Patients and family doctors highlight patient-led solutions for the primary care crisis

A new national report led by researchers at Unity Health Toronto and the University of Toronto, with input from close to 10,000 people in Canada, highlights patient-led solutions to the worsening family doctor shortage — and provides feedback from those directly affected on how to improve access to primary care across the country.

The report, prepared by OurCare, is part of the largest pan-Canadian conversation ever about primary care. OurCare is led by Tara Kiran, a family doctor and scientist with the MAP Centre for Urban Health Solutions at St. Michael's Hospital, who is vice-chair of quality and innovation for the department of family and community medicine at U of T’s Temerty Faculty of Medicine.

“We heard from almost 10,000 people across Canada who collectively spent about 10,000 hours engaging with us on how to improve the primary care system,” says Kiran. “People shared stories that were both heartwarming and heartbreaking.”

The OurCare initiative started in 2022 with a national survey on patient experiences, values, and priorities about the health system. Next, priorities panels were held in Ontario, British Columbia, Manitoba, Quebec, and Nova Scotia for over 150 randomly selected residents to learn about primary care and identify the reforms they believe Canada needs.

Finally, 10 community roundtables were held to receive in depth feedback from nearly 200 individuals from underserved communities, including First Nation, Inuit and Métis people; African, Caribbean and Black communities; immigrants, refugees, migrant workers and other newcomers; LGBTQIA+ migrants; and people with disabilities.

Data from OurCare showed the number of people across Canada without consistent access to a family doctor or nurse practitioner has risen from 4.5 million in 2019 to more than 6.5 million in 2023.

“Despite vastly different life experiences and backgrounds there was so much [the participants] agreed on. At its core, they felt strongly that every person deserves access to high quality primary care and that the system should be accountable to patients and the public,” says Kiran.

Findings from the OurCare initiative culminate in the OurCare Standard—six elements that summarize what Canadian residents believe everyone deserves, needs, and should expect from primary care.

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.

“The OurCare Standard describes what every person in Canada should expect from the primary care system,” says Kiran. “It’s a distillation of all that we heard. Now it’s up to those of us with any power in the system to act on the priorities people in Canada have so clearly articulated.”

The team have even provided a comparison tool so people can check how their care matches up to the OurCare standards.

OurCare is the culmination of Kiran’s many years spent working to make the health care system better. Her career in family medicine stems from a love of getting to know people, and her dedication to research from her enjoyment of asking and answering questions. The need for both is dire in Canada, and OurCare is a commitment to both family medicine and patients across the country.

“We are calling on governments, health care organizations, and health care leaders to act on these important findings, adopt the OurCare Standard in their practices and policies, and address the primary care crisis before it’s too late,” she says. “I’m very hopeful that this work and the voices of these patients influence policymakers and result in much-needed changes to the system.”

To learn more about the initiative and read the full report, visit the OurCare website.

This story is based on a news release from St. Michael's Hospital, Unity Health Toronto.