Canadian Medical Assocation

We first surveyed our members about their experiences with third-party forms in 2007. At that time, respondents told us these forms can be complex and time-consuming to complete, adding to their workload and cutting into their time with patients.

Since then, we’ve continued to work with the federal government to reduce the burden on physicians of completing these forms on behalf of patients. We revisited this topic in support of that work, asking physicians how they handle third-party forms and their concerns about them.

Completed:
December 2016

Distributed to:
3,689 e-Panel members

Responses:
663

Response rate:
18.0%

Want to share your perspective? Visit the CMA Member Voice e-Panel page for more information on how to participate in future surveys.

Completing these forms is time consuming at all levels in my practice — for the patient, the admin assistant who works with me and myself. Many of the questions we are asked require a bit of a guess approach to answering them.

- Member Voice e-Panel respondent

What members said

Our survey included a list of 13 common forms. To support our discussion of the results, we’ve numbered these forms as follows:

  1. Short-term disability claim form
  2. Long-term disability claim form
  3. Sick notes
  4. Canada Pension Plan disability medical report
  5. Disability Tax Credit Certificate (Canada Revenue Agency)
  6. Veterans’ Affairs disability benefit form
  7. Non-Insured Health Benefits prior authorization form (for First Nations and Inuit people)
  8. Health Canada Special Access Programme (Drugs) request form
  9. Canadian Adverse Drug Reaction Monitoring Program form
  10. Health Canada medical document for access to cannabis for medical purposes
  11. Medical Certificate for Employment Insurance: Sickness Benefits
  12. Medical Certificate for Employment Insurance: Compassionate Care Benefits
  13. Canada Child Benefit form

Most common forms

Respondents said they are most often asked to complete sick notes: 67.7% of respondents had to fill this form out at least weekly. 29.7% had to write a sick note more than five times per week and 38.0% had to do this one to five times each week.

The short-term disability claim form was the next most frequently completed: 42.3% of respondents said they are asked to fill out this form at least weekly. 5.3% received at least five requests per week and 37.0% received one to five requests per week.

The majority of respondents said they are seldom or never asked to complete forms 6–13.

Graphic showing how frequently members are asked to complete each type of form

Time required to complete third-party forms

Seven of the 13 forms take physicians between five and 10 minutes to fill out. Respondents identified the sick note as the quickest to complete, with 81.3% saying it requires five minutes or less. In comparison, the long-term disability claim form, Canada Pension Plan disability medical report and Veterans’ Affairs disability benefit form can take longer than 30 minutes to complete.

Billing practices

We asked participants who they charge when they fill out a third-party form. There were four options for each form:

  • Patient on a case-by-case basis
  • Patient via block fee (a predetermined amount charged to the patient to cover the cost of completing forms and other non-insured services)
  • Third-party
  • No one

Forms that respondents predominantly charged to patients on a case-by-case basis were the two types of disability claim forms and the Disability Tax Credit Certificate. Forms that respondents charged mainly to a third party were the Canada Pension Plan disability medical report and the Veterans’ Affairs disability benefit form. Other forms not billed to either the patient or a third party were forms 3, 7–10, 12 and 13.

Nearly 90% of respondents said they often refrained (65.2%) or sometimes refrained (24.1%) from billing their patients for these medical forms to avoid imposing undue financial stress on them.

Graphic showing who do you usually bill for the completion of the following forms?

Requests for other forms

68.9% of respondents said patients ask them to complete forms not among the 13 we identified, with the most common being:

  • Fitness test forms (mentioned in 18% of responses)
  • Provincial forms (mentioned in 10% of responses)
  • Disability forms (mentioned in 7% of responses)
  • Insurance forms (mentioned in 7% of responses)

Concerns about completing third-party forms

We asked respondents for their concerns about completing these forms for their patients. Several common themes emerged:

  • Form completion takes time away from direct patient care (75.0%)
  • Unfairly placed in the role of adjudicator (where the patient thinks the physician is responsible for approving their benefits) (74.8%)
  • Lack of compensation for completing forms (66.1%)
  • Number of inappropriate form completion requests from third parties (63.4%)
  • Number of inappropriate form completion requests from patients (37.3%)

It puts me in a difficult position to bill the patient. We are seen as carers not a business that charges patients directly. It can cause tension in the relationship.

- Member Voice e-Panel respondent

Additional concerns respondents cited included:

  • Administrative burden (e.g., frequency of requests, time involved, length of forms)
  • Vague or inappropriate requests for physicians (from the forms or from the patient directly)
  • Lack of standardization or poor design of forms
  • Lack of compensation and lack of standardized fees for completing forms

We DO have a professional responsibility to assess patients. Abrogating this is not good for the profession. I understand insurance/province needs info. Filling forms however is very time consuming, unfulfilling, poorly paid and takes away from patient care.

-Member Voice e-Panel respondent

What’s next

These survey results will help us identify opportunities to reduce the administrative burden of third-party forms on physicians and help us revise our existing policy on third-party forms. We’ll continue to work with the federal government and the insurance industry to simplify the third-party forms physicians are asked to fill out and to reduce the number of these forms.

Other e-Panel survey summaries

See what CMA members had to say about other health topics: