Physicians have raised unnecessary administrative burden as an issue impacting patient care, professional practice and the effectiveness of the health-care system.
In 2019, Doctors Nova Scotia (DNS), with the support of the Department of Health and Wellness, began working with the provincial Office of Regulatory Affairs and Service Effectiveness (the office) and the Department of Health and Wellness on a pilot project to reduce physician administrative burden.
The office has had demonstrable and quantifiable success in reducing unnecessary regulatory burden – or red tape – on business and is applying this experience to the physician community.
Throughout summer and fall 2019, the office met with dozens of physicians who detailed the toll of unnecessary administrative burden. In addition to describing the issue and its impact, physicians offered suggestions to reduce this burden. These thoughtful and candid discussions have informed a workplan for the pilot project. The workplan includes:
- Short-term actions: actions with the potential to be achieved and implemented by the end of 2020
- Pilot projects: More complex projects where pilot projects can be initiated before the end of 2020; and
- Foundational work: Work with longer-term impact, for example, measuring physician administrative burden.
Read the full workplan, along with the status of this work, here.
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.
Nearly 500 physicians from across Nova Scotia completed the survey, with each estimating how much time they spend on administrative work (including on specific tasks) and how much of this time they consider unnecessary. Physicians also detailed the sources of this burden and its impact, as well as the lessons learned from the COVID-19 pandemic and the different approaches to health care it has demanded.
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
- The COVID-19 pandemic has provided a window of opportunity to leverage short-term systemic improvements into longer-term reductions in administration and overall improvements to the health-care system
Read a full analysis of the survey results here.