REIMAGINE HEALTHCARE

Scaling Family Medicine: How Dr. Julie Wilson Built a Clinic Network for the Modern Practice

MEDFAR — Tue, 30 Jun 2026 21:18:50 GMT

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

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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
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Designed for Canadian primary care clinics. Built to support clinician retention, workflow efficiency, and sustainable access to care.
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Can Clinics Survive Without Thinking Like a Business? Reimagine Healthcare with Christopher Fisher

MEDFAR — Mon, 20 Apr 2026 23:00:01 GMT

Christopher Fisher works in a part of healthcare that often goes unnoticed, but plays a critical role in whether clinics succeed or struggle.

As the founder of Ontario Partners in Health (OPiH) and Capital Digital, he helps primary care clinics strengthen their operations, from staffing and finances to patient experience. With a non-traditional background in Political Science, he brings a pragmatic lens to one of healthcare’s biggest challenges: building clinics that are both effective and sustainable.

He’s also not afraid to challenge the status quo, especially when it comes to topics like profitability, growth, and the need for clinics to think beyond just reducing costs.

This raises an important question: what needs to change for clinics to become truly sustainable while still delivering the care patients expect?

Key Takeaways:

Healthcare has a system problem, not a people problem
Administrative work is the real bottleneck
AI is an enabler, not a replacement
Profitability is essential to better care
Clinics are leaving revenue on the table
Better tools = better care delivery

Standout Quotes:

"Profitability helps clinics deliver better care"

"Physician burnout is a major challenge in healthcare"

"AI can free staff for more meaningful work"

Timestamps:

00:00 Introduction and Guest Background

01:08 Christopher Fisher's Journey into Healthcare Management

02:03 Founding Ontario Partners in Health

03:04 Career Path and Core Values

08:17 Clinic Management as a Business

10:01 Measuring Clinic Success and Performance Metrics

13:37 Profitability in Clinics: Opportunities and Guardrails

19:00 Initial Steps in Clinic Assessment

20:21 Staffing Challenges and Recruitment Strategies

24:23 Creating a Positive Clinic Culture

26:14 Physician Burnout: Causes and Solutions

28:39 The Impact of AI on Reducing Cognitive Load

45:14 The Future of AI in Healthcare Operations

01:00:23 Ontario Healthcare System: Progress and Challenges

01:03:32 Advice for Healthcare Leaders and Policymakers

01:14:02 Final Thoughts and Inspirational 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

💬 Chat with our team to see how a next-generation EMR can help your clinic thrive — no commitment required

➡️ Subscribe to Reimagine Healthcare to hear more conversations with healthcare leaders shaping the future of care in Canada.

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Reimagine Care with Dr.Sienna Bourdon : Inside Shoreline Medical’s collaborative healthcare model

MEDFAR — Mon, 02 Mar 2026 23:10:04 GMT

Dr. Sienna Bourdon is doing the kind of primary care work that quietly holds an entire community together.

She’s a practicing family physician at Shoreline Medical on BC’s Saanich PeninsulaBC’s Saanich Peninsula, on the traditional and unceded territories of the W̱SÁNEĆ (Pauquachin, Tsartlip, Tsawout, Tseycum) Peoples. She’s also a medical director and a hospital medical staff president. She helps run a nonprofit clinic model that grew from five physicians to roughly 25 clinicians and an allied-health team—while still seeing patients three days a week, carving out leadership time, mentoring learners, and building systems that keep people out of the ER. And she’s doing it with a very clear north star: protect access, protect teams, and keep care rooted in what the community actually needs.

So how does she do all of this, and what can the rest of Canada learn from it?

Key Takeaways:

- Primary care scales best when it is designed around people, not ownership.
- Nonprofit models can unlock capital and community support that traditional clinics cannot.
- Access challenges are often operational problems with practical solutions.
- Standardized workflows enable scale while protecting clinical autonomy.
- Culture is the true engine of sustainable growth.
- Physician wellbeing must be measured and managed intentionally.
- Time-blocking and boundary-setting are leadership skills, not luxuries.
- Paying for indirect care is essential to long-term sustainability.
- Team-based care is critical to meeting population needs with limited supply.
- AI is already a must-have for reducing administrative burden, with guardrails needed for clinical reasoning.

Standout Quotes:

“Primary care is the backbone of our healthcare system. If we don’t do it well, everything else struggles.”
“Culture is the secret sauce. You can’t scale care without trust.”
“When physicians live in alignment with their values, burnout becomes far less likely.”
“We are one of the only essential services expected to fund our own infrastructure and that’s not sustainable.”

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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
💬 Chat with our team to see how a next-generation EMR can help your clinic thrive - no commitment required

Designed for Canadian primary care clinics. Built to support clinician retention, workflow efficiency, and sustainable access to care.

_

➡️Subscribe to Reimagine Healthcare to hear more conversations with physicians and healthcare leaders shaping the future of care in Canada.
► Spotify podcast
► Apple podcast

► Youtube
*Reimagine Healthcare is a MEDFAR podcast exploring how clinicians, leaders, and innovators are building more sustainable, human-centered healthcare systems.