Family doctors say paperwork getting in the way of primary care

The Kawartha Lakes Health Care Initiative (KLHCI) retention committee spent the fall interviewing family practitioners from across the city. The purpose of the interview/survey was to gather feedback from doctors already practicing in the city about their happiness and frustrations with their practices. The survey findings, now released to the public, are wide ranging but indicate that doctors are struggling with the amount of time they must spend on administrative tasks with no billing opportunity for this time spent.

Doctors told the KLHCI that their work and interactions with their patients and other doctors is generally quite satisfying. Local family doctors reported a 77 per cent satisfaction rate with their practices.

When asked why they have remained in Kawartha Lakes to practice medicine doctors told KLHCI the following: they have family and friends nearby; they have an established practice; there are schools and extra curriculars available for their family; they enjoy rural living; they are satisfied with the community personally and professionally; their spouse has found employment here; they enjoy their connections with their patients, practice and colleagues; and Kawartha Lakes is a nice place to practice medicine.

When asked what part of their day is stressful due to systematic problems, 37 per cent of doctors responded that the administrative side of medicine is taking away from the time they have for their patients.

While all of the family doctors “accepted paperwork as part of the practice requirements,” they told the KLHCI that form completion, reviewing lab work and specialist referrals are high on their list of things that make their work lives stressful. Doctors said they spend approximately 20 hours a week doing this paperwork which is unbillable. Doctors told the KLHCI that they are “feeling devalued by patients and the government” and that they are finding it more and more difficult to manage their practice with its inherent human resources issues along with increasing overhead so staff can be adequately compensated. Doctors are also very concerned that “they are struggling to find care for their patients.”

Doctors told the KLHCI that there is an increased demand from specialists, patients, insurance companies and employers for forms and documentation. Completing these forms and documents are not included in any compensation model and can average 1.5-2 hours per day. They also expressed frustration that specialists, after having seen a patient, ask family physicians to arrange MRIs or other procedures, rather than the request being made by the specialist.

Doctors note that “primary care is the key to the whole healthcare system” and should be taken seriously by all physicians and the government. Doctors told the KLHCI that a well-funded and healthy primary care system is “cheaper overall and better for patient care.” Doctors said, in addition, that “the system is not fairly compensating family physicians for their time.”

KLHCI, who views doctor retention as important as new doctor recruitment, plans to arrange for HR and practice management consultants to present to CKLs family physicians. KLHCI will also present and review this report with the MP and MPP for Kawartha Lakes. The Minister of Health, Ontario Health, Ontario Medical Association, Society of Rural Physicians, CKL physicians both family and specialists, municipal leaders, the Kawartha Lakes Health Team and Ross Memorial Hospital will receive a copy of the report also.

When contacted for further background on the survey results, Cindy Snider, recruitment and retention coordinator for the KLHCI, was asked in a telephone interview if the report had any solutions to the mountains of paperwork that family doctors are having to deal with on a daily basis.

“We honestly don’t have an answer yet,” Snider said. “We are advocating to see how we can help. We hope our report will be escalated to higher levels.”