Patients, politicians and clinicians agree: itβs high time to fix primary care in Canada. But, what could a stronger, more inclusive, more efficient public system look like? In this smart, engaging podcast, family doc and researcher Dr. Tara Kiran brings together the voices of frontline healthcare workers, patients, researchers and policymakers from around the world to unpack the issues and innovations that couldβand shouldβtransform primary care in Canada.
With a focus on actionable insights and real-world solutions, episodes will take you behind the scenes to understand how different health systems and clinics are solving access problems, stretching healthcare dollars and ensuring quality care for all. At the heart of each conversation is a shared commitment to a better public healthcare systemβone that not only serves every person in Canada, but leads the world.
In Victoria: Building a team to meet an access crisis
Season 3 Β· Episode 1
Thursday, October 22, 2026 β’ Duration 55:57
When Dr. Paul Sawchuk and Dr. Thuy-Nga βTiaβ Pham arrived in Victoria in the early 2020s, many patients told them they had gone eight or nine years without a family doctor. Both had practised family medicine for decades elsewhere, and both were taken aback by what they saw, including patients with cancers that had gone undiagnosed until very late. Today they lead the six Urgent and Primary Care Centres (UPCCs) run by Island Health in South Vancouver Island and work to improve access in the region.
In the Season 3 premiere of Primary Focus, host Dr. Tara Kiran tours the Gorge UPCC. There, nurses triage the waitlist so the most urgent patients are seen first. Nurses with added certifications assess and treat common conditions, and the whole team shares the work of completing forms for people without a doctor. We hear from team members about what makes their collaboration work.
Tara then sits down with Paul and Tia to talk about how the UPCCs have become an access point for the region, how they need to be selective with who they see on an ongoing basis, how they built a team culture that keeps people engaged, and a tension at the heart of primary care in Canada: do we have the resources for everyone to have an ongoing relationship with a family doctor or do we need to focus first on just providing some access to everyone?
Explore the Resources
Explore the Island Health Urgent Primary Care Centre model
See photos from my tours of the Gorge and Downtown UPCC campuses
Mainpro+ Credits
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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/podcastΒ
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit primaryfocus.substack.com
[From the Vault] In the Netherlands: whoβs accountable for access?
Thursday, September 17, 2026 β’ Duration 49:58
How do you design a system that delivers timely primary care β 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 β and consider what Canada can learn from the Dutch approach.
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
[From the Vault] In the Netherlands: after-hours care that works
Thursday, September 17, 2026 β’ Duration 45:42
Emergency departments in Canada are overcrowded β but what if they didnβt 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 β 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 β whether thatβs phone advice, an in-person visit, or a doctor dispatched directly to their home.
Itβs a system built on trust, triage, and teamwork β and it results in emergency rooms that are calm, efficient, and oftenβ¦ empty.
Mainpro+ Credits
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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/podcastΒ
Resources
If you missed Part 1 and Part 2, click to catch up.Β
See a gallery of Dr. Kiranβs photos from her trip to the Netherlands.
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
[From the Vault] In the Netherlands: a day in a GP practice (Part 2)
Thursday, September 3, 2026 β’ Duration 31:22
Why are Dutch GPs called βhuisartsβ β 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 doctorβs right hand β 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.
Mainpro+ Credits
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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/podcastΒ
Resources
If you missed Part One of the documentary series on the Netherlands, click here to catch up.Β
See a gallery of Dr. Kiranβs photos from her trip to the Netherlands.
Read Dr. Kiranβs for the Canadian Health Network on her trip
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
[From the Vault] In the Netherlands: a day in a GP practice (Part 1)
Thursday, September 3, 2026 β’ Duration 36:24
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 Hartman 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 βthe secret sauceβ of the Dutch primary care system. Stay tuned!
Mainpro+ Credits
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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/podcastΒ
Resources
See a gallery of Dr. Kiranβs photos from her trip to the Netherlands.
Read Dr. Kiranβs 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 CBCβs Read an article about Taraβs host, Dr. Tim Olde Hartman: Subscribe to our to get bonus content.
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
[Feed Swap] The Intersection Between Primary & Emergency Room Care with Dr. Anton Helman & Dr. Danielle Martin
Friday, August 21, 2026 β’ Duration 54:31
Is the primary care access problem the cause for ED overcrowding?β¨
Do emergency rooms have to be the safety net in our system - or is there another way?
How can primary care and emergency medicine better collaborate?
While the Primary Focus team takes a brief summer break, we are sharing a special crossover episode from Emergency Medicine Cases. Host Dr. Anton Helman sits down with Dr. Tara Kiran and Dr. Danielle Martin to talk about the place where primary and emergency care meet. Together, they unpack common myths and discuss howΒ integrated call-first triage, shared digital records, and an educated public can help us build a better system for everyone.
(Note: This episode was recorded in October 2025, prior to Dr. Danielle Martinβs election as Member of Parliament for University-Rosedale.The views and opinions expressed by Dr. Martin in this discussion were her own at the time of recording and do not represent or reflect the views, policies, or positions of the Government of Canada.)
Read more about the Dutch model of primary care or listen to our 4-part series on primary care in The Netherlands
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
In Spain: A healthcare centre in every community (Part 2)
Friday, June 19, 2026 β’ Duration 49:13
Can you imagine driving down the highway and seeing street signs directing you to your local primary care clinic instead of a hospital? In this episode, Dr. Tara Kiran hops in a car with health economist Tino Marti for a healthcare road trip across Catalonia, Spain, to tour three different clinics. They serve different populations in different settings under different governance models. But all three deliver care to every resident in their surrounding community.
First, they visit CAP Vilafranca North, a clinic run by the public agency that runs 80% of Cataloniaβs primary care centres, where rotating "health points" ensure even small rural villages of 1,000 people can get care in their community. Next, they tour CAP Castelldefels, a joint venture between the government and local municipalities that embraces the philosophy of "subsidiarity"βallowing nurses and administrative teams to independently treat minor issues so family doctors can focus on complex care. Finally, they head to CAP Sardenya, an entrepreneurial, clinician-owned cooperative that integrates university research and gives doctors more schedule flexibility.Β
Listen in to see how the Spanish model combines performance bonuses, quality dashboards, and community engagement to build a system where nobody falls through the cracks.
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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 . Your certificate will be emailed to you. Find more information at Β
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
In Spain: A healthcare centre in every community (Part 1)
Friday, June 5, 2026 β’ Duration 40:58
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 havenβt registered in advance. In this episode, Dr. Tara Kiran takes you on a journey to Spainβwhere 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 SalutβaΒ 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
Family doctors in Canada can now earn Mainpro+ credits by listening to Primary Focus Podcast episodes published after May 1, 2026.Β
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/podcastΒ
Listen to More Episodes About Community-based Primary Care Models
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
What the 2025 OurCare Survey Tells Us About Healthcare in Canada, with Kelly Grant
Friday, May 22, 2026 β’ Duration 39:55
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 β 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.caΒ
Read Kellyβs 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.Β
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 Β
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
In Durham: Community Wellness and Black Health
Season 2 Β· Episode 9
Thursday, March 5, 2026 β’ Duration 57:36
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 servicesβfrom mental health counseling and a regional diabetes team to food security programs, youth programming, and community gardensβTara 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 serveβand what other clinics in Canada might learn from Durhamβs 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 Centreβs innovative work, visit their website at www.durhamchc.ca.
Podcasthon
Primary Focus is proud to take part in Podcasthon, the worldβs 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. Itβs 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.Β
Learn more about Ontario Healthβs , informed by the work done by Francis Garwe and the Durham CHC
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit
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/podcastΒ
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus is supported by a grant from the St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus is supported by a grant from the St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus is supported by a grant from the St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus is supported by a grant from the St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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.Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, the St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
Original Emergency Medicine Cases Show Notes:
There are few things more frustrating for an Emergency Physician than caring for patient after patient who lands in the ED not because itβs necessarily the best place for their care, but because every other door in the health care system was closed, confusing or impossible to find. Emergency Medicine and Primary Care often operate in different worldsβone built around rapid diagnosis and uncertainty, the other around continuity and preventionβbut our patients move constantly between the two. In this special EM Cases podcast, EMβPrimary Care Health Systems Strategies, we step outside the usual ED lens with Dr. Tara Kiran (host of the Primary Focus podcast) and Dr. Danielle Martin to ask how we can deliver the right care, in the right place, at the right time. We challenge assumptions about what drives ED use and explore team-based primary care, after-hours cooperatives, call-first triage, virtual care, information sharing and warm handoffs. Drawing on models from Canada, the Netherlands, Denmark and elsewhere, we finish with practical strategies to reduce fragmentation, improve continuity and make the system work better for patients and providers.Β
Disclaimer: This episode was recorded in October 2025, prior to Dr. Danielle Martin becoming a candidate for government office. The views and opinions expressed by Dr. Martin in this discussion were her own at the time of recording and do not represent or reflect the views, policies, or positions of the Government of Canada.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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. Michaelβs 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. Kiranβs research here: https://maphealth.ca/kiran/Β
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, St. Michaelβs 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. Michaelβs Hospital and the University of Toronto.
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