete forms that invade our privacy, demanding information from doctors that would not be allowed in any other occupation. They ask questions that we would not be allowed to ask if we are interviewing any applicant coming to work for us. I think it is pushing the boundaries of human rights violation. Every year we have to re-certify with the college and then go through an even longer even more invasive re-certification for hospital privileges. All the information should be on one site - CMPA, health authority, college - why go through this time and time again?6. Finances. We should be given complex care fees for managing chronic pain and chronic mental health issues like PTSD - especially when a counselling fee is a mere 20 minutes - most of my counselling takes longer than 20 minutes. 7. Patient expectations - I can't believe how patient my patients are. Seniors suffering with disabling chronic pain from treatable OA of knees and hips shouldn't have to wait for years to get surgery.

Judy 4 months ago

1)Paperwork, of course. In particular the downloading of labour by the private insurance industry onto family physicians. Yes, they often pay for it, but more often we either must do it pro bono or force the patient to pay.2)The Fee for Service system. It is full of inequities. Mental health care is devalued relative to a specific set of physical health problems. Overall, tasks are not remunerated with any kind of consistency relative to the amount of care and time that they take, and this includes good physical exams and documentation, procedures, the psychosocial aspects of good care, etc.

Pirbawa 4 months ago

A continuous pressure to "See more people" in order to survive in a fee for service province, while also trying to balance the college and patient expectations of perfection, comprehensive assessments. Unpaid charting time, documentation time to provide highest standards of patient charting.

Twall 4 months ago

1. financial burden: crippling medical training debt combined with poor renumeration in fee for service system and high cost of living2. health system growth: lack of meaningful engagement between MOH and grassroots primary care providers leading to constant frustration, misleading PR from MOH and antagonistic relations between providers and health authorities3. paperwork and documentation requirements: unpaid time for clinical documentaiton required by college/MOH/insurance leads to many lost hours with family or for self-care4. culture of medicine: there are a lot of areas where care is "punted" to the GP, from specialists and allied providers alike. for example the Special authority form that is sent to the GP to complete because the specialist is "too busy"; or the disability form post op that the GP has to fill out because the specialist "Doesnt have time"

Twall 4 months ago

We need shared responsibility/accountability with our patients, with other docs, our health authority, the college, and the ministry of health! We are blamed for "the system shortages and short-comings". We do not practice at the top of our scope; we practice medicine plus so much more. We are de-valued and insulted by the lack of support. 1. Technology: EMRs have added to more admin time. Faxes/Emails/Review of labs/radiology We need to bill for this time. 2. The culture of medicine = "Kuroshi" = Japanese term for DEATH BY OVERWORK!3. Paperwork = we should refer to a salaried social worker in our Health Authority.4. Documentation. We should be paid for the time we spend with patients and the time we spend on documentation. 5. Health system growth. I live in Surrey. We are the least funded health authority and the fastest growing population. This is not sustainable for my patients or myself. 6. Practice requirements. I'm trying to keep-up the best I can. I read at night when the kids are in bed, or I read early in the morning before anyone wakes up. We need protected time, paid time, locum coverage. 7. Work environment. All the docs are smiling, but stressed. What's becoming more frequent is the moral demise that we experience nearly weekly from a patient that thinks it is okay to verbally harass or threaten my staff or other docs. 8. Patient expectations are unrealistic and unattainable in our current state. I cannot educated every patient each time why I cannot do their entire list, discuss "dr. google", or the labs that their naturopath wants me to order! The public needs to be educated about our realities. The media thus far has created more delusion!9. Clinical complexity. In Surrey, it's growing and will continue to grow. The current complex billing codes do not suffice. We need time based codes! Patients don't just come in for their DM2/HTN/CKD/CHF, they come in with that PLUS an infected toe, depression, paperwork, ICBC, WCB, questions about "dr google", labs from their naturopath, demands for an MRI, etc!Also, we need health policy for social determinants of health: my patients need coverage for their medications, counseling, OT/PT/Chiro, coaching, dietary/lifestyle guides, etc.10. Finances. Poor remuneration + Mortgage + Overhead + Taxes + cost of living in BC = treading water!

SUJ 4 months ago

Non-essential paperwork: forms for medications for pharmacare; forms for insurance coverage. Forms for pensions.Patient demands. I use email with patients, and it can take up a lot of time.Sick or demanding patients. Unreasonable expectations. Demand for disability designation when impaired but not actually disabled.Concern about too many new docs in my field moving into the area, with marked reduction in wait list as a result (good for patients, but sometimes leaving me with gaps in the day.) Nothing stopping new arrivals since no need for hospital privileges (non surgical).Would like to cut back, but financial demands preclude it. Need to take more time off, but worry I can't afford to take more than a few weeks off at a time.Admin demands for the HA.

riderPi 4 months ago

Evolving technology is all around us and we have to fight administration for funds to get the standard of care introduced, yet are expected by patients to provide cutting edge care. In addition, there is little respect for our expertise when we present to administrators who think we are only trying to get more money for our division/department.

me me 4 months ago

The paperwork is biggest burden - endless disability reports, WCB reports, ICBC reports, applications insurance etc etc etc. This takes up to 20hours of my week. These forms could easily be reduced or filled out by a salaried social worker / nurse.As a GP one of the biggest frustrations is having to do work for my specialist colleagues - ie have my staff call patients with appointment instructions etc. Also very frustrating when specialists who are seeing a patient for the same issue long term request new referrals every 6 months for the same issue instead of recalling patients on their own. The lack of non-medication coverage for my patients is very frustrating. So many of my patients would benefit greatly from OT, PT, obesity lifestyle interventions and counseling/psychotherapy but there is such limited access and beyond the means of most patients. It is incredibly hard to see my patients suffer in a system that does not support these well evidenced interventions.

vicgp15 4 months ago

Over burdened with paperwork, overhead,lack of funding, high demands of patients. Lack of respect.Specific examples- here for ref. letter to get my ear wax cleaned by ENT- already have an appointment- here for work note-my icbc lawyer sent me- have to have appointment every 2 weeks-600 dollars take home is not a lot

Van Fam Doc 4 months ago