Primary care in Canada: So much innovation, so little change

The development of Canadian primary care has been shaped by a series of pol icy legacies that continue to affect the possibilities for change in primar y care through their cumulative effects on the health care system and the p rocess of health policy development. The pursuit of radical systemwide chan ge in the face of unfavorable circumstances (created in large part by those legacies) has resulted in missed opportunities for cumulative incremental change. While major changes in primary care policy seem unlikely in the nea r future, significant incremental change is possible, but it will require a reorientation of the policy development process.