Primary Focus with Dr. Tara Kiran

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.
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 
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.
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 
Resources
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 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.
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

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.
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 
Resources
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.
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 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 “the secret sauce” 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. 
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 
Resources
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.
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

Is the primary care access problem the cause for ED overcrowding?

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 how  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 Martin’s 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.)
Listen to the full conversation on EM Cases on their podcast feed (search “Emergency Medicine Cases” on your favourite app.
View a one-page summary of the conversation produced by EM Cases
Listen to our previous interview with Dr. Danielle Martin
Read more about the Dutch model of primary care or listen to our 4-part series on primary care in The Netherlands
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. 
Primary Focus receives financial support from the MAP Centre for Urban Health Solutions, the 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.

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 it’s 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 worlds—one built around rapid diagnosis and uncertainty, the other around continuity and prevention—but our patients move constantly between the two. In this special EM Cases podcast, EM–Primary 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. 
Please consider a donation to EM Cases to support our mission of providing high quality free open access medical education here: https://emergencymedicinecases.com/donation/. 
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.


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