Canada’s health workforce faces growing workload challenges with clinicians stretched across rising demands, administrative tasks, and system pressures. Low-value care often goes unnoticed as a contributor to that strain. The cascades of follow-up tests, referrals, and appointments reveal the hidden hours of work that divert time and energy from necessary care.

Dr. René Wittmer, a family physician in Quebec, understands the pressures of clinician workload firsthand. He shares the importance of making time spent on low-value care more visible and sees Choosing Wisely recommendations as a practical approach to help ease workload burden.

“There are many things that we do for no reason,” explains Dr. Wittmer. “Cutting back on things that don’t offer any advantages to patients allows clinicians to reallocate that time to things that will help patients feel better, live longer and that really make a difference.”

Even small tasks add up. Routine blood tests, bone density scans, and imaging for lower back pain without red flags can collectively take days and weeks of clinician time each year. For example, one case study of a clinic with 10 clinicians estimated that avoiding routine blood work for patients without clear clinical indications could free up 20 days annually. Beyond the time saved, many low-value interventions add little or no benefit and, in some cases, can cause harm.

To help clinicians estimate the amount of time low-value care takes in their practice, Dr Wittmer created the Time Needed to Treat (TNT) calculator. While this online tool provides time estimates, its broader purpose is to encourage reflection on practice patterns and identify areas where unnecessary interventions could be reduced.

The benefits of reducing low-value care extend beyond workload alone. The time that Dr. Wittmer saves can be spent on engaging in shared decision-making with his patients and working in other ways to reduce the risk of harm.

“I can spend time having conversations with my patients and focus on what will actually make a difference for them,” he shares.

Looking ahead, Dr. Wittmer hopes to expand the TNT calculator to account for patient time as well. Time spent travelling to appointments, waiting in clinics, or undergoing unnecessary interventions also goes unnoticed. By making the hidden hours of low-value care visible, clinicians and patients have more time to focus on what matters most.

Interested in learning more or reflecting on your own practice? Access all these resources through our Workload Burden webpage.