“The Pitt” and the patient: Reflections on Empathy and Health Systems

I may be late to the proverbial “party” on this one (as usual), but I recently watched The Pitt, (a show set over one 15-hour hospital shift in a hospital’s ER in Pittsburgh Pennsylvania), and given my work history in healthcare, some of the themes really hit home. I’ve never worked in a hospital, but I was struck by how the show pulls the viewer into every small moment, every decision, every bit of exhaustion and empathy that defines a day in healthcare.

Having spent much of my career on what’s often called the “admin side” of health, I found myself reflecting on the tension between clinicians and administrators that runs through the story. Though The Pitt is based on the U.S. system, I know the challenges and tensions aren’t unique to the United States, it’s something often felt in Canada as well.  Whether tracking performance indicators or caring for a patient in crisis, everyone’s under strain.

In the show, Dr. Robbie lashes out at hospital leadership for being too focused on quality scores.  Those macro-level KPIs can seem detached from the person needing immediate care, but as someone who’s worked in health system operations, I couldn’t help but think: it all matters. The metrics, the money, the moments are all part of the same ecosystem.  The challenge is aligning them and balancing them with the same goal.

Most of my own work has been in what I would call the “private but not private” side of healthcare — leading integrated medical centres that bridge universal coverage and patient-paid services. It’s a space that doesn’t always fit neatly into policy conversations or appeals for funding or support, but it’s where I learned that if we are truly to solve our healthcare crisis, we need to recognize the unique role that all providers and organizations play in the patient's journey. Healthcare truly does depend on effective collaboration, humility, and respect across every level.

In the end, The Pitt reminded me that no health system is immune to stress and conflicting demands. Yet amid all the pressure and complexity, one truth that connects everyone working in healthcare: the patient is the reason for the work.  Whether a physiotherapist supporting a post-op patient in a private setting, a nurse working a night shift or the head of a health authority, we must ensure that the patient never gets lost between the spreadsheets and the stretchers.  As Canada’s health system becomes increasingly disjointed, spanning public, private, non-profit, and hybrid arrangements, it is imperative to keep the patient at the centre of it all and begin looking at the system from this higher level lens - not simply the universal system or with the hospital lens.

The patient journey doesn’t end when the patient leaves the hospital.  As care becomes more distributed across public, private, and community settings, improving that transition is critical and offers a huge opportunity to improve the patient’s journey and outcome.

If you work in allied health or integrated care and also recognize a huge opportunity to improve the patient journey, lets connect and exchange ideas.

Using Systems Thinking to Bridge the Gap between Family Medicine & Allied Healthcare

One of the challenges with our Canadian healthcare system is how disjointed it can be at certain points in a patient’s care journey. Within the hospital system, roles exist to examine and resolve these handoff points, but one area I’ve grappled with throughout my career as a leader of health centres is the disconnection between Family Practice and allied health practitioners. When patients are referred for services such as physiotherapy, chiropractic, or pedorthics, they often leave the clinic with a prescription or referral and must then navigate insurance coverage, find an appropriate provider, and hope their GP receives feedback to close the loop and support better chance for healing.

This disjointed patient experience creates several challenges: patients end up coordinating their own care, communication gaps emerge between providers and patients, and the overall patient experience suffers. This challenge has been near and dear to my heart: how to ensure patient compliance once they “exit” the universal system, close the communication loop with external providers, support follow-up despite service costs, and measure outcomes? Finding answers to these questions is central to delivering effective, patient-centered care. Improving the connection between GPs and allied health practitioners not only enhances patient outcomes but also strengthens the healthcare system overall.

At first glance, this may seem like a simple referral problem. Yet when we apply systems thinking, it becomes clear that the issue is far more complex—a structural gap affecting patient outcomes, clinic efficiency, the effectiveness of GP-allied provider relationships, and ultimately a missed opportunity for improving patient care and experience.

Systems thinking allows us to look beyond surface-level symptoms and examine interconnections, feedback loops, and leverage points contributing to the problem. In this scenario, the system includes:

• The Family Practice clinic – the public-care hub, coordinating care and capturing patient outcomes.

• Allied healthcare providers – physiotherapists, chiropractors, pedorthists, and massage therapists operating largely in private streams.

• The patient – navigating insurance, scheduling, and essentially forced to be the hub of their own continuity of care.

Feedback loops are critical: delayed or missed physiotherapy can lead to repeat GP visits, additional strain on the public system, and frustration for patients. Small changes in the system can produce outsized benefits—but only if we address underlying structures rather than isolated symptoms.

So, what’s the solution? While fully shared EMRs can help, the reality is that fully integrating EMR systems across all private and public providers in the province is unlikely in the near term. Instead, here are some practical alternatives:

• Referral Tracking Dashboards – Internal trackers combined with patient follow-up can measure the percentage of referrals successfully booked within a set timeframe.

• Patient Navigators – Clinic staff can help patients navigate insurance, recommend vetted physiotherapists, or pre-book appointments. Measurement: completion rates and patient-reported ease.

• Relationships with Allied Health Providers - Relationships with trusted providers streamline scheduling and feedback. Measurement: time-to-first-appointment.

• Feedback Loops from Allied Providers – Short progress notes returned to the GP allow clinics to close the loop and track patient outcomes. AI can help highlight relevant notes for physicians during the next patient visit.

These interventions are measurable, implementable, and strengthen the GP’s role as the hub of patient care. Of course, physicians’ EMRs must be configured to properly track these activities.

For allied healthcare providers: it pays to get to know the Family Medicine physicians in your catchment area. In a previous post on LinkedIN, I discussed marketing tips for physiotherapists and other allied health providers; this one is a winner. Improving these systems doesn’t just help GPs and patients—allied healthcare providers also benefit:

• Reduced lost patients/no-shows, improving revenue predictability.

• Clearer communication, minimizing duplicated assessments and aligning care plans.

• Enhanced reputation and patient experience, generating referrals and trust.

My suggestion: start small, with 5–6 Family Medicine Clinics. After years of developing relationships with Family Medicine physicians to support better referral pathways, I can attest that this approach works.

Things are progressing; we have seen some pockets of innovation in Canada. Certain Health Authorities, Divisons of Family Practice (Primary Care Networks), and Collaborative Service Committees are exploring ways to better integrate the patient journey between Family Medicine and allied health providers. However, much of this work remains localized, leaving many clinics fragmented.

The GP-to-allied health referral gap illustrates a broader principle: systems thinking is not just an abstract concept—it is a practical tool for improving outcomes, efficiency, and patient-centered care. By mapping interconnections, identifying leverage points, and implementing feasible, measurable solutions, clinics can strengthen both public and private care streams, creating a healthcare ecosystem that truly serves patients, providers, and communities alike.

If you are an allied health or family medicine clinic looking to improve referral pathways, enhance communication, and strengthen patient outcomes, Afya Consulting can help. Or, if you’re also super passionate about this topic - I would love to chat more. Let’s work together to transform how your clinic coordinates care across the patient journey. 

Is Your Clinic Ready for AI?

Practical Tips to Consider

Disclaimer: I’m not a legal expert or privacy regulator.  This article is to help distill key themes and offer some practical starting points for clinic leaders.

We Create a LOT of Data—But Who’s Using It?

As humans interacting with phones, wearables, and digital health systems, we create copious amounts of data every day.

• The average person generates hundreds of gigabytes of data daily—and potentially terabytes per year (IDC & Seagate, 2020).

• In healthcare, even where patient records and imaging contain rich insights, only 3–5% of this information is actively used to improve care (IBM Watson Health, 2021; Deloitte, 2023).

• A 2023 Canadian Medical Association survey found that only 20% of Canadians feel confident they understand how their health data is being used.

And the truth is—many health providers don’t either.

As AI tools enter clinics and data volumes grow, these transparency and trust gaps are only getting more urgent.

Canada’s AI Momentum in Healthcare

AI is reshaping healthcare in Canada—from drug development and diagnostics to administrative workflows, telehealth, and triage. We're seeing new technologies emerge across research, clinical, and operational functions.

That’s not necessarily a bad thing.

When implemented ethically and safely, AI can help scale research, detect patterns in patient populations, reduce clinician burden, and improve care coordination. It can even enhance administrative efficiency through automated note-taking and scheduling.

But it’s not all smooth sailing.

• Federal AI-specific legislation (like Bill C-27) is still in progress.

• Provincial regulators are updating privacy guidance in real-time.

• And EMR vendors or AI startups may use data in ways clinicians and patients don’t expect—or consent to.

The Privacy & Security Reality for Clinics

Privacy and data security are among the top concerns in AI adoption across Canadian healthcare.

• Only 21% of Canadian physicians feel confident that AI tools can protect patient privacy (CMA, 2023).

• The sector has experienced over a dozen high-profile cyberattacks in recent years—including attacks on SickKids Hospital and Newfoundland’s provincial health system.

• Canada’s privacy regulators are actively investigating how data from clinics is used by vendors, including for AI model training.

For small- to mid-sized clinics, this can feel overwhelming. But you don’t need to be a privacy lawyer to take meaningful action.

What Can Clinic Owners Do?

Here are five practical actions to consider:

1. Conduct a Privacy & Security Review

• Read your EMR’s Data Processing Agreement (DPA) or Terms of Service. Confirm that they won't use any of the data without explicit consent from you and/or the patient.

• Ask whether data is stored in Canada (this affects legal jurisdiction).

• Ensure the vendor isn’t using patient data for AI model training or analytics—unless you’ve explicitly agreed to it (see the first bullet above).

2. Ensure Informed Consent

• If you’re using AI tools (like note-taking assistants), be transparent with patients.

• Explain how their data is used, whether it’s stored, and if it’s shared.

3. Appoint an AI/Privacy/Security Designate

• This could be you as the clinic owner, or a clinic manager.

• Someone who has clear expectations and is empowered to become informed in a quickly-changing landscape.

4. Track Evolving Regulations (see point #3)

• Stay informed about provincial laws (like PHIPA, PIPA, Law 25 in Québec).

• Monitor updates from the Office of the Privacy Commissioner, CMA, and your own professional college or association.

5. Create an AI Policy for Your Clinic

• Even a one-pager outlining how you use AI and manage patient data builds accountability and trust.

Communicating With Patients

Trust is the foundation of all healthcare relationships.

Clearly explain how digital tools and AI enhance care—from reminders and record-keeping to personalized recommendations—while emphasizing your commitment to protecting personal health information.

A Final Note for Patients (really, all of us!)

If you’re a patient reading this, I encourage you: ask questions. You have a right to know:

• What data is being collected

• Where it’s stored

• Whether it’s being used for anything beyond your care

Read the forms you sign when you start with a new clinician. Healthcare is becoming more digital and data-driven every day. The more informed we all are, the better choices we can make—for our care and our privacy.Don’t worry about sounding professional. Sound like you. There are over 1.5 billion websites out there, but your story is what’s going to separate this one from the rest. If you read the words back and don’t hear your own voice in your head, that’s a good sign you still have more work to do.

Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.

Navigating the Rise of Corporate Care: Support for Independent Veterinarians and Health Practitioners

The Canadian health landscape - for both humans and animals - is changing.

Veterinary medicine and many human allied health services in Canada traditionally had something in common: they were independently owned and operated by the professionals who provided the care. These practices weren’t just businesses—they were cornerstones of their communities. Personalized, relationship-based, and practitioner-led. But in recent years, we’ve seen a growing trend toward corporatization. From urban veterinary hospitals to physiotherapy clinics to multi-disciplinary health centres, large investor-backed groups are consolidating the market.

The Data: A Snapshot of a Shifting Landscape

• Veterinary Clinics: Today, about 1 in 5 veterinary clinics in Canada is corporate-owned, and nearly 40% of veterinarians now practice within these models. (Competition Bureau Canada, 2024)

• Physiotherapy Clinics: Though private practices still dominate, corporate-backed regional chains—like LifeMark (owned by Loblaw/Shoppers Drug Mart)—are expanding rapidly. As of 2025, there are approximately 18,600 physiotherapy businesses in Canada. (IBISWorld, 2025)

• Chiropractic Clinics: Roughly 69% of chiropractors in Canada still operate as sole proprietors, meaning approximately 31% are now part of multi-site or corporate-owned operations. (Canadian Chiropractic Resources Databank, 2024)

What This Means for Independent Clinics

If you’re running an independent clinic, these shifts are more than just headlines.

You might be:

• Feeling pressure to match corporate pricing or hours.

• Struggling to recruit or retain staff.

• Wondering how to plan for growth—or succession.

• Working harder than ever but feeling unsure how to compete.

The truth is, independent clinics still form the majority in most sectors. But the rise of corporate care is advancing—and fast. That creates a strategic imperative for small, practitioner-led clinics to adapt smartly, without losing what makes them special.

Why Independent Clinics Still Matter

Corporatized clinics may offer standardization, access to capital, and marketing muscle—but they can’t replicate the deep community ties, continuity of care, and values-based service that independent providers deliver every day.

Your clinic doesn’t need to become corporate to thrive.  But it does need to be clear, focused, and supported in how it operates, grows, and evolves.

I work with independent clinic owners in both human and animal health—from physiotherapists to veterinarians—who want to stay small, local, and practitioner-led without burning out or falling behind.

Together, we tackle:

• Strategic planning and business model refinement

• Team building and staff retention

• Operational efficiency and process improvement

• Sustainable growth—or right-sizing for peace of mind

I support your clinic’s goals with clarity, calm, and strategy—while always centering the values that led you into care in the first place.

Let’s Connect

If you're an independent clinic owner feeling the weight of change, I’d love to connect. And if you're thinking about starting a practice in today’s competitive landscape—veterinary, physiotherapy, or any of the allied health sectors—but feel uncertain about how to stand out, let's talk.

Together, we can strengthen and protect what makes your vision meaningful, while building the clarity, structure, and strategy your clinic needs to thrive in a changing market.

Send me a message or book a FREE 30 minute conversation. I’m here to support your success.