When it comes to primary care, attachment isn’t access
6.5 million Canadians don’t have access to a family doctor, and that number is rising fast.
As the health of Canadians suffers, some are looking to other countries for inspiration. The Dutch model is gaining attention as a potential solution, but is it really the fix we need?
Proponents of the Dutch system, including Dr. Tara Kiran, often point to its 99 per cent attachment rate between patients and family doctors as evidence of its success. But attachment alone is a poor metric for timely access to care.
A more local example is Nova Scotia, where attachment rates are on the rise. People in the province are still waiting months for appointments.
Canada had an 86 per cent attachment rate in 2020, not far behind the Netherlands. Yet in 2023, only a quarter of us were able to get same-day or next-day appointments. That’s a steep decline from 43 per cent in 2016.
On this metric, the Netherlands performs better, with 54 per cent of patients accessing same-day or next-day care in 2023. That’s double Canada’s rate, but it still leaves nearly half the population without timely access.
The Dutch system is also in decline. In 2016, their same-day and next-day appointment rate was 77 per cent.
From 2016 to 2023, Canada’s timely access declined by 17 percentage points, while the Netherlands declined by 23. While the Dutch system may outperform Canada on the basis of this one metric — attachment — it serves only half the population promptly and is degrading even faster.
Any comparison between the two nations also does not account for Canada’s vast geography, rural populations, and regional disparities in care.
While both countries have fragmented delivery systems, the scale and complexity of Canada's challenges are far greater. Instead of copying a model that’s also struggling, we should build something better.
Yes, I am a hopeless optimist, and I see the current crisis as an opportunity to rebuild Canadian healthcare into a patient-centred model that solves problems here at home and, one day, could even help countries like the Netherlands address their own.
Part of the solution lies in enabling all allied health professionals to work at the top of their scope. If I sprain my ankle and visit a physiotherapist, the physio cannot order an MRI, even if they’re fully qualified to do so. Instead I have to book in with my family physician (assuming I have one), who then orders the MRI. Once the results come in, they’re faxed to the physio, who may or may not send a report back.
If my ankle pain persists, I go back to my family doctor, who will probably be missing critical context about the earlier treatment.
At any point during this chain, my case risks falling through the cracks.
This outdated model prevents professionals from doing their jobs effectively, burdens physicians with avoidable administrative tasks, and delays care for patients who deserve better. We need better technology pathways that connect patients, physicians, and allied professionals.
It is 2025, and patients can access almost anything online except their own medical records.
Physicians are drowning in paperwork because the digital tools meant to help them are outdated, fragmented, and poorly designed. Allied professionals are left sitting on the sidelines, not because they lack skill, but because health ministries across Canada have failed to modernize how care is delivered.
The solution is not to look elsewhere for models that are already failing. Instead, we need to build smarter infrastructure designed around patients, powered by collaboration, and focused on outcomes that actually improve care.
Every developed country is facing the same staffing and funding pressures, but Canada has a rare chance to lead rather than follow.
The truth is, the Dutch system is just another sinking ship. So let's stop looking for lifeboats and start building the healthcare system of the future — one the Netherlands and the world will want to copy from us.
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Jeevan Singh is the founder and CEO of PocketMD, a Canadian healthcare platform built to reduce administrative burden for physicians, support scalable team-based care, and ensure patients are active participants in their care.