Medical society wants to limit sick notes

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The New Brunswick Medical Society is calling for legislation to follow the lead of other provinces to eliminate administrative paperwork for physicians.

Medical society president Dr. Paula Keating said in a statement on Tuesday the society strongly supports measures aimed at reducing the burden of excessive paperwork for family physicians, especially the elimination of sick notes for short-term leaves.

“Every unnecessary government form or sick note is one less primary care visit for patients waiting to be seen,” she said.

Keating said she is pleased to see New Brunswick’s government taking the issue of physician red tape seriously, and exploring areas for improvement. The joint task force with the province and medical society has already identified dozens of forms to be transformed or eliminated.

“However, they have not shown interest in moving ahead with transformative legislation targeting sick notes. We sincerely hope New Brunswick will follow in the footsteps of Quebec, Nova Scotia and Ontario, who have all reduced unnecessary physician paperwork through changes in legislation,” she said.

Provinces taking steps to reduce red tape

Work is already underway in several provinces to alleviate the administrative burden on family physicians.

Last week, Quebec labour minister Jean Boulet announced he will table a bill to cut red tape, so family doctors can free up 500,000 additional medical appointments for patients annually, Postmedia has reported.

Boulet’s bill would prohibit insurers from requiring that a person consult a doctor to be reimbursed for equipment, like a cane or orthopedic equipment , or the services of a physiotherapist or massage therapist.

Meanwhile, Ontario will soon introduce legislation that, if passed, will no longer allow employers to require a sick note from a doctor for the provincially protected three days of sick leave workers are entitled to.

Employers will retain the right to require another form of evidence from an employee such as an attestation or a receipt for over-the-counter medication, Postmedia has reported.

Nova Scotia has the Office of Regulatory Affairs and Service Effectiveness (ORAS) which began looking for ways to reduce paperwork for physicians in 2020 after seeing success in cutting back on red tape for businesses.

Leanne Hachey, the office’s executive director, said her office surveyed 500 Nova Scotia physicians and compiled a list of 45 action items on reducing paperwork for physicians with initiatives such as standardizing forms for short-term and long-term disability. More than 30 items have been achieved, and the rest are in the process of completion.

Physicians used to have close to 30 forms for the different insurance providers, and the care providers used to spend their evenings and weekends filling out the paperwork. Through the work of ORAS it was reduced to one form.

Nova Scotia has also introduced the Medical Certificates for Employee Absence Act, which prohibits employers from requesting sick notes from employees for the first two illness-related absences of five days or less.

The office’s goal is to eliminate 400,000 hours of administrative work for physicians by the end of 2024. Hachey said the office is looking to work with the federal government to simplify and standardize other forms like veterans’ paperwork, and disability tax credits.

“We do hope if we give them a little bit more time to do what they love to do, which is take care of us, and a little less time on stuff they may not need to do, like filling out forms, they will be more likely to come to Nova Scotia,” she said.

Dr. Kathleen Ross, president of the Canadian Medical Association, said it is estimated physicians nationwide have roughly a combined 18.5 million hours of “unnecessary administrative burden,” which is the same as 50,000 patient visits a year.

“All of those things on the desk at the end of the day is additional work, and takes away time we could be spending with patients, committing to our education, or even committing to our families so we could have better work-life balance,” she said.

Ross said the CMA is working with the federal government on streamlining some of the forms and identifying which ones are cumbersome.

The CMA is also saying some of the paperwork could be done by other health professionals treating patients, such as physiotherapists and occupational therapists.

I think it's something worth looking into

Rob McKee

In New Brunswick, Liberal health critic Rob McKee said his party has received feedback from New Brunswick stakeholders in favour of exploring similar initiatives regarding sick notes and limiting the requirements of doctor’s notes for things like orthopedic equipment and massage therapy as long as it does not increase insurance rates for New Brunswickers.

“If we can make it easier for people to obtain care and treatment they need I think it’s something worth looking into,” he said.

Health Department spokesperson Sean Hatchard said in an email the department is always looking at ways to improve the quality of health-care services in New Brunswick.

“It is interested in learning more about how this initiative in Quebec could impact both physicians and patients,” Hatchard said.

Artificial intelligence is another tool being considered to alleviate some of the paperwork, such as an AI scribe that produces the first draft of chart notes for an appointment, with the consent of the patient, in order to reduce time a physician spends on their chart notes.

Ross said the CMA is waiting for guidance from the federal government on setting guardrails for incorporating AI into community practices.