In 2021, the Ontario Medical Association published a report that said that ‘patient expectation/patient accountability’ was the leading cause of physician burnout.

On May 28, 2023, Dr. Adam Stewart posted a good blog on this topic: Burnout: Some Patients are to Blame.

My colleagues at Queen’s University and I recently conducted a research study asking Family Physicians in Ontario what they think can be done about this.

Seventeen Family Physicians in Ontario (95% Female) were given instant cameras to take pictures at work or in their personal life to document how patient expectations contributed to burnout and to develop ideas about how to educate patients about this problem and how to manage it.

The photographs and discussion will not likely be a surprise to any current or former Family Physicians:

• Piles of forms/charts/letters needing attention
• Late hours at the computer or clinic
• Safety concerns
• Consultations about issues that patient have already sought advice about from social media or other sources
• Etc, etc.

Several suggestions were made by the Family Physicians about what action(s) could be taken to deal with these issues. Some of these ideas have been implemented in clinics and others are new ideas.

The strategies for educating patients about the capacity and scope of Family Physicians included:

• Using timers to convey time limits for office visits
• Patient agreements that clearly outline rules on patient behaviour and practice operations
• Emphasizing patient responsibility for completing paperwork and allowing reasonable time for physicians to respond

The Ministry of Health, Public Health Units, and medical associations were identified as having a responsibility in educating the public about the role of Family Physicians. This must ensure that only appropriate tasks fall to Family Physicians as well as increasing transparency on how Primary Care is funded.

We hope to share this information as broadly as possible which may include photo exhibits in clinics, publications and conference presentations.

Many thanks to Dr. Adam Stewart for assisting us with recruitment and for the ability to share our findings with you. Thanks as well to the many busy and hardworking Family Physicians who participated in this research over the past 18 months. You know who you are 🙂

Photo #1: Poster – I am a Doctor not a …’

“I had had a week where I was being asked to do some tasks that I didn’t necessarily think were “my job”, and so that’s why I took a picture of it. And then I thought, you know, are they my job? What is my job?”

Photo #2: Lonely car left in parking lot at dusk

“the idea of the photo is that this is my car, and this is the gigantic parking lot of our medical building, and it is the only car that is there, sun setting in the back. It’s probably taken around 7. I am the last person standing. This is not an evening clinic day, either. This is just a getting through the paperwork day”.

Photo #3: Vase of yellow tulips – How it feels to be a Family Physician – going in many directions

“multiple patient encounters where they come in with long lists, and “have like within that period, to address all these items that seem to be going in all these different directions.”

Photo #4: Photo with weight-loss solution found from Tik-Tok

“So that’s why I took a picture of that, because it really was what my desk looks like, and it was really the TikTok and the weight loss thing that I think has really increased and put demand on patients for expectations of us. It’s our problem now, not theirs”  

by Dr. David Pinkerton

June 23rd, 2026