A group of family physicians in Peterborough is urging action to reduce the administrative burden on medical professionals.
“The increasing burden of administrative work has been attributed to physician burnout, a diminishing family physician workforce and has compromised access to primary care for all Ontarians,” reads a new study by Peterborough family physician Dr. Madura Sundareswaran along with Queen’s University medical student Max Moloney.
Dr. Sundareswaran is the founder and medical director of the Peterborough Newcomer Health Clinic and the founder of the Peterborough Family Physician Think Tank, now known as PTBO Fam Docs, which is a consulting and brainstorming group of independent family physicians that focuses on local advocacy and the grassroots-level changes needed to support doctor recruitment and retention from the perspective of family physicians.
Local physician group examines when administrative tasks become a burden
“We are trying to unify the voice of family doctors in the community and make sure that people continue to have good, consistent, and sustainable access to primary care,” Dr. Sundareswaran told kawarthaNOW.
Having practised as a family doctor in Peterborough since 2019, Dr. Sundareswaran noticed three years ago there was no formal structure for community-based family physicians to share and address challenges they face in practice, and formed PTBO Fam Docs.
“We focus on advocacy efforts and initiatives as well as supporting family doctors in their day-to-day practices,” she said.
In particular, Dr. Sundareswaran said that PTBO Fam Docs focuses on issues created and faced at a local level, rather than duplicating the work of provincial and federal organizations such as the College of Family Physicians of Canada and the Ontario College of Family Physicians.
A current focus of PTBO Fam Docs is the impacts and causes of administrative burden in small and community-based family practices in Peterborough.
In conducting the study called Addressing administrative burden in family medicine: a local quality improvement initiative, Dr. Sundareswaran explained the first action was to establish a definition of administrative burden that recognized non-medical tasks that remain essential to a physician’s practice.
“There’s a difference between an administrative task and a task that is burdensome, where something doesn’t feel like it’s good value for what it is that needs to be done,” she said.
The organization began by referring to the Canadian Medical Association (CMA), which defines administrative burden as “tasks that demand a disproportionate amount of effort relative to the value they generate for patients and health systems.”
The CMA includes four key elements: excessive volume of administrative tasks, redundancies and inefficiencies in the healthcare system, assignment of low-value tasks to physicians, and tasks that are not appropriately compensated.
Excess documentation emerges as the most common administrative burden
Dr. Sundaswaren said that, through stakeholder engagement sessions with local family doctors, they found further challenges and themes spanning across multiple practices.
“We were very explicit with the group that these are things that have to be locally driven,” she added.
The PTBO Fam Docs study identified a total of eight elements of administrative burden, which include the CMA elements and more: excess volume, inefficiencies of the healthcare system, misallocated tasks and responsibilities, impacts on therapeutic or professional relationships, increased cognitive and emotional load, ineffective communication, low-value tasks, and inadequate compensation.
The study received 146 physician submissions of administrative burden, of which 138 were analyzed. The most common category of administrative burden was excess volume, which includes physicians receiving numerous copies of the same documents, identical prescription renewal requests, and templates that include extensive historical patient information.
Dr. Sundareswaren said that, in practice, administrative burden can manifest as receiving stacks of patient medical information that must be comprehended, or being asked to complete disparate and overly long workplace medical forms.
“We want to have all this data available, but there is a risk and there is a danger to that — which is there is too much data,” she explained. “How do we make sure that patient care isn’t compromised in an attempt to provide so much information?”
The study further explains that excess volume can be caused by duplicate, blank, or other unnecessary pages being included without verification.
“The volume of excess documentation was significant, with individuals describing receiving 10s to 100s pages of irrelevant and unnecessary information,” reads the study.
Administrative demands affect a patient’s access to and relationship with their family doctor
Dr. Sundareswaran also noted the study identified administrative burden from employers as a result of requirements for medical documentation to justify work absences and accommodations (for example, sick notes).
Another important consideration of administrative burden, she added, is the impact that it has on patient care and patient-provider relationships.
“If your family doctor is spending too much time filtering through hundreds of pages of stuff, instead of seeing you in their office, your wait times are going to be longer and there’s a higher chance that something important is going to be missed,” she explained.
Dr. Sundareswaran said that the impact of administrative burden on the ability of physicians to provide patient care was the most significant finding from their research so far.
In addition, the study notes that inefficient administrative processes also negatively impact the patient-physician relationship due to associated costs, duplicated tasks, delays, and confusion.
“Whether it’s repeated renewal requests from pharmacies or inappropriate delegation of work or referral rejections, these create tension between family physicians and specialists or community organisations.”
Dr. Sundareswaran told kawarthaNOW that, following the publication of the study, PTBO Fam Docs is entering the implementation stage of its work using this research as a baseline of shared expectation.
Healthcare partners, employers, and patients all have a role in reducing administrative burden
Implementation will include working with partners and stakeholders such as the Peterborough Regional Health Centre and the Peterborough Ontario Health Team to begin auditing current processes and procedures to establish where administrative burden on family physicians can be reduced.
For example, the inconsistent use of electronic medical records management systems between primary and tertiary care teams can lead to the need to duplicate documentation of testing or changes to medications.
Dr. Sundareswaran also said the group will work with employers to provide professional consultation on medical forms to ensure they are efficient, relevant, and easy to use by family physicians.
While patients and the public were not involved in the study itself, they will be consulted when disseminating the study results through patient and family advisory councils of key stakeholder organizations.
The study has resulted in three key recommendations to reduce administrative burden on family physicians: send it once, send it right; reconnect with family physicians; and act now.
These recommendations and the findings of the study align with national advocacy initiatives such as calls from the CMA to restrict employer requirements for sick notes and to promote alternatives such as self-certification and flexible leave policies.
Dr. Sundareswaran said that, to achieve the goal of reducing administrative burden, it must be an effort taken on by all stakeholders — including patients.
Addressing administrative burden in family medicine: a local quality improvement initiative was published on October 12, 2026 in BMJ Open Quality, a peer-reviewed open-access journal covering all content in healthcare improvement work.
