Scaling Family Medicine. How Dr. Julie Wilson Built a Clinic Network for the Modern Practice
REIMAGINE HEALTHCAREShow Notes
In this episode, Dr. Julie Wilson, family physician and founder of Terra Nova Medical Clinics, BC's largest independently funded primary care network, shares the vision and conviction that drove her to build over 25 clinics without a single outside investor. She speaks candidly about what the pandemic revealed about the fragility of solo practice, and why she believes the only viable path forward is scale: not for profit's sake, but for the survival of full-service medicine. The conversation digs into a striking paradox, one where clinics operating on razor-thin margins quietly cut speculums, vaccines, and autoclaves while the costs of those omissions silently accumulate elsewhere in the system. Dr. Wilson also reflects on the new longitudinal payment model, its unintended consequences for walk-in coverage, and why she mortgaged two homes to keep expanding into underserved communities. A rare, ground-level account of what it actually takes to keep primary care alive in British Columbia, and what it would look like if the system finally started measuring the right things.
Standout Quotes:
"I just can't continue like this. Society cannot continue like this. And I'll just keep doing what I can, one foot in front of the other until this problem is fixed." "We are here because I am upset at the medical system, and we are here to do a good job for society. But how do we do that? We are going to take care of each other." "If every doctor in the system is wondering how a person can be financially viable, that means we are in a very unhealthy state." "I mortgaged my house and my mother's house to fund further expansion. Even if I lose all that money, I will still feel at peace that at least I've done something good." "If you don't feel comfortable giving doctors more money, okay, buy all clinics vaccine fridges, buy them an autoclave, give them free sutures. It doesn't have to be monetary." "There is unlimited work to do. That job just wasn't being done."
Timestamps:
00:00 Introduction 00:40 What Drew Her to Family Medicine 01:36 Building Terra Nova: From One Clinic to 25+ 04:32 The Inflection Point and the Case for Scale 06:34 Culture, Values, and What Makes Terra Nova Different 09:03 Defining Success: Patients, People, and Profitability 13:03 Shrinkflation in Medicine and the Cost of Thin Margins 15:31 Competing Without Outside Investors 17:12 The Advantages of Scale 20:43 Technology, Operations, and Keeping Teams Aligned 22:44 Terra Nova's Biggest Challenges Today 24:14 The Vancouver Division Study: Clinics on the Brink 27:44 The Longitudinal Payment Model: What's Working and What's Not 32:10 Navigating Policy, Health Authorities, and Advocacy 33:56 Leadership Style, Core Values, and Tough Trade-offs 36:40 Life as a Physician, Founder, and Mother of Two 44:03 AI in Medicine: A Must-Have 47:23 If She Were Minister of Health 51:53 Hope for the Future and Final Message
_ To help clinics reduce administrative burden without compromising quality of care, MEDFAR created Scribe AI, fully integrated with MYLE EMR. 👉 Start your Scribe AI trial: https://www.careway.ai/fr?utm_source=podcast&utm_medium=podcast&utm_campaign=podcast+Dr+Wilson 💬 Chat with our team to see how a next-generation EMR can help your clinic thrive — no commitment required: [Calendly link] Designed for Canadian primary care clinics. Built to support clinician retention, workflow efficiency, and sustainable access to care. _
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