Paperwork burden driving Ontario family doctor to quit, amid critical GP shortage

Ontario is in the midst of a critical shortage of family doctors, and one more is leaving the profession, meaning her roughly 1,000 patients will join the millions of residents looking for primary care.

Mississauga physician Dr. Fan-Wah Mang tells CityNews there are multiple reasons she has decided to shut her practice down on May 31.

“I’m simply burnt out. I’m physically and mentally exhausted,” said Dr. Mang.

She has been a family doctor for 29 years and hoped to work for up to 10 more years. Dr. Mang said it’s not the patients that have her burnt out, it’s the paperwork.

“I’m overburdened by too much administrative work. I have an inbox, I probably read over 100 reports a day,” explained Dr. Mang. “It’s just unsustainable if I have to be on the computer until midnight every night, all day Saturday, all day Sunday. It would be nice to have dinner with my family.”

She spends up to 25 hours per week alone on lab reports, x-ray results, and lately on processing pharmacists’ prescriptions. The administrative work has forced her to cut the time she sees patients from four days to three days per week.

When her clinic is open, she sees about 20 patients per day. The Ontario health care system pays her up to $40 per patient visit. After taxes and administrative costs, Dr. Mang takes home roughly $60,000 a year. There isn’t enough in the budget to hire an administrative assistant, and she just can’t do it anymore.

“I had to make a very difficult decision,” Dr. Mang said. “If I can’t afford to maintain my practice, because if I cut to less than three days a week, I won’t make the overhead. My only option is to close.”

But Dr. Mang worries about her patients, including Patricia MacKay, who cares for her 108-year-old mother and her ailing husband. It was Dr. Mang who discovered he had had a silent heart attack.

“This just put me stressed to the max,” said Mackay. “She is a fantastic doctor. She is caring for her patients, she advocates for her patients.”

“If family doctors are not being supported by our government and taken seriously, then people are going to go to emergency that don’t have family doctors. Emergencies are already overloaded, so what are you going to do?,” said Mackay.

It won’t be easy for any of Dr. Mang’s patients to find a new family doctor, it can take months, even years.

The Ontario Medical Association (OMA) estimates there are currently 2.3 million Ontarians who don’t have a family physician. The problem has been growing for over a decade. As the population grows, physicians retire and fewer medical students choose to become family physicians.

Dr. Andrew Park, president of the OMA, said this is because people don’t see it as an attractive option at this point. “We need to ensure that the profession of being a family physician is viable and sustainable for future generations.”

He agrees that paperwork and the administrative work has been a real issue for family physicians.

“The solution is, first off, let’s get rid of some of the forms that are not necessary. And the ones that are necessary — let’s reduce them in terms of what is necessary from a physician perspective,” said Dr. Park.

“I think that’s the first thing we have to have — a real care to this. We’re overutilizing an extremely valuable resource in our family doctors for something that’s not very valuable to the patient or the system at large.”

The Ford government has said they have set up a Burnout Task Force and launched an initiative called Patients Before PaperWork aimed at further tackling “the administrative burden on physicians while reducing the risk of delays in diagnosis and treatment.”

“Our work has significantly accelerated work to simplify forms and we look forward to sharing the improvements that have been made in the near future,” read a statement from the Minister of Health.

“We all have to come up with solutions and work together in a nonpartisan fashion to ensure that every person in Ontario gets the care that they need,” said Dr. Park, adding they are working with the government.

Dr. Mang said if there are changes, it is too late for her but she hopes they will help future family doctors.

With files from Meredith Bond