You might have guessed it. Paperwork and administrative burdens is the number one issue that frustrates doctors, according to a new poll.

This year when Medical Economics polled its physician readers, it asked them “What’s ruining medicine for physicians?”

Some 44% said paperwork and administrative burdens, according to the publication (PDF). That’s typical. For instance, the American Academy of Family Physicians called reducing the administrative burden weighing down doctors the "most pressing priority" for its physicians and earlier this year adopted a host of principles aimed at correcting the problem.

RELATED: AAFP aims to reduce administrative burden, the ‘most pressing priority’ for family physicians

Here are the other top issues that doctors said frustrate them and get in the way of treating patients and running their practices:

1. Paperwork and administrative burdens. 

2. Difficulty using EHRs (41%). No wonder doctors are frustrated with EHRs. Primary care physicians spend more than half of their workday interacting with electronic health records, an American Medical Association (AMA) study found. Seven in 10 doctors said they are frustrated with the way EHRs have impacted their relationship with patients, according to a new poll by Stanford Medicine. 

3. Government regulations (26%). Compliance isn’t easy and it’s expensive. Nearly half of practices spend more than $40,000 per physician to comply with new and existing federal regulations, the Medical Group Management Association found.

4. Prior authorizations (24%). Dealing with prior authorizations is such a big headache for doctors, six leading health industry groups that represent both physicians and payers joined together earlier this year in a collaboration to improve the processes.

5. Replacing primary care physicians with nurse practitioners and physician assistants (19%). Fewer patients with employer-sponsored insurance are visiting their primary care doctors, but more are seeing other advanced practice providers, a study released last month found.

6. Having no negotiating leverage with payers (18%). When there’s less competition, payers can exercise market power in a way that can negatively impact patients and healthcare providers, an AMA report said.

7. Increasing practice staff and overhead costs (15%). A 2019 survey painted a tough financial picture for medical groups. In 2017, medical groups saw a continuing increase in cost pressures and an inability to grow revenues, leading to diminished operating results, the AMGA's consulting division found.

8. Imbalance in primary care versus specialist reimbursement (15%). While primary care doctors are in demand, specialists are still drawing those top salaries. At an estimated $590,000, invasive cardiologists have the highest starting salaries, according to a 2018 report. But the demand for family medicine physicians translated to an all-time high starting salary averaging $241,000.

9. Maintenance of certification (MOC) costs and requirements (12%). There’s been a backlash from physicians over tougher requirements and costs of MOC. MOC adds no clinical value to the practice of medicine, according to 65% of physicians in a survey released this fall. The survey of 515 U.S. physicians by MDLinx found that almost 55% of respondents want to see those controversial MOC requirements revoked, while 48.5% said they would prefer more continuing medical education hours replace the current MOC recertification process.