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.

managing very elderly and complicated and frail patients seemingly on my own. When I make a referral to home care, nobody even calls me or writes to me to discuss patient or the case.paper work paper work, charting, charting, charting to justify my billings and to defend myself medico-legally. increasingly more off the clock work which I never get paid for

kchang 4 months ago

Family doctors are the dump off point for everyone: pharmacists, specialists, nurses, ICBC, employers. (requiring forms)Medicine is becoming more complex medicolegally, technologically, ethically and the CMPA and College hold us to impossible standards. Medicine has swung from being paternal to all rights belonging to patients and no basic rights for doctors.We are subjected to audits, complaints, assessments and so on that cost us even more time, energy and resources and we don't get compensated for it.

kchang 4 months ago

I'm sad to say that my passion was always to open my doors as a full-service family doctor but the overhead, practice management burden, lack of available locums for coverage and overall burden of paperwork in general practice has steered me toward facility-based and hospital-based medicine. I'm now >5 years into practice and no longer locum thus establishing myself as a 'specialist' in family medicine not out of desire but because of the system pressures. I'm hoping that primary care reform will lead to meaningful change that will entice me back into full-service practice but I'm not optimistic.

fp2019 4 months ago

office staff issues- new staff after 20 years. very very limited pool of qualified people and current staff is not adjusting/learning as well as hoped creating issues with timely patient f/u and numerous other office implications ( including me going in on we to accomplish MOA office work)personal responsibilities/ issues poor colleague supportit seems number of no show and last minute cancellations are increasing significantly. my office is booked not to have overlap and I run on time 90 plus % of the time so no shows that were booked for 30 minutes is wasted time.

IM NH 4 months ago

Oncology is getting more complex year by year; technology and advancement do not make our jobs necessarily easier. Quality assurance initiatives and such mandates as medication reconciliation are valuable but take more time. We have not been given enough support to run these programs. The physician's role (in my area) is a quagmire of poorly defined boundaries and our group ends up absorbing the extra work mandated by administration, most of which does not need to be done by physicians. This solution of convenience does not require extra resources and exploits the physican's role as the 'most responsible provider'. Many of us are burning out. Physicians should be free to focus on the things that only we can do - this way we can accomplish much more for our patients. We could see more patients more quickly if we had a bit more help...

DrFaustus 4 months ago

I agree with all 10 areas above plus the following:I have a combination of highly complex patients that have unrealistic expectation as to what can be achieved in a visit. I find it enormously challenging to get a patient to come in for regular checks to allow me to do comprehensive continuation of care. My patients will wait until the last pill to come in for review often only twice a year. Even scheduling regular follow ups does not seem to translate the importance of regular review. Patient education is so important for this group. Missed appointments without being able to recoup financial losses for this time. Patients that consistently miss appointments should have some form of documentation sent to them about wasting resources.Mental Health burden on FP is enormous and time consuming. There is very limited counselling available for uninsured patients who would greatly benefit from this. Our fees for managing Mental health desperately need review. The current mental health clinic is over burdened and under funded leaving patients with little or no Counselling. This increases reliance on pharmaceuticals and increases relapses. Seems like a penny wise and pound foolish policy. Giving us more time and better fees for this would assist us managing the patients better.The ever increasing administrative load is incredible. I can spend 20 hours a week on paperwork. Most of this time is unpaid. Patients expect us to read up on new and advancing surgeries, treatments and procedures that can be out of our scope of practice. We have no recourse to bill for this time spent away from our families. Not all patients can afford to pay for form completion not covered by insurances/ MSP. We are getting more and more forms to complete. Too many forms makes me grumpy and miserable and takes away the joy of being a doctor. Taking on a new complex care patient is no longer incentivised. Previously we could bill a fee for taking on a complex patient and use this fee to compensate for time spent reviewing previous charts and reports to formulate a health care plan for each patient. I just cannot afford to do this individual approach anymore. This means that my quality of patient care will in all likeliness decrease. FP are not going to feel inclined to take on Complex patients anymore and they are the patient population that most need a FP.Most of us have huge financial burdens of Overheads, family commitments and equipment. This is not conducive to being able to take any leave. So FP are burning out faster than ever. 2 weeks funded leave should be a consideration for FP if we are to combat FP burnout. Money is probably the biggest stressor of most physicians.FP Locums are a new endangered species. I am consistently unable to get a locum to cover. Young doctors are specialising as there is more financial incentive to be a specialist. This means that in 20 years there will be less FP to cover a higher work load as existing FP retire. This only means that patient care will drop.Equipment is unfunded / not subsidised. FP will not replace equipment unless absolutely needed. Most equipment is not calibrated annually as in the rural area it would be close to impossible to get equipment calibrated. Fee for service is grossly underpaid. There needs to be a overhaul of how we are paid. Getting $30 a patient for such important work is insulting. To provide comprehensive care at a level which is demanded by the college we should be paid double that at least in order to spend more quality time with a patient. The more pressure we work under the more mistakes are going to be made and the patient suffers and doctor health suffers.

KootzB 4 months ago

Increasing numbers and complexity of patients

Cheryl 4 months ago

Documentation in the era of EMR is onerous! Our traditional SOAP format is not appropriate for several problems. Consults and diagnostics require extraordinary amounts of time to review.

Cheryl 4 months ago

I am a family doc, but working in a clinic that is focussed on chronic pain currently. Full time family medicine was my life for 15 years and the constant financial pressure to carry the overhead, difficulty in taking any time off for this reason, constant after hours work and on call time, brought me to a place of realizing if I didn't make a change I would hugely regret it at retirement age. I have been able to change my circumstance and am really happy now, but feel for those still stuck in the hamster wheel feeling totally exhausted and overburdened. The entitled attitudes that one is met with daily and feeling of being there just to complete a pre-decided shopping list from google really made it hard to find joy in the day. Daily multiple patients arrived with lists, sometimes a few pages long, upset that they waited for the appointment. I'm very grateful for the ability to work, and a fair income, but family practice us in crisis, undervalued, with not enough people to cover the patient base and an aging population with increasingly complex healthcare needs.

Momdoc 4 months ago

As a rural GP, I find a lack of local resources frustrating as well as poor access to specialist care, mental health resources, and counselling for patients. Overhead costs are out of control and makes recruitment a challenge. More and more family physicians are opting to work ER or as hospitalists where they don't have overhead. Ongoing patient demands and unrealistic expectations of the system and timely access to care adds to the stress. I love the work that I do and I am incredibly lucky to have a amazing group of GP's in my community I work with, but we all feel stretched thin. Stress is also caused by not enough time, too much charting/paperwork, EMR issues, pressure to take on unattached patients, and after hours coverage. Finally, trying to balance all of this with family life and self care is a constant struggle.

ruralGP 4 months ago

failure to support adequate fee-for-service money for family physicians. being under paid makes everything a burden. the basic fee has gone from $27 to $31 in twenty years. sessional has more than doubled in that same time. people are eager to be family practitioners, but cannot afford fulltime fee-for-service now, so supplement with cosmetic procedures, hospital work, etc. this is shameful.

cmhall 4 months ago

I am an American FP with extensive experience. The US medical system has more problems than the Canadian system, and the Canadian system is more physician friendly. No surprise I keep coming back to do rural locums.Burdens:1: EMR. New Zealand's national MedTech32 is functional, robust, intuitive and improves patient care. Is it too late for BC to make MedTech32 its national EMR? We would all benefit2. Licensure: CPSBC is not the physician's friend. They lay fees at every turn and make nonsensical requirements. Yes, our profession needs regulation, but the College seems to be more about feathering their own nest than about helping doctors3. Immigration: Rural BC has a physician shortage that is not going away any time soon, yet I have to renew my work permit every year. BC recognizes there are ongoing unmet needs in other fields, and made work permits easier for other professionals. Why not docs who want to work in rural and remote locations?4. Patient transfers: The ST segments are up, the troponins are positive, and I am stuck on the phone with someone in Vancouver who doesn't know locations of Mackenzie or Prince George. The worst was 4 hours trying to get the ambulance 50 meters. PTN is a great idea but really needs to be improved. 5. Hard to access specialists. We've all been there.

yoyodoc 4 months ago

As a new GP, I am staggered by the amount of paperwork I receive on a daily basis. As the "quarterbacks" of the medical system, we have to lay eyes on every single piece of bloodwork, consult, etc. that comes in and decide if it is actionable. We know that the ordering physician is responsible for the result, but the patient is often not contacted for several days if abnormal and frequently calls the office to discuss with us. How do we make sure this is followed up, even if it's not our "responsibility"? Additionally, patient expectations are at an all time high. They want to be seen immediately, often within hours. If their rx has run out, they want their pharmacy to obtain refills the same day, often leading to multiple faxes from a beleaguered pharmacist who states "the patient is waiting". They have done reading on Google and feel that they understand medicine better than we do and come in requesting many tests, most of which are not indicated, but do not want to pay for them. Meanwhile, we are receiving emails from Francine Lemire stating that there is a perception that family docs only address one issue per visit, which is a "safety concern". Combined with the stress of an over-burdened healthcare system, external pressures to "attach more patients" and care for an underserved population, overhead increasing steadily (rent, staff wage requests), how can we not try to set some limits on our time, if still in a fee for service model?

user1111 4 months ago

- High demand of patients : never coming in with just one thing, having high expectations for the system (expectation of immediate care) and not being paid for more complex issues- Taking work home : struggling to document everything during the day, no time to do results, referrals etc- over burdened with irrelevant results (ie from specialists)

CJCS 4 months ago

1. Managing personal illness with workload. Although physician health is a more prominent discussion topic now, the reality of this is that a heavy workload with numerous call shift does not promote wellbeing or even allow time to tend to ones personal health. This will lead to burnout in any physician.2. The cost of living in BC is out of hand. Thoughts of ever buying a house as a young physician necessitate moving to a rural location or most often out of province.

Flyingfootball 4 months ago

1. Primitive EMRs. I have added "data entry" to my job description. Takes away from my "real" job- building a relationship with my patient, making diagnosis, collaborating on treatment plan. 6 million clicks per year (studies show) and more than 1/3 of time spent with computer. ?are we short of docs or are they just clicking away their precious time.2. Lack of access to resources for patients in and outside hospital. Criticized for not getting patients out of hospital fast enough yet have virtually no physio services on weekends to prevent deconditioning. "3. Administrators idea of "collaboration". Collaborating is really just ticking a box to say they "engaged" with physicians and then instituting changes with total disregard to our input. Don't waste my time.4. Balancing demands of clinical work and committee/leadership time. Poor remuneration for leadership roles vs clinical work. It is great docs are being asked to take on leadership roles and give input to the System. But, They don't realize it means we must either work longer hours or reduce clinical time (=reduced patient care). I feel like I am a cheap deal.5. I resent that FP are paid less than specialists for committee time. FP are specialists too.6. Government and other organizations believing that cradle to grave care is still possible in the 21st Century. It is not, without burning out physicians. The culture of medicine is so stooped in "tradition" that it is not nimble enough to adapt to societal values of the 21st C. I look to what the youngest generation of physicians are doing to adapt and see great possibiities. 7. Non-compassionate leadership- at all levels- MoH, HA, Colleges, professional organizations, department heads, etc. Studies show that compassionate leadership reduces burnout and creates strong team-work and peer support. There is a growing burden in supporting stressed physician colleagues, who do not have appropriate access to physician-oriented resources. Sorry, but PHP of BC is doing it.

welldoc 4 months ago

Patient expectations are at an all time high for physicians while patient trust in physician knowledge/expertise is at an all time low. This environment puts huge strain on physicians and contributes to burnout and low morale.Increasing paperwork and practice requirements also put additional demands on physicians.Technology is increasing my work load especially in hospital based work where CST is moving unit clerk work onto physicians without realizing the increased time required of physicians to do this. Doctors need appropriate staff and tech support in clerical matters to facilitate good patient care.Finances are on ongoing issue. Providing good clinical care in an environment of increasing demands is becoming more and more difficult. Sometimes it seems that actually spending time with patients and their families is considered secondary to paperwork and tech requirements of the job.

Heather Cherneski 4 months ago

Paperwork, and a lack of appropriate staff to help us relieve the immense load of paperwork that must be completed for patients on a daily basis.Culture of medicine has improved but there is still pressure on trainees to “suck it up” in times of stress

Pedsk 4 months ago

My main burden, is lack of evidence based resources for psychiatric patients. (iam a psychiatrist)and the unrealistic expectations that the health care system expects of physicians within this terrible lack of resources. I am frustrated that only with mental patients do we decide we cannot give lifesaving treatments to them. Because they cost 3000 dollars a year / patient (like a DBT program) .That the health authorities will start a good program listening to the evidence , then make major cuts to the program so the program is ineffective, then cancel the program. Often with little input from physicians Would we give half a dose of an antibiotic to patients and then say the antibiotic failed? My second concern is how poorly run and staffed are the resources we have. Hospital systems and outpatient resources are understaffed resulting in overuse of inpatient resources and a lack of supports for patients in the hospital. I am constantly hearing complaints from patients and families regarding the lack of resources, their loved ones in a hallway stretcher for 7 days etc. I actually love my jobs and have a lot of joy at work, but my hope that the system of mental health health care in BC will change is diminishing rapidly.

Kmcgarvey 4 months ago

- On call demands: I'm on call for Surgery and Emergency Room. My husband for Surgery, anesthesia, Emergency and Obstetrics. We have about 4 days per month that we're not on call. It's simply too much, but not enough people to share the call load.

Ruraldoc1 4 months ago