I wanted to be a doctor, not an administrator

All through medical school, we were warned about burnout. There were resilience seminars, wellness lectures, and free pizza lunches to “boost morale.” What no one told us was that burnout isn’t a lack of resilience. It’s a design flaw.

I survived residency on lukewarm coffee and half-melted Clif Bars, running between wards while being told to take a walk or practice gratitude. The advice never matched the reality. The problem wasn’t attitude or endurance. It was structure.

Medicine has quietly turned into an administrative sport. We train for years to diagnose disease, but spend our days managing inboxes, chasing faxes, and completing forms no one reads. The system tells us to work smarter, but gives us workflows designed to waste time.

When I started independent practice, I thought I could escape the chaos by being organized. I was wrong. Within months, my so-called days off were swallowed by paperwork. Ten to twelve hours a week disappeared into scheduling, messages, and documentation. When my medical office assistant took vacation, I woke up at 5:30 a.m. to clear my inbox before clinic, laptop on my nightstand.

At one point, I calculated that I was spending almost 30 hours a week - three full clinic days - on administrative tasks. That’s time I could have spent seeing another hundred patients.

I wasn’t burned out because I didn’t love medicine. I was burned out because medicine no longer felt like medicine. It felt like clerical work in disguise.

The system has normalized inefficiency to the point of absurdity. We click through a dozen redundant screens to bill one visit. We fill out electronic forms that still have to be faxed. We hire staff to manage paperwork created by other staff. Every “innovation” seems to add another step.

Worse, the culture of medicine rewards martyrdom. We still confuse exhaustion with dedication, and self-sacrifice with professionalism. We congratulate doctors for surviving systems that shouldn’t exist in the first place.

A few years ago, I decided to stop coping and start measuring by running a quality improvement project. I tracked every minute my staff and I spent on administrative work. The numbers were staggering, but they showed what needed to change.

I rebuilt my workflows using Canadian-made automation tools like Cortico and Waive the Wait, which integrate with EMRs to handle booking, reminders, intake, and document sorting. Within weeks, the chaos began to settle.

Real change wasn’t statistical - it was emotional. My days ended when the clinic did. My assistant could take a proper lunch break. I could close my laptop at a reasonable hour and actually rest.

That experience taught me something I wish I’d learned in medical school: no one is coming to fix this for us. We have to treat the way we work with the same curiosity and rigour we bring to patient care. There’s QI funding available. There are automation tools, research grants, and independent projects that can improve this. It isn’t something we’re taught, but it’s something we have to learn as a profession.

Hospitals and health authorities measure lots of metrics except the one variable that matters most - how much of a doctor’s day is actually spent doctoring. We’re living in a healthcare system advanced enough to utilize AI for diagnostics, yet still relying on fax machines for referrals. That contradiction isn’t just inefficient; it’s unethical.

What’s been stolen from us isn’t just time. It’s agency. Physicians are trained to solve complex problems, yet we work in systems that prevent us from solving them. We design ventilators to save seconds, but tolerate workflows that waste hours.

Administrative overload isn’t a moral issue. It’s an operational one. Burnout isn’t caused by empathy fatigue. It’s caused by friction. Doctors aren’t overwhelmed because they see too many patients. They’re overwhelmed because they spend too much of their day not seeing them.

Automation isn’t a magic bullet, but in a field that still runs on fax machines, it’s an ethical obligation. When inefficiency costs patients access to care - when doctors are too buried in paperwork to see the people waiting - it’s not optional to fix it. It’s part of practicing good medicine.

I’ve started helping other clinics audit their systems, and I see the same pattern everywhere: staff drowning in repetitive tasks, physicians apologizing for delays they didn’t create, patients waiting weeks because a referral is buried in a queue no one can see. This isn’t burnout. It’s system collapse wearing a stethoscope.

We keep losing good physicians to frustration, not failure. They don’t leave because they can’t handle the medicine. They leave because they can’t handle the nonsense.

The fix won’t come from wellness posters or another task force. It’ll come from doctors deciding that inefficiency is no longer part of the job description.

I didn’t end up quitting, but I came close. And unless we start redesigning workflows to honour the time and attention it takes to practice real medicine, more of us will.

Competing interests

Dr Sarah Baldwin provides independent consulting services related to clinical workflow optimization and serves as a physician advisor for Cortico Health Technologies, a company that develops automation tools for medical clinics. She receives no financial compensation for Cortico product sales or performance.

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