Reimagine Healthcare with Dr. Julie Wilson
What happens when a family doctor looks at British Columbia’s strained primary care system and decides not to accept the status quo?
In this episode, Dr. Julie Wilson, founder of Terra Nova Medical Clinics, shares the story of building one of British Columbia’s largest primary care networks, serving over 250,000 patients with 100+ clinicians.
Her journey started with a simple observation: the rest of the world had already moved past the isolated, single-doctor office model. Kaiser Permanente had 4,000 family doctors working together.1 Large collaborative groups existed across Australia. The siloed practice model was dying everywhere, but not in British Columbia.
Key Takeaways
- The isolated solo-doctor model is under strain: Rising complexity, admin burden, and financial pressure are making it harder to sustain.
- Scale creates stability: Shared infrastructure and teams reduce risk and improve continuity of care
- Technology expands capacity: AI and automation reduce admin work and unlock more time for care.
- AI-powered clinic bots
- Vacation coverage
- 7-day access
- 24/7 on-call
- AI does not replace jobs: When patients finally have access to care, there is always more meaningful work to fill in.
- Shifting care to ERs is costly: When clinics can’t provide services, the system pays more elsewhere.
The One-Person Office: A System Built for Another Era
The traditional model, one doctor, one assistant, one clinic, was designed for a simpler time.
This system worked when care was paper-based. As complexity rises, the cracks start to show. At the same time, a new generation of physicians is entering the workforce with different expectations. Fewer are willing to take on the risk of running a solo micro-business without support, coverage, or time off.
“If you can’t switch family doctors because there are no family doctors, and your family doctor’s office does not have a speculum, where are you getting seen? Nowhere, I guess, the emergency department.”
Building a culture first
Ask Dr. Julie Wilson what drives the positive energy across her clinics: clarity of purpose. She ensures every team member understands why they are there, that the system requires fixing, and that meaningful change begins by first taking care of one another.
One non-negotiable rule applies everywhere: everyone, always, is to be treated with respect, kindness, and compassion. Terra Nova backs its people with unlimited food and drink, team events, a Discord community, maternity and paternity leave, and extended health and dental benefits, not because data demanded it, but because it was simply the right thing to do.
The economics nobody wants to talk about
Talking about profit in Canadian medicine is taboo. Dr. Julie challenges this directly. When equipment costs four times what it did a decade ago and government fee schedules don’t keep pace with inflation, where does the contingency come from? For most clinics, nowhere. So when something breaks, they close. Patients lose their doctor, data migrates, and care continuity shatters.
“The concept of making money in primary care or medicine is considered very negatively. But this also creates a problem, because there’s making money and there’s having contingency.‘’
The result is a system where clinics fold the moment anything unexpected happens. Not from greed, from fragility. And that fragility has a direct cost to patients.
‘’I hardly even use the word ‘business’ at this point when you’re talking about these kinds of numbers. This is essentially charity that clinicians are giving to society.”
Her message to policymakers: if handing doctors more cash feels politically uncomfortable, then buy them vaccine fridges, autoclaves, sutures, and gloves. Send them a business advisor. The solutions don’t have to be cash transfers, but the fragility must be acknowledged and acted on.
On The Reimagine Healthcare Podcast, we explore how healthcare leaders across Canada are building smarter, more human systems of care, through innovation, technology, and better workflows.
Technology as a force multiplier
Early technology adoption has been central to Terra Nova’s growth. Dr. Julie built an internal AI assistant, TerraBot, trained on CMPA articles, CSPC guidelines, clinic policies, EHR documentation, and training modules. Staff can query it in real time and get reliable, context-aware answers on the spot.
On AI replacing workers: the concern misses the point entirely.
‘’How can you imagine that adding an AI receptionist is cutting jobs? That job just wasn’t being done.”
Work that wasn’t getting done, the three-year-old rash the patient never booked an appointment for, the screening exam that was skipped , that backlog fills in the moment care becomes accessible. AI doesn’t take jobs. It makes room for all the care that was always waiting to happen.
If you were Minister of Health, what would you do?
Dr. Wilson’s answer cuts straight to the root: the system can’t fix what it can’t see. Too many funding decisions are made on incomplete data, statistics the average Canadian, or even the average policymaker, has never encountered.
“I would spend my time trying to fix the statistical gaps, because if you don’t know what’s happening, how can you solve the problem?”
Before new programs, before cash transfers, before restructuring, measure reality. The average family doctor’s precarious financial situation is a surprise to most Canadians. Making it visible is where the solution starts.
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🎧 Also worth a listen
If this topic caught your interest, you might also enjoy episode 1 of the podcast: “Can Clinics Survive Without Thinking Like a Business?” with Christopher Fisher.
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