I first met Jane Philpott on a cold winter morning in 2015, not long after she was sworn into her first cabinet post as minister of health. I was working with three Saskatchewan First Nations to address the opioid crisis, and it was their hope that I could communicate the reality on the ground to the newly minted minister. Sitting around the table were Philpott, her political staff and senior bureaucrats. Knowing her background as a physician, I framed our issues around a lack of quality improvement, patient safety and patient-centred care. I was blunt in targeting specific issues within the First Nations and Inuit Health Branch of Health Canada. Several participants bristled at my comments. Philpott sat engaged and thoughtful, asking for clarification and occasionally signalling for her department to quietly listen.