CBC's Omar Dabaghi-Pacheco follows Dr. Alykhan Abdulla for a day
It's just after six o'clock on a frigid Ottawa morning.
The sun won't rise for another hour, but Dr. Alykhan Abdulla is already racing against the clock.
He's been studying his patient's charts throughout the weekend, preparing for some very long days at his small family practice in Manotick in the city's south end.
"I'm contemplating all the things where I'm going to potentially have problems with. And that always makes me feel a little worried and anxious," said Abdulla.
He worries he might miss something that could have grave health consequences. That fear has changed the way he feels driving to a job he's done for three decades.
"It's a sense of dread in some ways. I've been working all weekend to prepare for this week, the opportunity to get a bit of a break hasn't really happened," he says.
On his busier days, Abdulla could have between 25 and 40 patients go through his office, each with problems he's following, new problems they bring and a medical trajectory he needs to put them on.
Tuesdays can be overwhelming, in particular.
"It's important to know what they're coming for. Collect the data, pre-prepare the charts if possible, make sure we're not missing anything so we can be as efficient as possible."
He used to see 50 or so patients a day, but now he can barely manage half of that. He sets aside 20 minutes tops for each patient and their paperwork.
Any longer than that and it will become near impossible to complete the day's work.
So much paperwork
His first patient arrives slightly ahead of schedule, with an injured shoulder and some unfinished business from his last visit.
Abdulla recommends a series of tests and a plan for a colonoscopy. He spends seven minutes on his patient, leaving him another 13 minutes to fire off the paperwork.
"I'm gonna do a couple of things. I'm gonna send the referral along that he requires. I'm going to make sure that, if there's any messages in my system, that I deal with them."
Abdulla has been practising family medicine for three decades. Gone are the days when he used to go to the hospital to do obstetrical care, deliver babies and assist in surgeries. That variety of work has given way to piles of paperwork and an endless stream of aging patients with complex conditions, desperate for care.
He's learned how to make this work, but the demands of the job have changed.
"It's the administrative stuff that drowns you," said Abdulla.