Indigenous healing changes the texture of team-based primary care in Winnipeg
An interprofessional primary care clinic in Winnipeg tried something medicine has often talked about but rarely built into routine operations: it brought Indigenous healing into the center of care rather than leaving it at the margins. Guided by Two-Eyed Seeing and the Eco-Normalization framework, the developmental evaluation followed patients and providers from November 2023 to July 2024 and examined what happens when an Indigenous Elder, a Knowledge Keeper, and a mental health counsellor become part of the care environment itself.
The study was small, but the clinical signal was unusually coherent. Patients and providers described improved cultural safety, stronger trust, and deeper engagement when Indigenous ways of knowing were woven into a team-based model instead of appended as an afterthought. In a health system where Indigenous patients have long faced fragmented access, mistrust, and the cumulative burden of intergenerational trauma, those changes matter at the bedside long before they appear in administrative outcomes.
A developmental evaluation built around Indigenous ways of knowing
The clinic-based evaluation included surveys, semistructured interviews, and a facilitated sharing circle. Nine Indigenous and non-Indigenous patients and 14 health care providers participated. Quantitative findings were handled descriptively, while qualitative data were examined through deductive content analysis using the Eco-Normalization Framework and the Empathy Map analysis.
The design matters because the intervention was not a discrete prescription or procedural protocol. It was a relationship-based restructuring of care, one that tried to normalize Indigenous healing within a Western primary care setting without stripping away its cultural meaning. Two-Eyed Seeing provided the conceptual frame for holding both knowledge systems together; the practical question was whether the clinic could make that coexistence feel authentic to patients and workable for providers.
It could, at least in this setting.
Nine themes defined what patients and providers experienced
Nine themes emerged from the interviews and sharing circle: valuing Indigenous ways of knowing and healing; culturally relevant, holistic care; incorporating Indigenous healing practices; whole-person care; collaboration within a team-based model; relationship building; barriers to health care access; lost traditional knowledge and continuation of intergenerational trauma; and centrality of emotional health.
The thematic profile reads like a clinical map of what conventional primary care often misses. Patients did not describe healing only as symptom control or medication reconciliation. They described the importance of emotional health, ceremony, land-based healing, and a care environment that recognized body, mind, spirit, and community together. Providers, in turn, described a model in which collaboration was not limited to clinician-to-clinician handoffs but extended to community partnerships and the presence of Indigenous leadership inside the clinic space.
The result was not merely a different service package. It was a different clinical posture.
Trust, cultural safety, and engagement moved in the same direction
Patients and providers reported improved cultural safety, enhanced trust, and deeper engagement when Indigenous healing practices were embedded into care. Those experiences are clinically meaningful because trust is not an abstraction in Indigenous health care; it determines whether people return, disclose symptoms, accept referrals, and remain connected to chronic disease management.
A clinic can offer access on paper and still fail in practice if patients do not feel seen or respected. Here, the presence of an Elder and Knowledge Keeper helped anchor the encounter in Indigenous knowledge systems, while the mental health counsellor reinforced the emotional dimension of care that often remains under-treated in primary care workflows. The integration of ceremony and land-based healing also gave the model a concrete cultural form, rather than reducing reconciliation to language alone.
For providers, the model appeared to deepen relational work rather than replace it. Team-based primary care often emphasizes scope sharing and workflow efficiency, but this evaluation shows that collaboration can also widen the moral and cultural frame of care when Indigenous leadership is built into the team.
Structural barriers remained outside the clinic walls
Even with those gains, the evaluation identified persistent barriers to health care access beyond the clinic itself. Sustainability concerns also surfaced. A model like this depends on more than goodwill from individual clinicians; it requires stable funding, institutional support, and governance structures that do not collapse when a pilot period ends.
Those limits are not peripheral. They define whether culturally safe care survives as a lived practice or becomes a short-term demonstration project. The study makes clear that healing practices can be integrated inside a primary care clinic, but the surrounding system still shapes who can reach that clinic, how often they can return, and whether the work is supported over time.
Reconciliation in practice depends on governance and training
The conclusion points beyond the clinic toward structural transformation. Sustainable funding, Indigenous governance, and embedding Indigenous ways of knowing into health professional education were identified as critical for scaling and sustaining similar models. The evaluation also aligns with the Truth and Reconciliation Commission of Canada’s Calls to Action, not as a symbolic gesture but as a practical roadmap for how primary care might become more equitable.
For health systems, the implications are direct. Interprofessional teams can provide a platform for Indigenous healing, but they cannot substitute for governance that centers Indigenous authority or education that prepares clinicians to work respectfully within Indigenous frameworks. Without those elements, integration risks becoming superficial, dependent on individual champions and vulnerable to turnover.
This study offers a more durable lesson than a simple statement of feasibility. Indigenous healing can function inside team-based primary care and improve the quality of the clinical relationship, but the model’s future depends on whether institutions are willing to fund, protect, and structurally embed what patients and providers found valuable here.