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.

-Expectations from patient eg short wait times in the ER. Even two hours feels unacceptably long.-Often in Rural, you can't shake being "a doctor". On the soccer field, at the pub - you're always the doctor. Boundaries are important, but not always easy.- Sense of perfectionism - we are so hard on ourselves that we can't handle it when we make mistakes. Even when we agree that "everyone makes mistakes"

Ruraldoc1 4 months ago

understaffed - unable to find psychiatric colleagues to join a well-functioning inpatient team, despite having a good reputation as a team; and we are not the only ones with this issue.One of the most painful aspects of working in the hospital is discharging patients back into the community without being able to refer them to ongoing psychological treatment when needed (as most patients can't afford psychologists, and outpatient psychiatrists that provide psychological treatment as well as med management are few and far between).

vch123 4 months ago

The greatest burden is being on call so much of the time (40%). It is the one aspect of my work that I actually detest. Being on call is oppressive, and takes away one's sense of freedom.I have learned through the years of my career that the younger generation have the right attitude, of having more balance in life, and more time for their families, particularly their young children. Physicians should not be expected to sacrifice their role as parents and life partners in order to show society how privileged and honoured we are to look after strangers. Those of us trained long ago have been burdened with this yoke of feeling indebted to the society which helped support our institutions of medical education through tax revenues. The definition of obligation of duty is not necessarily made clear by our College in all instances. Of course we mean to do well for our patients, but what we sacrifice to do so is often unappreciated. Call it "burn out", perhaps, but idealism is boundless only among saints.Another burden is one I don't face myself, but one which affects younger physicians, namely the financial burden of living in the Vancouver area. One almost needs two generous full time incomes to afford a family home.Finally, I have learned that there is an emotional burden when different physician groups are in conflict. We as physicians must have each others' backs, and not quarrel with each other over such matters as fees and funding allocations. Those among us who have endured conflicts over such issues have felt embittered and hurt. We must learn to compromise and cooperate, because only then can we feel we belong to a profession whose members care about each other.

bossanova 4 months ago

Technology--lack of access to computers in ED, slow response times, multi-click per function/order, multiple platformsWork environment--I work in an emergency department where over half of my patients are not seen in an appropriate care space (are seen in the hallway stretcher or in chairs). Proper physicals are not possible and diagnoses are missed.

hdainc 4 months ago

This forum is long overdue!Reading all the comments certainly helps me to realize that I am not the only one who is "burnt out"! I have been a GP for over 30 years and overall I love practicing family medicine but now I can hardly wait to get out-this system is sick and the way I practice is not sustainable! At one time we all looked after patients from cradle to grave-then came the midwives who were paid much more for deliveries than us so most GPs quit maternity care.Then came MOCAP which was so divisive to our profession-when I was on call working seeing all kinds of patients and yet my specialist colleagues were getting paid to simply be available it caused huge animosity amongst us.Then came increasing overhead costs with a lack of significant fee increases.The basic 0100 fee when I started was $18.75-now 34 years later it is just over $30_this is a pathetic joke!!! I take my dog to the Vet and his fee is $75 for the same visit that I get $30-what a disgrace.I agree that increasing patient demands, increased forms-that all state the patient is resposible for the forms,huge paperwork,fears of the yellow College letters,fears of audits ,the complexity of billing, etc. are making this job less appealing.Patients have no idea of how little we are paid and when they come in with lists it is so anxiety producing to myself.I have been a clinical instructor for some time now for medical students and unfortunately I have been totally honest with them encouraging them to definitely go into specialties as General Practice conditions have deteriorated terribly-what a sad statement!!!

Marshall20 4 months ago

1. Conflicting demands to achieve maximum efficiency, support adequate volumes of patients in a practice panel, see sufficient numbers of patients in a day to respond to patient requests for service while demonstrating good care through comprehensive charting and sufficient access to supporting medical documentation. 2. Fee schedules in fee-for-service that favour volume over comprehensive care, particularly for patients who don't fall into the narrowly-defined "Chronic Disease Management" categories. Demands of billing enough to pay overhead compete with doing what is right for the patient in the room3. Since I work in Primary Care as well as Walk-in, I end up seeing many patient who either do not have their own FP yet have complex medical and/or social issues. It is frustrating for them as well as me when I cannot offer them the care they deserve in a piecemeal fashion. Additionally, I also see other GP's patients when they say they are unable to get an appointment in a timely fashion. That often requires me and other walk-in doctors to do the work of chronic disease management, yet we do not get any of the financial benefits for Chronic Disease Management 4. Resources for timely and affordable access to mental health care are scarce and convoluted to get access to and varies from region to region. I do not consult Psychiatry often but when I do it seems a battle to make any direct referral5. Resources for Social Work / Social Services are challenging to get access to especially on short notice. Once again, people without sufficient financial wherewithal are the most at risk and the least likely to be able to get help

Lifeguard 4 months ago

the fee for service renumeration structure, stagnant fees and skyrocketing costs of running a practice make every day feel like a race to generate enough billings to cover costs and pay myself a reasonable amount. It limits my ability to care humanely for my patients and their needs. I feel like i need to plan my day in 5 minute billable increments which is wearing me down. Creates greater resentment towards annoying things like paperwork and administration. It we were properly compensated to work in a humane way, that other stuff would be tolerable.

JRoss 4 months ago

1) mounting paperwork irrelevant to patient careeg. BCCA follow up forms on cancer patients, when last seen, requires time to go back to chart and fill in, no compensation for this, just expected of us. - Care homes- require admission medications, done prior to admission, then a medication reconciliation within a few days of admission, increased paper work, increased risk of error duplicate work. - relicensing process each year for College and privileging for Health authorities- extra time/ prolonged reappointment process, privileging dictionary frought with potential omissions of procedural privileges. Seems tedious when same physicians reapplying for same privileges every year. Medicolegal work requrests- I have started just advising that I am overburdened with patient care needs and cannot do these in a timely fashion,

AP 4 months ago

It would be nice to have more billing options for patients with mental health concerns since we invest so much time with them but aren't necessarily remunerated for that time/effort.

DrM 4 months ago

The cost of living here is getting out of hand and with rent/overhead continuing to climb, I don't see myself staying much longer despite a huge need for GPs in the community.

DrM 4 months ago

Resource finding/Social issues --- lack of support in finding resources in community for patients, lack of awareness of what resources are available and which patients would qualify for which resources. Feeling unable to support patients with social/socioeconomic issues and/or spending a lot of additional unpaid time trying to help people --- doing a job that would be better allocated to a social worker or community support worker. Mental Health --- I have a significant number of patients with challenging mental health issues, often compounded by difficult psychosocial issues. Complete lack of counselling resources if patient's do not have money/benefits, often delayed/difficult access to psychiatric consultation and/or follow up. Again, spending significant amounts of unpaid time attempting to counsel patients myself and/or help them find resources --- this is not only unpaid, takes away from my dealing with other medical issues, but is also something that I am not adequately trained to do. As a younger female physician fairly new to starting my own practice I have been inundated with these types of patients and find that I do not have a balanced practice. Chronic pain - again as above few resources, poor access to chronic pain clinics/multidisciplinary teams. Patient entitlement, lack of understanding of the role of a family physician, poor "PR" for family physicians ; poor fee structure for basic office visit which limits time we can spend with patients/doing preventative care and thus exacerbates the public opinion that we do not care/spend the time as do naturopaths etc.

EP 4 months ago

None

10009 4 months ago

None

10009 4 months ago

walk in clinics. How does paying my walk in clinic colleague the exact same fee for service when he orders unnecessary tests, often duplicates work already done, doesn't examine the patient, doesn't follow up or arrange for consultants. He does 1 min of work and I do 30-60 min clean up and we make the same - well just for the visit because really as his overhead is subsided he is making a ton more.

user24601 4 months ago

lack of remuneration for complex patients. payment does not reflect effort/complexity

user24601 4 months ago

paperwork. lack of remuneration for paperwork, forms

user24601 4 months ago

working in a rural community, many of our specialists are not Canadian trainined nor have they passed their exams. How does the province, health authority and hospital continue to allow sub standard care. This negatively affects my patients and my practice of medicine.

user24601 4 months ago

newer generation of graduating family doctors are not actually interested in family medicine! They don't want to do call, they don't want to do the hard stuff. Who are we training and why have we allowed this to become the norm and acceptable?

user24601 4 months ago

starting to see the lack of family doctors caring for their patients in the hospital setting, leading to fragmentation of care, duplication of tests and investigations, lack of clear understanding of the patient and poor follow up in the community

user24601 4 months ago

Specialists order tests then when critical values come in AFTER HOURS the lab calls the GP and reports that the Internist who ordered the tests is refusing to manage the patient but wants the family doctor to follow up on the results and admit the patient to the hospital and consult back to them after. Query? If you order the tests are you not medically and legally responsible to follow up on them instead of telling a Lab Technician to call the GP with the results????The lack of specialist support for ill patients and the loss of patient-centered care behooves me....What happened to the oath "Do no harm?" In summary, the lack of management by some specialists makes me not ever want to even consult them because I fear my patients will get worse care...that's my burden. Problem is, in a smaller community you don't have a wide choice of specialists to cherry pick from.

Im@work 4 months ago