Why did Canada’s referrals and lab tests rise?

Administrative workload increased for Canadian physicians

A Canadian study finds that physician administrative burden per patient visit increased substantially over more than a decade. Over 11 years, referral rates per patient visit rose by 57%, and laboratory tests per patient visit increased by 29%. In contrast, the rate of prescriptions per patient contact stayed roughly the same.

The pattern points to a shift in how clinical time and actions are distributed: more downstream testing and specialist routing occurred alongside increasing administration requirements. While the report describes these changes at the visit level, it highlights a practical problem for health systems—growing administrative workload can reshape what happens during care, potentially adding complexity for both providers and patients.

This matters because referrals and lab work can have real consequences for cost, patient experience, and care efficiency. More referrals may also mean longer waits for specialty appointments, while additional lab testing can increase financial and operational pressure.

The findings also suggest that physicians were not simply “doing more of everything,” since prescriptions per patient contact did not increase in the same way. That divergence is important for interpreting what is driving the change: it may be more tied to non-treatment tasks or workflow pressures than to direct medication decisions.

For clinicians and policymakers, the result strengthens the case that administrative workload is not a neutral burden. It may influence clinical processes that determine how care is delivered.

• Referral and lab-use per visit rose sharply
• Prescription rates stayed about steady
• Administrative workload may be reshaping visit-level care workflows