Primary Focus with Dr. Tara Kiran

In this episode of Primary Focus, host Dr. Tara Kiran tours the Lu’ma Medical Centre, an urban Indigenous primary care clinic located on the unceded territories of the Musqueam, Squamish, and Tsleil-Waututh nations in Vancouver. Guided by Dr. Michael Dumont (an Anishinaabe physician from Shawanaga First Nation), she sees a space deliberately designed to strip away clinical sterility, featuring cedar-wrapped interiors, a traditional medicine pharmacy, and an on-site sweat lodge.
We hear how Lu’ma puts "two-eyed seeing" into practice, operating a dual pharmacy that pairs conventional pharmaceuticals with 38 traditional plant medicines, many harvested in ceremony, and employing "social navigators" to tackle housing, identification, and the social determinants of health. And Dr. Dumont shares how clinicians anywhere can create cultural safety in small ways, from how we introduce ourselves to resisting the urge to interrupt when a patient is telling a story.
Explore the Resources & System Data
Learn more about the Lu’ma Group of Companies
Reflect on how we can address the Truth and Reconciliation Commission’s Health-Related Calls to Action
See photos of my tour of the Lu’ma Medical Centre
Listen to our related episode with Dr. Mandy Buss on culturally inclusive care for Indigenous People
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 
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.


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

When Dr. Paul Sawchuk and Dr. Thuy-Nga “Tia” 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
Get more information on the UBC Okanagan Primary Care Nursing Micro-Credentials program Nurse Kia mentioned
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. 
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 
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.


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 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