Policy Statement on Administrative Burden

New Brunswick Medical Society (NBMS) Position

Health systems across Canada, including in New Brunswick, are facing significant complex challenges to providing care. Chronic shortages of health human resources, a population that is sicker and older than ever, and capacity constraints have each placed significant tension on the system. For family physicians across Canada, administrative burden has increased the strain on physician practices perhaps more than any other issue.  Much of this administration has been deemed unnecessary, including work that may not require a physician’s clinical expertise to be complete. The cumulative impact of administrative burden makes it significantly harder for physicians to do what they do best: care for their patients.

 

NBMS Recommends

  • That the Government of New Brunswick set a goal of reducing unnecessary administrative work of New Brunswick physicians by 25 per cent per year. This would result in recapturing 36,757.75 physician hours per year to be directed towards patient care.
  • The development of an agreement with the Government of New Brunswick which would ensure: that no additional forms for physicians will be created without first consulting the NBMS; and that physicians are compensated for future completion of current forms.
  • The reduction of sick note requirements by employers – except in exceptional circumstances.

 

Background

Department of Social Development Forms

The NBMS Reducing the Administrative Burden on Physicians Working Group collaborated with the New Brunswick Department of Social Development to reduce, remove or streamline physician involvement with 29 medical application forms.  Recommendations were put forth by the working group and ultimately accepted by government ranging from modifying/eliminating the renewal process, broadening the range of authorized prescribers, streamlining processes, and removing the requirement for physician involvement with certain forms.

Reductions in physician involvement were achieved by:

  • completely removing the need for physician participation in 3 instances;
  • expanding authorization to other medical professionals in 9 instances;
  • streamlining the existing form/process used in 15 instances; and
  • reducing or removing the renewal requirements in 13 instances.

Paperwork Task Force

The Paperwork Taskforce was created to examine the variety and volume of paperwork requests that physicians must complete for government departments, insurance companies, lawyers and other third parties. The Taskforce was asked to consider the purpose and appropriateness of these requests, and to make recommendations to reduce the burden currently placed on physicians. The Taskforce began its work in the fall of 2019 and continued its work into the spring of 2020. The Covid-19 pandemic delayed release of the report until 2023, but many of the recommendations remain relevant.

Canadian Medical Association (CMA) Advocacy

The CMA believes that completing sick notes for short-term minor illnesses is unnecessary and underscores the inefficient use of scarce heath care resources. They have drafted a position paper in consultation with provincial and territorial medical associations which encourages a shift away from physician involvement in confirming minor illnesses, promoting more practical and mutually agreed-upon alternatives.

Specifically, the Canadian Medical Association’s policy on sick notes emphasizes that short-term absences from work due to minor illnesses should be addressed directly between employers and employees. The policy asserts that such cases do not necessitate physician confirmation of illness, as this would be an inefficient use of limited health care resources. The responsibility for overseeing employee absenteeism lies with the employer, not the physician, nor the health care system.

 

Analysis

The Canadian Federation of Independent Business (CFIB) completed a cross-Canada study on administrative burden and reducing physician red-tape. The CFIB study was based on research conducted in Nova Scotia, a leader in working to address the problem of administrative burden.[1]  Research discovered that each physician in Nova Scotia spends the equivalent of more than one full day per week (10.6 hours) on administrative tasks.

The study also identified the portion of administrative work (NS context) that is: unnecessary (38%), including work that could be completed by someone other than a physician (24%), and tasks that could likely be eliminated (14%).

A similar problem exists in New Brunswick. Based on the 2,022 practicing physicians in New Brunswick[2]:

  • 1,050,226 hours per year are spent on administrative work, which is 9.98 hours per week per NB physician;
  • NB physicians spend 399,086 hours per year doing unnecessary administrative work; 252,054 of these administrative hours are work that could be done by someone else, and 147,031 hours are administrative work that could be eliminated.

That is equivalent to 1,197,259 patient visits per year and approximately 152 full time physicians.[3]

 

Further Considerations

Improvements are possible and should be pursued – even if only incrementally – as Nova Scotia has shown.  For example, the CFIB estimates that reducing physician red tape by a modest 10% (Nova Scotia’s goal) could save the equivalent of 5.5 million patient visits per year, across Canada.

 

Relevant Legislation

N/A

 

References

The complete listing of updated medically related forms at the New Brunswick Department of Social Development: Listing of Updated Medically Related Forms (gnb.ca)
The Government of New Brunswick’s press release on administrative burden: Initiatives to reduce administrative burden for physicians, improve collaborative care model (gnb.ca)
Link to the Canadian Medical Association position paper on sick notes: CMA calls for elimination of workplace sick notes to create more health care capacity | CMA
Link to the Confederation of Independent Business report Patients Before Paperwork: www.cfib-fcei.ca/en/media/canadian-doctors-spend-over-18-million-hours-a-year-on-unnecessary-administrative-work

 

History

Approved by New Brunswick Medical Society Board: March 28, 2025

[1] This work was recognized by CFIB in 2022 with a Golden Scissors Award for leadership in red tape reduction.
[2] Estimates are based on using Nova Scotia’s data as a benchmark.
[3] (Canadian Federation of Independent Business, 2023)

 

Contact Information

Jamie Yeamans, Health Policy and Economics Specialist, NBMS at jyeamans@nbms.nb.ca