Physicians have raised unnecessary administrative burden as an issue impacting patient care, professional practice and the effectiveness of the health-care system.

Since 2019, Doctors Nova Scotia (DNS), with the support of the Department of Health and Wellness, has worked with the provincial Office of Regulatory Affairs and Service Effectiveness (ORASE) to reduce physician administrative burden.

Doctors in Nova Scotia collectively spend 1.36 million hours a year on administrative tasks. While much of that work is important, doctors report 500,000 hours of this work is considered unnecessary.

The Nova Scotia government set the first target of its kind in Canada to reduce unnecessary administrative burden on doctors by 50,000 hours a year, the equivalent of 150,000 patient visits. The target was set after consultation with Doctors Nova Scotia and a survey of physicians. 

More than fifteen actions have been identified to help reduce physician administrative burden by 2023.

Completed work

Work completed to date includes:

• Legislation to limit the circumstances in which employers can require employees to provide medical notes
• Simplified the maternal serum screening process (more information to come in early 2023)
• Improved the Employment Support and Income Assistance (ESIA) Medical Assessment form
  • The form has been improved to reduce back-and-forth between doctors and intake workers; sections requiring completion are now flagged by intake workers; physician compensation to complete the form has increased by 60%
• Simplified credentialing for the IWK
  • The credentialing process moved from paper-based to an easy-access online system

Physician involvement

Physician support of this work has been and will be critical to the success of the ORASE. 

The team leading this work will need physician knowledge and expertise to better understand the source of burden, to design improvements, and to measure the “before and after.” When that is the case, physicians will be asked to lend their expertise, in a way and time that works for them. 

Physicians will receive opportunities to participate via DNS communications.

Measuring physician administrative burden

Measuring regulatory or administrative burden is critical to understanding and communicating its significance.

To better understand the size and scope of physician administrative burden, the office worked with DNS and other key stakeholders on a survey to quantify physician administrative burden and its impact. With this work, Nova Scotia becomes this first province in Canada to measure physician administrative burden.

Key findings from the survey include:

• On average, Nova Scotia physicians spend more than one full day per week (10.6 hours) on administrative tasks
• Physicians reported that 38% of this time was spent on unnecessary administrative tasks: 24% was work that could be done by another role and 14% was work that could be eliminated entirely
• The top contributors to unnecessary administrative burden were completing medical forms, doctor’s notes, business operations, billing (including shadow billing), licensing and privileging
• The health system itself, including the complexity of the governing and oversight bodies, also contributed to physician administrative burden
• Physicians reported administrative burden was a significant contributor to burnout and that they could use the freed-up time to achieve better work/life balance and patient care

Read a full analysis of the survey results here.