Why do 6.5 million people in Canada lack a family doctor or access to primary care—and what can be done about it?

In this podcast, Dr. Tara Kiran unpacks the root causes of Canada’s primary care crisis and, more importantly, explores solutions. The podcast is centred on the OurCare Standard—six simple statements that define what every person in Canada should expect from the primary care system:

1. Everyone has a relationship with a primary care clinician who works with other health professionals in a publicly funded team.

2. Everyone receives ongoing care from their primary care team and can access them in a timely way.

3. Everyone’s primary care team is connected to community and social services that together support their physical, mental, and social well-being.

4. Everyone can access their health record online and share it with their clinicians.

5. Everyone receives culturally safe care that meets their needs from clinicians that represent the diversity of the communities they serve.

6. Everyone receives care from a primary care system that is accountable to the communities it serves.

To explore how we can achieve this vision, Dr. Kiran travels across Canada and around the world, uncovering what’s working in places like the Netherlands, Costa Rica, and Denmark—countries known for high-quality primary care. She also takes listeners inside innovative clinics across Canada that are rethinking how care is delivered.

Join Dr. Kiran as she dives deep into the challenges, innovations, and possibilities for building a better primary care system for all.

About Dr. Tara Kiran: Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at the MAP Centre for Urban Health Solutions. She is the Fidani Chair in Improvement and Innovation at the University of Toronto, an Associate Professor in the Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto, and a Senior Adjunct Scientist at ICES. In her research and practice, she finds and tests solutions to make healthcare more inclusive and effective. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. 

Important Links:Visit primaryfocus.ca to learn more. Read about the OurCare Standard at ourcare.caSubscribe to our Substack newsletterLearn more about Dr. Kiran's research: and work to improve practice in Canada.

Join Dr. Tara Kiran as she explores just how bad the primary care crisis is in Canada and the history of exactly how we got here. To do that, she phones her friend (and boss), Dr. Danielle Martin, to dissect the foundational elements of Canada's healthcare system, discuss why the system is grappling with significant gaps, and to ask the thorny question of where accountability lies, and who exactly should bear the responsibility for the system’s shortcomings.

Tara and Danielle also reflect on their own experiences as family doctors and they unpack both the challenges and rewards of family medicine in Canada, from administrative burdens leading to burnout, to the magic that comes with being trusted to care for Canadian patients. 

Resources mentioned in the episode:

Danielle’s book “Better Now: Six Big Ideas to Improve Health Care for All Canadians”

Danielle’s now viral testimony to a US Senate Committee on healthcare

Related articles you might like:

Canada has more family doctors than ever. Why is it so hard to see them? By Kelly Grant, Globe and Mail 2022

Keeping the front door open: ensuring access to primary care for all in Canada by Tara Kiran, Canadian Medical Association Journal 2022

We need bold reform to fix family health care by Tara Kiran, Globe and Mail 2023

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to 

About Dr. Tara Kiran: Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. She is the Fidani Chair in Improvement and Innovation at the University of Toronto, an Associate Professor in the Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto, and a Senior Adjunct Scientist at ICES. In her research and practice, she finds and tests solutions to make healthcare more inclusive and effective. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Funding: Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

Join Dr. Tara Kiran as she learns about how the Northern Connections Medical Centre in Winnipeg is revolutionizing primary care for Indigenous communities. Dr. Kiran tours the facility and interviews Dr. Mandy Buss, who highlights the clinic’s culturally inclusive and trauma-informed practices, and the critical need for increased Indigenous representation in the medical field. Through real-life stories and discussions on systemic racism and historical barriers, this episode examines how a patient-centred and culturally competent healthcare system that honours Indigenous traditions can help address the significant health inequities and barriers to care experienced by First Nations, Métis, and Inuit people.Resources mentioned in the episode:The Truth and Reconciliation Commission Health Calls to Action

Related articles you might like:

CMAJ Commentary: Ensuring incoming cohorts of medical students better represent the diversity of Indigenous communities in Canada

Research study: Changes in health indicator gaps between First Nations and other residents of Manitoba

Reports from the OurCare Community Roundtables

“The Unforgotten” - a five part film from the Canadian Medical Association about Indigenous Health in Canada

More about Primary Focus:Subscribe to our Substack newsletterVisit our website at primaryfocus.caTake the OurCare national survey to share your experiences with primary care

Do you have an idea for an episode? Email primary.focus@unityhealth.to 

About Dr. Tara Kiran: Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Funding: Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

What if getting a family doctor was as simple as enrolling your child in your local public school? Dr. Rita McCracken joins Dr. Tara Kiran to explore what primary care can learn from public education. They unpack why healthcare access should be treated as a right, the structural barriers that keep primary care fragmented, and how shifting responsibility from individual doctors to community-based teams could ensure equitable, reliable care for all. Plus, Dr. McCracken shares insights from her landmark survey of BC family doctors—and what they’re really asking for.Read Dr. McCracken’s articles “What can publicly funded schools teach us about how to fix the family doctor shortage?” and Family physician perspectives on primary care reform priorities: a cross-sectional surveySubscribe to our Substack newsletter to get bonus content.Take the OurCare national survey to share your experiences with primary care.Do you have an idea for an episode? Email primary.focus@unityhealth.to 

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

How is it that 99% of people in the Netherlands have access to primary care? How can Dutch doctors look after large numbers of patients while still providing primary care? Those are some of the questions Dr. Kiran is set on answering when she visits the Netherlands to learn more about their primary care system. In the first of this four part series, Dr. Kiran brings you with her as she visits a GP practice in Nijmegen. She shadows Dr. Tim Olde Hartmen and Dr. Suzanne Ligthart to understand a typical work day. She meets key members of their team and unpacks how they all work together. In Part Two, Dr. Kiran introduces you to what she called “the secret sauce” of the Dutch primary care system. Stay tuned!

See a gallery of Dr. Kiran’s photos from her trip to the Netherlands.

Read Dr. Kiran’s 4-part series on the Netherlands published in the Medical Post and the insights she shared with Andre Picard at the Globe and Mail.

Listen to Dr. Kiran speaking about her trip on CBC’s White Coat, Black Art

Read an article about Tara’s host, Dr. Tim Olde Hartman: A Giant Standing on the Shoulders of Giants

Subscribe to our Substack newsletter to get bonus content.

Take the OurCare national survey to share your experiences with primary care.

Do you have an idea for an episode? Email primary.focus@unityhealth.to 

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

Why are Dutch GPs called “huisarts” — house doctors? In Part Two of her visit to a Nijmegen clinic, Dr. Tara Kiran talks with Dr. Suzanne Ligthart about the Dutch tradition of home visits. She then meets Kris Arts, a practice assistant, and learns how these highly trained team members serve as the doctor’s right hand — expertly triaging patients, coordinating follow-up, and keeping the clinic running smoothly. Dr. Kiran ends the episode with reflections on what Canada might learn from the Dutch approach to primary care. Stay tuned for Part 3 where Tara takes listeners behind-the-scenes to explore the Dutch after-hours care system.

If you missed Part One of the documentary series on the Netherlands, click here to catch up. 

See a gallery of Dr. Kiran’s photos from her trip to the Netherlands.

Hear Dr. Kiran speaking about her trip on CBC’s White Coat, Black Art

Read Dr. Kiran’s 4-part series for the Canadian Health Network on her trip

Read an article about Tara’s host, Dr. Tim Olde Hartman: A Giant Standing on the Shoulders of Giants

Subscribe to our Substack newsletter to get bonus content.

Take the OurCare national survey to share your experiences with primary care.

Do you have an idea for an episode? Email primary.focus@unityhealth.to 

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

How do you design a system that delivers timely primary care — not by chance, but by design? In this final episode in the Netherlands, Tara visits a health insurance company and reflects with her travel companion, Rosemary Hannam on what stood out from their trip to the Netherlands. They discuss how features like standardized GP contracts, clear access guarantees, strong physician leadership and a customer-orientation help keep primary care timely and organized — and consider what Canada can learn from the Dutch approach.

If you missed Part 1,  Part 2 or Part 3, click to catch up. 

See a gallery of Dr. Kiran’s photos from her trip to the Netherlands.

Hear Dr. Kiran speaking about her trip on CBC’s White Coat, Black Art

Read Dr. Kiran’s 4-part series for the Medical Post on her trip

Subscribe to our Substack newsletter to get bonus content.

Take the OurCare national survey to share your experiences with primary care.

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

Emergency departments in Canada are overcrowded — but what if they didn’t have to be? In Part Three of her audio documentary series from the Netherlands, Dr. Tara Kiran takes listeners behind the scenes at two Dutch after-hours clinics: one in the university town of Nijmegen, and another in bustling Amsterdam. She follows Dr. Tim Olde Hartman into a modern after-hours centre that serves over 400,000 people — and learns how Dutch GPs came together to fix a broken model. Rather than being on call alone, GPs in the Netherlands now work together in large regional cooperatives to provide care 24/7. Patients call one number, speak with a specially trained practice assistant, and are guided to the right level of care — whether that’s phone advice, an in-person visit, or a doctor dispatched directly to their home.

It’s a system built on trust, triage, and teamwork — and it results in emergency rooms that are calm, efficient, and often… empty.

Stay tuned for Part Four, where Tara reflects on the trip with colleague Rosemary Hannam, who joined her in the Netherlands just before becoming Strategic Advisor on Primary Care at Ontario Health.

If you missed Part 1 and Part 2, click to catch up. 

See a gallery of Dr. Kiran’s photos from her trip to the Netherlands.

Hear Dr. Kiran speaking about her trip on CBC’s White Coat, Black Art

Read Dr. Kiran’s 4-part series for the Canadian Health Network on her trip

Read an article on after hours care in the Netherlands called "Quality of after-hours care in the Netherlands: a narrative review"

Subscribe to our Substack newsletter to get bonus content.

Take the OurCare national survey to share your experiences with primary care.

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this special episode, host Dr. Tara Kiran reflects on the passage of Ontario’s new Primary Care Act—the first legislation of its kind in Canada. Joined by Peter MacLeod, founder of MASS LBP and co-lead of the OurCare initiative, Tara and Peter take you behind the scenes of a national public dialogue that helped shape the new law. Nearly 10,000 Canadians participated in the OurCare process and what they said they wanted from the primary care system is now reflected in Ontario’s legislation. This episode is a story of civic imagination, moral beauty—and a hopeful step toward primary care that works for everyone.

Resources mentioned in the episode:

Read more about OurCare and OurCare Standard: OurCare.ca

Meet some of the OurCare panelists: https://www.youtube.com/watch?v=ShkxhIJBCh8&t=25s

Review Ontario’s Primary Care Act: https://www.ontario.ca/laws/statute/s25008 

Watch the press conference where Ontario’s Minister of Health, Sylvia Jones, announces the Primary Care Act: https://www.youtube.com/watch?v=RFYZOosIZngRelated articles you might like:

Results from the OurCare provincial priority panels

Dr. Tara Kiran’s Opinion piece in the Toronto Star

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Take the OurCare national survey to share your experiences with primary care.

Do you have an idea for an episode? Email primary.focus@unityhealth.to Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

As Canada faces a family doctor shortage, Tara calls up her friend Dr. Ruth Lavergne, a primary care researcher at Dalhousie University, to ask how we ended up an estimated 23,000 doctors short — despite training more in recent years. Together they explore how the work of family doctors has grown more complex, why more are choosing focused practice or shorter hours, and how payment reforms are shaping — but not necessarily solving — the challenge. Along the way, they reflect on the moral and emotional strain of family medicine, the choices doctors make to preserve balance and meaning, and what it would take to make family medicine not just better paid, but a better job. Stay tuned to the end, when several family doctors sound off about their own practice choices — whether full-service or something different — and what led them there.

Research mentioned in this episode

The federal report estimating Canada is 23,000 family doctors short

Tara’s research on the shift away from full-service family medicine

Ruth’s research on career choices and administrative burden in primary care

Dive into the commentary on physician payment that was a Ruth-Tara platonic meet-cute

Here's the cross-country comparisons on physician payment mentioned in the episode

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

This season, we’re diving into innovative primary care practices across Canada—starting in Alberta, where one family practice is making timely, high-quality care a reality for more than 25,000 patients within a fully capitated model. In this episode, Tara visits Crowfoot Family Practice in Calgary—a clinic that’s getting team-based care right. Physicians here manage patient panels about 30 percent larger than their peers, thanks to a model where 35–40 percent of care is delivered by non-physicians. Executive Director Shauna Thome gives us a tour of the clinic, and then she and medical director Dr. Janet Reynolds join Tara in conversation. They talk about how the role of the physician on the team is different, how the team is piloting new ways to attach patients without a family doctor, and how continuous quality improvement—with patients as partners—shapes the clinic’s culture.

Research mentioned in this episode

Explore more about the Crowfoot Village Family PracticeTake a look at the case study evaluation Health Quality Alberta published on CrowfootRead more about the Calgary Foothills Primary Care Network Dr. Janey Reynolds leadsRead the final report from the Modernizing Alberta’s Primary Care System (MAPS) processCheck out this article that talks about how teams are our hope for the future and can theoretically help doctors care for more patientsSee some photos of Crowfoot Village Family Practice

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this episode of Primary Focus, Dr. Tara Kiran travels to Renfrew County, Ontario, where an innovative team is tackling the family doctor shortage with a new kind of hybrid care - where your doctor is virtual, but your team is on-site. At the Petawawa Centennial Family Health Centre, Dr. Jonathan Fitzsimon shows Tara how patients are matched with virtual family physicians who work alongside local nurses, pharmacists, and other health professionals to provide full-service, ongoing care. The result? More than 6,000 people who once had no family doctor are now receiving comprehensive, team-based care. It’s a story about creativity, access, and what’s possible when rural communities rethink how primary care can be delivered.

Further reading:

Explore more about the Petawawa Centennial Family Health Centre Read a report summarizing Renfrew’s Integrated Virtual Care model 

Dive into research on the Integrated Virtual Care model including papers on early patient outcomes, patient experience, and staff experience. 

See some photos of Petawawa Centennial Family Health Centre (link to post)

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by the St. Michael’s Foundation and the MAP Centre for Urban Health Solutions. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

This episode is the first in a two-part series on the primary care system in Costa Rica. Dr.Tara Kiran sits down with Dr. Madeline Pesec, an internal medicine physician and pediatrician, to explore Costa Rica’s ambitious primary health care system. They talk about how Costa Rica's commitment to health as a human right and its community-oriented primary care have led to significant improvements in health outcomes. From the concept of "Hospital Without Walls" to the role of community health workers, Madeline shares insights from her extensive research and personal experiences in Costa Rica. Then, join us in our next episode where Tara goes on a tour of a Costa Rican clinic and speaks to members of the EBAIS (Equipos Básicos de Atención Integral de Salud) about both how and why they do their work. 

Further reading:

Take a look at the research article that first introduced me to Madeline

Explore this brief Commonwealth Fund case study on the Costa Rican primary care system or dive deeper into this more detailed case study from Ariadne Labs 

Read the article “Costa Ricans Live Longer Than We Do. What’s the Secret?” in the New Yorker magazine by Dr. Atul Gawande

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by the MAP Centre for Urban Health Solutions, St. Michael’s Foundation and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this episode, we take you to Saint-Hyacinthe to see how a team in Quebec is transforming timely access to primary care. Quebec has more interprofessional primary care teams than anywhere else in Canada — yet it remains one of the provinces struggling most with access. So how do you turn a team into one that actually works? Dr. Kiran sits down with Dr. Isabelle Gaboury, a researcher and QI leader who, alongside colleague Mylaine Breton, has modernized the “advanced access” model for today’s interprofessional clinics. Together, they’ve coached more than 40 practices to redesign workflows, clarify roles, and use data to constantly iterate. Then I take you inside GMFU Richelieu-Yamaska, where waits dropped from 14–16 days to just 3. You’ll hear how receptionists learned to triage using a symptom-based algorithm, how nurses and social workers took on new responsibilities, and how the whole clinic shifted from working harder to working differently. It’s a story about change management, team-based care, and what it really takes to deliver timely, patient-centred access — in Quebec and across Canada.

Resources mentioned in the episode:

An article on why it’s so hard to find a family doctor in Quebec

Isabelle and Mylaine’s contemporary advanced access model

How Canada compares to peer countries when it comes to timely care

An older commentary from Tara that delves into why timely access is such a problem in Canada

A summary of Quebec’s data from the OurCare survey

Explore Quebec data from the 2022 OurCare National Survey at data.ourcare.ca or read this article

Visit the website for GMFU Richlieu-Yamaska

Listen to our 4-part series on The Netherlands (mentioned in this episode when discussing training for primary care nurses

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by the MAP Centre for Urban Health Solutions, St. Michael’s Foundation and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this episode, Dr. Tara Kiran travels to Vancouver, British Columbia, to visit the Umbrella Multicultural Health Co-op Clinic — a clinic built by and for newcomer communities. Umbrella pairs physicians and nurse practitioners with cross-cultural health brokers who act as language and cultural interpreters, helping bridge gaps not just in communication, but in navigating the healthcare system itself. Tara tours the clinic with Naomi Armstrong, Director of Integrated Health Programs, and then sits down with Dr. Mei-Ling Weidmeyer, family physician and clinical lead. Together, they discuss Umbrella’s origins as a mobile clinic for migrant farm workers, its cooperative governance model, and how culturally safe, community-accountable primary care can have a meaningful impact on people’s lives.

Donate to UmbrellaUmbrella relies on donations from the public to continue offering services to newcomers–especially for those without insurance coverage. To donate to Umbrella Multicultural Health Co-op, head to their website umbrellacoop.ca 

Research and programs mentioned in this episode

Learn about the OurCare Standard and how it was developed

Watch this 3-minute video about Umbrella

Read a research paper or short report on how Umbrella is integrating cross-cultural health brokers in primary care

Find out more about national efforts to bring cross-cultural health brokers to primary care

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michael’s Foundation, and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this episode, Tara speaks with Dr. Nicole Boutilier, Executive Vice President of Medicine and Clinical Operations at the Nova Scotia Health Authority —  a family doctor leading primary care transformation from within the government. Dr. Boutilier walks Tara through Nova Scotia’s multi-pronged plan to improve primary care access: transforming the province’s centralized waitlist into an active patient management tool, building and strengthening Health Homes (team-based primary care clinics), creating pathways for people without a family doctor to access care while they wait, and modernizing how data flows — so patients can access and share their own health information through the YourHealthNS app.

Research and programs mentioned in this episode

Read the OurCare reports from the Provincial Priorities Panels (including Nova Scotia’s).

Find out more about Nova Scotia’s Need a Family Practice Registry and Health Homes model.

Get more info on Nova Scotia’s Longitudinal Family Medicine (LFM) physician payment model.

Watch a video about how the YourHealthNS app gives patients access to their health data.

Learn more about Nova Scotia’s new pathways for integrating internationally-trained medical graduates and the new Cape Breton Medical Campus training rural family doctors.

Dive into the research on virtual care in Canada.

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by a grant from the St. Michael’s Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In Part Two of our Costa Rica series, Dr. Tara Kiran takes you inside an EBAIS (Equipos Básicos de Atención Integral de Salud) clinic on the Nicoya Peninsula in Costa Rica to see what it actually looks like to deliver primary care beyond clinic walls. Costa Rica organizes primary care around geography. Each clinic is accountable for a defined population — and community health workers play a central role in making sure no one is missed. They visit households, provide education on prevention and chronic condition management, deliver vaccines, identify risks early, and act as a bridge between public health and clinical care. It isn’t a perfect system. But it is an ambitious one. And it offers a powerful contrast to Canada’s often fragmented approach to primary care and public health — reminding us that building a system where everyone has care is not just a matter of funding, but of design.

Further reading:

Listen to Part 1 of our series on Costa Rica with Dr. Madeline Pesec

Take a look at the research article that first introduced me to Madeline (co-authored by Dr. Atul Gawande) 

Explore this brief Commonwealth Fund case study on the Costa Rican primary care system or dive deeper into this more detailed case study from Ariadne Labs 

Read the article “Costa Ricans Live Longer Than We Do. What’s the Secret?” in the New Yorker magazine by Dr. Atul Gawande

Read the BBC article Tara mentioned about how Nicoya Peninsula is home to a large number of centenarians

Learn more about rising violence in Costa Rica related to femicide and gang violence

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise. 

More about Primary Focus:

Subscribe to our Substack newsletter

Visit our website at primaryfocus.ca

Learn about the OurCare Standard

Do you have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus is supported by the MAP Centre for Urban Health Solutions, St. Michael’s Foundation and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

In this episode, Dr. Tara Kiran travels to Durham, Ontario, to visit the Durham Community Health Centre, where CEO Francis Garwe leads a team rethinking what primary care can look like when it is truly rooted in community. Touring a repurposed public school that now houses a wide range of services—from mental health counseling and a regional diabetes team to food security programs, youth programming, and community gardens—Tara sees firsthand how Durham CHC addresses the social determinants of health alongside clinical care. She then sits down with Francis Garwe, Dr. Akeem Stewart, and Dr. Kirk Stewart to discuss how the centre is advancing Black health through initiatives like the Kliniki clinic and a community ambassador model designed to build trust and improve access. Together they explore what it takes to co-create programs with the communities they serve—and what other clinics in Canada might learn from Durham’s approach to equity-driven primary care.

Donate to Durham CHC

Durham CHC relies on private donations, grants, and other sources to fund some of the important services they offer that address social determinants of health. To support the Durham Community Health Centre’s innovative work, visit their website at www.durhamchc.ca.

Podcasthon

Primary Focus is proud to take part in Podcasthon, the world’s largest charity podcast event! We were tasked with creating an episode dedicated to supporting a charity or non-profit that truly matters to us, and we chose Durham CHC. Podcasthon brings together podcasters globally to raise awareness for important causes - without any money involved. It’s all about uniting voices to make an impact, with more than 1,000 podcasts highlighting a charity of their choice. Listen to more episodes as part of Podcasthon here. 

Research and programs mentioned in this episode

Get more information on the Durham Community Health Centre. 

Learn more about Ontario Health’s Black Health Plan, informed by the work done by Francis Garwe and the Durham CHC

Find out about the Black Health Committee, a committee for the Alliance for Healthier Communities

Visit the Black Physicians Association of Ontario website to learn more about their work on Black health

MAINPRO CREDITS: Family doctors can claim Mainpro Credits by completing a linking learning exercise.

Listen to other episodes of Primary Focus in our series on community-driven health equity clinics:

In Costa Rica: How a middle-income country built a world-class primary care systemIn Costa Rica: integrating public health and primary careIn Vancouver: A Clinic Accountable to the Community It Serves

More about Primary Focus:

Subscribe to our Substack newsletter

Have an idea for an episode? Email primary.focus@unityhealth.to

Dr. Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michael’s Foundation, and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

More than 5.8 million adults in Canada don't have a regular family doctor, nurse practitioner or primary care clinic--and where you live has a lot to do with whether you're one of them. To make sense of the newest research on primary care in Canada, Dr. Tara Kiran flips the script and welcomes award-winning health reporter Kelly Grant from The Globe and Mail to ask her the tough questions.

Together, they dig deep into the newly released 2025 OurCare Survey data, exploring why provinces like Manitoba and Ontario are faring better, why Quebec leads the nation in out-of-pocket medical fees, and why patients in the Territories report being more satisfied with care. The data raises as many questions about healthcare as it answers — which is exactly what makes this conversation worth hearing.

Explore the Data

The 2025 OurCare Survey tracks how primary care is performing in every province and territory. You can dive into the results yourself at OurCare.ca 

Read the reports at OurCare.ca/survey 

Explore the interactive dashboard at data.ourcare.ca 

Read Kelly’s piece in the Globe and Mail summarizing the key findings

Mainpro+ Credits

Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026. 

This self-learning Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 30 Mainpro+ credits, with 1 credit available per eligible episode. To claim your credit, listen to the episode, review the show notes and complete the self-learning survey. Your certificate will be emailed to you. Find more information at OurCare.ca/podcast 

Listen to an episode about the genesis of the OurCare Survey

A historic win for primary care in Ontario with Peter MacLeod

Why millions of Canadians are still waiting for a family doctor with Dr. Danielle Martin

More about Primary Focus:

Subscribe to our Substack newsletter

Have an idea for an episode? Email primary.focus@unityhealth.to

Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michael’s Foundation, and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.

Imagine living in a country where no resident struggles to access primary care. There are no wait lists. Everyone can be seen at the local health centre, even if they haven’t registered in advance. In this episode, Dr. Tara Kiran takes you on a journey to Spain—where the right to primary care is guaranteed in law and where every community has a local health centre. Walking through the streets and historic health ministries of Barcelona, Tara speaks with health economist Tino Marti and healthcare strategy director Dr. Rafael Ruiz to understand how neighbourhood hubs bring doctors, nurses, social workers, and even publicly-covered psychologists and physiotherapists under one roof to care for entire communities. Finally, Tara sits down with digital health leader Dr. Oscar Solans to learn about La Meva Salut—a  patient app that has given millions of Catalans easy digital access to lab tests, imaging, medications and more since 2009.Learn more about Spanish primary health care

Read this four-page summary on primary care teams in Catalonia

Review this comprehensive policy paper to dive deeper into primary care transformation in Spain 

Mainpro+ Credits

Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026. 

This self-learning Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 30 Mainpro+ credits, with 1 credit available per eligible episode. To claim your credit, listen to the episode, review the show notes and complete the self-learning survey. Your certificate will be emailed to you. Find more information at OurCare.ca/podcast 

Listen to More Episodes About Community-based Primary Care Models

If you want to learn more about how different jurisdictions organize community-oriented, team-based care models, listen to these related episodes:

In Costa Rica: How a middle-income country built a world-class primary care system

In Costa Rica: Integrating public health and primary care

In Durham: Community Wellness and Black Health

More about Primary Focus:

Subscribe to our Substack newsletter

Have an idea for an episode? Email primary.focus@unityhealth.to

Tara Kiran is a family physician and researcher who is passionate about building a stronger, more equitable primary care system in Canada. She practices at St. Michael’s Hospital, Unity Health Toronto where she is also a scientist at MAP Centre for Urban Health Solutions. In 2022, Dr. Kiran launched OurCare, a national initiative to engage the public in shaping the future of primary care in Canada. You can learn more about Dr. Kiran’s research here: https://maphealth.ca/kiran/ 

Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michael’s Foundation, and the Max Bell Foundation. Dr. Tara Kiran is supported as the Fidani Chair in Improvement and Innovation at the University of Toronto and a Scientist in the Departments of Family and Community Medicine at St. Michael’s Hospital and the University of Toronto.