Fixing the business side of primary care in times of crisis

Canada’s primary care system is in crisis. Rising overhead costs and heavy administrative burdens are pushing family physicians and nurse practitioners, especially new ones, away from opening their own practices, while others are leaving their existing ones. For many providers, running a clinic today feels less like delivering care and more like managing a small business. They’re not only responsible for treating patients, but also for handling staffing, paperwork, and day-to-day operations. The double duty of providing care and managing a practice is contributing to growing burnout. At the same time, access to care is dropping, and more than 6.5 million Canadians now have no family doctor, according to the OurCare national survey. While governments have introduced reforms like new payment models to alleviate the issue, most still overlook the business side of running a clinic, which is essential to keeping practices open and ensuring patients are cared for.

With funding from the Canadian Institutes of Health Research, Telfer School of Management Associate Professor Agnes Grudniewicz and her team are leading a groundbreaking project to explore how primary care practices are managed behind the scenes. Grudniewicz’s interest in primary care goes beyond research. After witnessing firsthand the harmful consequences of poor-quality care, she made a bold decision to leave behind a career path in finance to pursue one dedicated to improving the primary care system. “I wanted it to be better for everyone,” she says.

Bringing research where patient care begins

The research is being conducted in clinics across Ontario, British Columbia, and Nova Scotia. Grudniewicz and her team will survey managers, talk to staff, and study how different clinics are run. The aim is to determine what is working well, where the gaps are, and what support clinic leaders need to help them thrive.

For Grudniewicz, “Primary care is the foundation of our healthcare systems. But a healthy primary care system is about more than just the interaction between a patient and a family physician.” She emphasizes that this is where people first go for health services. It brings together doctors, nurses, and other professionals to support everything from check-ups to mental health and long-term conditions, making sure patients get the care they need over time.  “We are excited to help address the huge gap in evidence around how to manage a primary care practice.”

Working with front-line providers, the team will co-develop practical tools, training resources, evidence-based strategies, and policy recommendations to help clinics optimize primary care operations.

The impact of easing the pressure

By tackling the often-neglected business side of primary care delivery, Grudniewicz and her team are contributing to relieving a crisis at the core of Canada’s healthcare system. The findings from this research will not only ease administrative burdens and reduce burnout among primary care providers but also support more efficient clinic operations and stronger frontline teams. Ultimately, this means better access and more consistent care for Canadians. At a time when the primary care system is under tremendous pressure, this research offers a much-needed solution, one that strengthens the foundation of how care is delivered to ensure it remains accessible, reliable, and efficient for many years to come.