Primary Focus with Dr. Tara Kiran

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.caMeet some of the OurCare panelists: https://www.youtube.com/watch?v=ShkxhIJBCh8&t=25sReview 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 panelsDr. Tara Kiran’s Opinion piece in the Toronto StarMore about Primary Focus:Subscribe to our Substack newsletterVisit our website at primaryfocus.caLearn about the OurCare StandardTake 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. 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

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 ArtRead Dr. Kiran’s 4-part series for the Medical Post on her tripSubscribe 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. 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

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 ArtRead Dr. Kiran’s 4-part series for the Canadian Health Network on her tripRead 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.toDr. 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 is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit primaryfocus.substack.com

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 ArtRead Dr. Kiran’s 4-part series for the Canadian Health Network on her tripRead an article about Tara’s host, Dr. Tim Olde Hartman: A Giant Standing on the Shoulders of GiantsSubscribe 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. 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

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

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. 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

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 ActionRelated articles you might like:CMAJ Commentary: Ensuring incoming cohorts of medical students better represent the diversity of Indigenous communities in CanadaResearch study: Changes in health indicator gaps between First Nations and other residents of ManitobaReports from the OurCare Community Roundtables“The Unforgotten” - a five part film from the Canadian Medical Association about Indigenous Health in CanadaMore about Primary Focus:Subscribe to our Substack newsletterVisit our website at primaryfocus.caTake the OurCare national survey to share your experiences with primary careDo 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. 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

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 healthcareRelated 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 2022Keeping the front door open: ensuring access to primary care for all in Canada by Tara Kiran, Canadian Medical Association Journal 2022We need bold reform to fix family health care by Tara Kiran, Globe and Mail 2023More about Primary Focus:Subscribe to our Substack newsletterVisit our website at primaryfocus.caLearn 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. 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

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. 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