[00:00:00] Sean Bruke: Welcome to the Care to Listen podcast. In today’s episode, we’re diving deep into the evolving world of primary care with Dr. Julie Wilson. We’ll hear about her inspiring journey from becoming a physician to running her own clinical group while navigating the challenges of parenthood and IVF. Today’s episode is being broadcasted to you on the unceded and traditional territories of the Musqueam, Squamish, and Tsleil Waututh Nations.

[00:00:24] Hello and welcome back to another episode of the Care to Listen podcast. I’m your host Sean Burke and joining me today is an esteemed guest, Dr. Julie Wilson. Welcome to the show, Dr. Wilson. 

[00:00:35] Dr. Julie Wilson: Thank you so much for having me. 

[00:00:36] Sean Bruke: So being a family physician, a founder of Terranova Medical Clinics, I know that you’re somebody who’s deeply passionate and When it comes to transforming the healthcare landscape in BC.

[00:00:47] Um, and today that’s exactly what we’re hoping to talk about is just get a little bit more of an insight from your perspective, um, what you’re seeing, how you’re. Uh, improving your clinic and, and basically making it better, uh, for the other physicians that work with you. So maybe we could just start off by getting to know, you know, who you are a little bit more and you could share, you know, from your perspective, uh, your introduction.

[00:01:11] Dr. Julie Wilson: Oh, thank you so much. I mean, this is certainly a topic I could talk forever about. So, uh, thank you for asking me to speak about this. Yeah, so, um, my name is Dr. Julie Wilson and I am a family physician. I did my training here at UBC and then my residency for family medicine at the University of Toronto. I built my first medical clinic in 2015 in Richmond, BC, and I did it with the, the thought That I wanted to bring a more modern form of health care to British Columbia back in the day.

[00:01:48] I mean, most of you will remember because it wasn’t that long ago, but family medicine really was just one or two physicians working in a single office, relatively quite dingy, maybe one or two secretaries, everything on paper. And, um, not much collaboration between the physicians, the hospitals, or between multiple physicians or clinics.

[00:02:08] So, when I had gone to Toronto, and people in Ontario know about this, but they have something called the Family Health Teams. Um, they’ve various versions of it, but essentially where we were working in my residency at St. Michael’s Hospital, we had about, um, 30 to 50 physicians, as well as allied healthcare providers.

[00:02:26] And, um, it was all associated with the hospital. So for example, if I wanted an MRI for my patient, I could just call them. Call down to the hospital and get it for this patient the same day and we had Many nurses to work with people to collaborate with specialists would come to our office and everything was in the cloud So that meant that everything was on the computer.

[00:02:48] So it was just much easier to access Note taking became better, so therefore you could read more about the patients and basically do a much better job. And when I came back home to Vancouver, um, there was nothing like that. So my husband, who’s also a family physician, who also did his residency in Toronto, at Toronto Western Hospital, he and I decided to build our mini version of that in Richmond, where my husband’s from.

[00:03:12] And we built an 11 room clinic, which was considered very large at the time. And We added physiotherapy right away, but we had built it with the idea that we would be adding allied health care providers and more physicians to create a collaborative model, um, something that was unusual at the time. So we did that.

[00:03:31] We had about four or five physicians and we ran that way. We’ve had during that time, a general surgeon, a rheumatologist, some dermatologists, multiple family physicians. We ended up. Um, adding nurse practitioners who would run their own practices similar to a family position and they would work in the team.

[00:03:49] That was a new addition once they started the primary care networks in British Columbia and the divisions of family practice. So every time there was a new program, we would jump on it and we’d say, let us be the first ones. Let us do it. Let’s figure it out together. So, um, I’m very familiar with many people in, um, In the management of family medicine in the city, the allied health, and I even helped train them just volunteering because I was just so excited about this new model of health care.

[00:04:15] So that’s what we did. That was always my goal. And it was always my goal to build a good workplace. There’s another facet to it, which is essentially that in medicine, there can be some workplaces which are not pleasant to work in. Right? And there’s, there can be workplace cultures that, that you have low control over and that’s where you work and it, it just makes burnout very high.

[00:04:41] It’s not all workplaces, but it could be. And what I wanted was more control over that. So I wanted to be able to, my motto was, I want to go to work happy, be happy while I’m there. And be happy when I, when I leave. 

[00:04:52] Sean Bruke: Seems like a great, you know, a great model to stand for and to, to attract more physicians to work with you, um, and to have a greater impact ultimately on the patients that you serve.

[00:05:03] I I’m curious, like, and I do want to jump into that culture and how you’ve established that within your, your clinic, but I want to jump back first to talking a bit about your experience. So building a business, creating the culture within that, but also being a physician and working with clients, I think patients, sorry, that can be challenging in and of itself.

[00:05:25] So maybe could you walk through a little bit about some of your learning journey and what you’ve had to go through Uh, to get to this point. 

[00:05:32] Dr. Julie Wilson: Yeah, for sure. So there’s the medicine aspect. So as a family doctor, you know, you do your residency, uh, you see a lot of patients, but then when you start on your own, it is terrifying, right?

[00:05:41] There’s no one to ask, no one to help you, um, especially in the old fashioned days when it was just you or maybe one other person in the office, right? So, uh, That was a big learning curve. Uh, I accepted a lot of patients and I always like to take actually more complicated patients or people who have mental health concerns because I feel that I’m making a bigger difference that way.

[00:06:05] I also love babies. So, we have the only vaccine program in Richmond outside of public health. And I also believe in women’s health. A lot of women don’t get pap smears because maybe they feel embarrassed with a male physician and such. So, um, we always have done walk in pap tests for BC cancer. to just allow people to come and get that.

[00:06:24] Same with flu shots and other vaccines. So I enjoyed that part of the medicine and we continued to improve our protocols and including getting absolutely everybody up to date on preventative care. So it is your family doctor’s mandate to get you up to date on your preventative care. Make sure you have your stool samples or colonoscopies, mammograms, pap tests, etc.

[00:06:46] But most family doctors are so overwhelmed, it’s sort of a side note. You happen to come in because you twisted your ankle and then if they look at your chart long enough they might say, hey, I notice that you’re really behind on your mammogram or bone density scan, and then they might order it for you.

[00:07:00] But I wanted to make a systematic protocol for you. for that to make sure absolutely everyone was up to date. So, I’ve done that and uh, all of our patients are up to date. Tens of thousands of them. And it’s one of the proudest things I’ve ever done. So there’s, on the medicine side, there’s just been constant improvement, constant work.

[00:07:17] I’m now, um, 10 years into my full practice, 16 years since I started in medicine. I feel quite confident in my practice, but I definitely see over those years, it’s been a huge learning journey, learning to communicate, learning to build rapport, learning to hear people and learning to do the medicine and then learning the algorithms for what’s available in the community.

[00:07:39] So that was a journey at the same time. I was building a business. And very naively, I thought, how hard can this be? Anybody can open a business. Look at every store out there. That’s a business. Everyone’s doing it. So I thought, you know what, what does a receptionist even do? Just hire anybody. It should be fine.

[00:07:56] I think I interviewed one person and that was it. And I was like, this should be easy. And I got everything started and it was like faulty towers. If you’ve ever seen that, it was just, it was just a mess after a mess, like a disaster after disaster. And then we would just. fix it and then something else would happen and then we’d fix it.

[00:08:16] So over time I learned to respect that, um, the front desk is actually the most important position in the clinic and, uh, that you need systems and algorithms and setup and training and work culture. And we’ve built that by respecting everyone, giving them autonomy, asking them their choices. Like instead of me telling the front desk what they should do in a situation, I asked them what they think they should do because they’re the one doing it.

[00:08:41] So I assumed that they would. And I’ll be back with a new video. In the meantime, I’ll see you guys later. Bye for now. And that’s it, or something like that. So we’ve added in as many things as possible. And then we’ve also, um, basically, one of the things I’ve done is I’ve let my staff hire other staff members, rather than me hiring from above.

[00:09:17] And that way they’re able to find people that they feel they can collaborate with. Then they all train each other so that they all feel responsibility for everyone’s ability In the front, at the front desk and ability to work. And then they all have a relationship with all of the other people who work there.

[00:09:34] Um, and I find that that has made a huge difference when, when you know someone and you care about someone, you’re much more likely to help them and to do a good job. 

[00:09:45] Sean Bruke: Well, it sounds like that empowerment model really has, you know, been something that’s brought success to your, your team. I’m curious when it comes back to the, the learning journey and, you know, To get to the point where you actually learn and and find outcomes to move forward and make things better But when you’re in it, it can be extremely difficult You know often the times we talk about burnout we talk about, you know, the stress that it comes with and here you’re trying to run a business you’re trying to meet the needs of your your patients and to You have all this other stuff going on.

[00:10:22] Could you walk us through a little bit, maybe how you were able to, you know, process some of those challenges, that stressful times, um, and get through some of those moments. 

[00:10:33] Dr. Julie Wilson: Yeah, for sure. I mean, I purposely did this right after I completed residency. A lot of people said, wait, wait until you know your medicine a bit better and then open.

[00:10:42] But I thought there’s no time that my work ethic will be greater than now, because then I’ll just think about it. You know, get, I’ll, I’ll, I’ll get a bit lazy. In medical school, we had to work long hours in our last two years. And then in, in residency, we worked very long hours and we worked really hard.

[00:10:57] And I just applied that kind of work ethic. To running the business, I assumed that it would be, you know, the same level of not knowing what you’re doing and heartbreak and long hours and sleeplessness as residency would be. So I called it my, my fellowship in business. So it took a few years and it was, it was a lot of work when, you know, when something, you know, um, breaks down at your business, it’s kind of like your house flooding.

[00:11:23] You can’t say I’ll deal with this tomorrow. You just have to deal with it right now. Right. And I. was lucky that, of course, my husband was there. He’s also a family physician, as I said. Um, we were able to work through it together. And, um, my mom is an accountant. She was my first secretary, which, for better or for worse, was a choice that we made.

[00:11:40] You know, uh, working with family is great, but it’s also hard to give them instructions. So, we all worked together, we all put in an incredible number of hours, and by just adjusting and adjusting and adjusting, iteration after iteration, we became competent, I would say. 

[00:11:56] Sean Bruke: Did you ever feel like there was a time where you were just absolutely worn out?

[00:12:01] Dr. Julie Wilson: So many times. A lot of times. 

[00:12:04] Sean Bruke: And how did you deal with that? 

[00:12:07] Dr. Julie Wilson: I don’t mind the sensation of feeling worn out, I guess. Maybe now that I’m older, maybe I care more, but I perceive it to be like a sensation of a job well done or that I’m trying really hard. Um, how do I deal with it? I I have a really good support system, I have great friends, great family, I have great patients, I love talking to my patients.

[00:12:32] I think partly doing family medicine and then doing business kept, um, kept my day quite varied. So whenever I was tired of the business, I’d be back in the clinic seeing the patients. Whenever I was so tired of the patients and so tired of seeing people, I’d be back doing the business. And I think that variability in my day to day schedule.

[00:12:53] Helped me to actually complete more tasks and to get more things done. 

[00:12:58] Sean Bruke: That’s amazing. And also to, you know, you add on another layer of element or an element there to consider as well, to being a relatively new parent, um, and going through that journey as well, too. So maybe, you know, could you speak to a little bit of balancing all those different demands and, you know, what that was like?

[00:13:16] Dr. Julie Wilson: Yeah, I think that’s when I felt the most worn out, actually. Um, not so much when I had my baby, but I, I had fertility difficulties. So I ended up doing in vitro fertilization a number of times. And then I had a number of health complications with that. So I felt during that time when you’re on these hormones and you’re off these hormones, you’re getting ascites, which is fluid buildup in the abdomen, and you’re finding it hard to breathe and hard to walk, and you’re still going to work.

[00:13:42] Right. I hadn’t taken a sick day in 10 years. I had taken zero sick days. Even if I would go to hospital for something, I would just change my shift to the evening and then I would just come back from the hospital and do my work. Or I would do work from my hospital bed if I was very, very sick because you just don’t get time off.

[00:14:02] Um, and that’s again, one of the things that has caused me to really, really focus on. What I’m doing in my current business model, which is allowing doctors to have that time off, which is extremely rare. So, I’ll hold that to the side for now, but, um, That’s the time I did feel the most worn out when I was physically unwell, and talking to all my patients, feeling like I want to empathize with them.

[00:14:28] I want to help them, but I’m feeling so sick myself, sicker than a lot of them, that sometimes you start to lose your bit of your empathy, which is the worst thing in family medicine. And then when you want, when you’re running your business, you have to keep on trying improving. But when you’re feeling worn out, you want to just keep things as they are, right?

[00:14:46] You don’t want to keep on improving. So you just have to really mentally push saying, I’m just, I’m just going to do it anyways. So one of the things that I do to get things done is I bite off more than I can chew. that I think I can chew and then I just force myself to chew it. I just, then I just do it.

[00:15:03] And then over time, things got better. Um, I had my beautiful baby. I got a lot of help from my family. I took three weeks off of work, uh, and then I was back at work because I couldn’t find coverage for my maternity leave. And that’s it. You know, that was sad, but at the same time, I was actually very happy to not have to leave my patients, because I was really worried about them, if somebody else would be, you know, taking care of them the same way that I would have, if they would have the same connection with them, if we’d, if, uh, making sure nothing was missed with them, because I’d already known them for so many years.

[00:15:37] So, um, Um, I, I’ve just continued to be working and luckily since COVID has happened, you know, there have been some changes such as telemedicine. So I’ve been able to adjust my schedule. So I’m working from home more often and that allows me to balance things a lot better. I can see my patients. I can do the business.

[00:15:57] And I can spend more time with my baby. 

[00:15:59] Sean Bruke: So finding those support systems that can, can help you navigate whatever the challenges are that coming towards you and then figuring out a little bit, okay, how could you maybe shift your schedule? It sounds like, you know, just being able to, to obviously balance it all sounds extremely difficult when there’s so much.

[00:16:16] Um, and then also to providing a, a workplace and an environment for other physicians so that they maybe don’t have to experience some of the same challenges that you’ve had. 

[00:16:24] Dr. Julie Wilson: Yeah. Empathy is, empathy and frustration are big motivators for me, right? So, you know, I know it’s hard to have a baby because I have so many patients who are pregnant and I, and have babies.

[00:16:34] So I know what the pain points are. I know what’s difficult for them. And that, again, that helped me plan many, many things. Everything in my life is overplanned. So I planned everything as much as I could. And that helped me to have the support system in place to take care of my child and myself. Um, but not everybody has that ability to plan all those things ahead of time, or maybe the will or the foresight to do so.

[00:16:56] So I’m trying to build a system where people can just do regular things like they would just say in a. So, regular, maybe government job where you can get sick or take a vacation or get pregnant or have a sick child or have any number, maybe a hobby that you want to do that you need every morning off but you only want to work in the evening or something like that.

[00:17:15] So, I’ve, I really adjusted my work model to that. Um, my workplace model and that has helped me really, really expand. That’s why we’re going to have nine clinics in the next six months. Six clinics currently open and we’re just recruiting and recruiting because a lot of people are attracted to this work model, which is not available anywhere else in the province as far as I’m aware.

[00:17:36] Sean Bruke: Hmm. Well, let’s, let’s jump into that a little bit. Um, you know, the current state of primary care, um, and in particular, you talk to anyone who doesn’t have a family doctor, trying to find a family doctor can be difficult, stressful, and, you know, I think when we hear about some of the different models that, that you’ve been creating, it sounds like, okay, well, why aren’t more people doing this?

[00:17:59] Um, so I’m curious, like, just even to start with, what are you doing differently when it comes to the recruiting process, um, to be able to, to attract different physicians, and, and how does that shortage of doctors really affect the patient care? 

[00:18:14] Dr. Julie Wilson: Yeah, shortage of doctors. is, is a huge issue, right? I mean, firstly, people may or may not like their doctor or may not have a good connection with them.

[00:18:24] That already is a problem because if you don’t have a good connection with someone who’s in charge of something very critical, like your physical and mental health, you’re not going to get great care, even if they are a good doctor. It’s just, you have to connect to be able to do that. If there are no doctors, Uh, you’re, and you’re considered lucky to have a family doctor at all.

[00:18:43] You can’t switch to find someone who you do have a better connection with. So, and on top of all the people who would just have no care except for the emergency room. Right? So there’s multiple problems with that. We used to think when I was young, oh, there’s a doctor shortage. But I remember when I started practice, they said, Oh, if you’re a woman, no problem.

[00:19:01] You’ll be full in a year. Don’t worry. If you’re a man, you’ll be full in three years. You’ll, you’ll have a full practice. I just had a doctor start recently in Richmond and she has accepted 1000 patients in two months. Right. So it’s, it’s a different world out there now. Right. And before, if you didn’t have a family doctor, you could go to a walk in clinic.

[00:19:20] And, um, there were many people who had many family doctors. Like I would have some patients who would have like three or four and they would just see who was ever available at the time and you’d be like, okay, that’s fine. And you weren’t really concerned about, about this situation. It was, it was a free for all.

[00:19:35] And, um, with the pandemic, so many people retired. So, so many people retired, and then all the walk in clinics ended up closing for a number of reasons, including staffing difficulties. If you’re going to be paying people not far from minimum wage and you want them to work in a highly dangerous, infectious field, it’s, it’s just not going to work out well, as you can imagine, right?

[00:19:58] So, Um, now, people can’t go to the walk in clinics, their family doctors have retired, and there’s not many young Canadian trained doctors that want to settle down in family medicine. They want to be family doctors, but they don’t necessarily want to settle down, accept all of those patients, and then have that forever responsibility that they’re not allowed to get out of, which is 365, 24 7 care of all of their patients.

[00:20:24] This is their legal responsibility. So, what I’ve done is said, yeah, I can see why no young person would saddle themselves down with that. They would, you know, do a hospital shift, do some emergency, do a locum, which is like a substitute, um, things like that. So, I said, well, what if we could have a large call group, so you’re not on call all the time.

[00:20:48] What if we could have a large cross coverage group, which means instead of finding a substitute locum doctor while you’re gone, we just have enough people working all the time that it absorbs into the larger physician or nurse practitioner panel so that you can just go away and you’re scheduled to have vacations and you can be sick and you can have maternity time off and paternity time off or whatever it is you need to do and you can work whatever hours you want.

[00:21:15] This is a question I get a lot when I recruit people. So what are the hours of the clinic? Nine to five? So I have to come in? I said no, when you want to come You just tell me ahead of time and I will ask a staff to come at the same time. And then you can come and go as you please. You know, and they say, really, that’s amazing.

[00:21:31] I’m like, well, if you want to work till midnight, patients are going to love that. And if you want to start at 6am, there’s going to be patients who love that. It’s actually better for us if we’re not all working at all the same hours. It’s better for society if people work at various hours. For example, I have been working the weekends for, you know, Ten years now.

[00:21:48] And I love it. People are in a great mood on the weekend. They love to see me on the weekend. I love to see them on the weekend. But I completely avoid coming in on Mondays. It’s just a bad vibe. Right. Bad vibe. So, um, This and more. I have done more things. So basically, a lot of the things that I find difficult or everything that I find difficult and upsetting, I try and solve that problem and assume that everyone else would be bothered by the same thing.

[00:22:14] And then I try and fix it and then people want to work there. I also ask people because I assume that I don’t have all the same things that irritate me as everyone else. I ask them, what bothers you? And I ask for so much feedback. And we’re doing quality improvement projects three or four times a month, just adjusting and adjusting and adjusting to make sure that it works for everyone.

[00:22:33] And that’s why we have great retention, great recruitment, and everyone is much happier. And then when you come to the clinic, you feel happier because everyone is happier. 

[00:22:42] Sean Bruke: Hmm. So it sounds like there’s a lot of, Uh, work and emphasis that’s been put on like in an economies of scale perspective. So the more number of people that you have, the more flexibility that you can build into your existing pool of doctors.

[00:22:55] Dr. Julie Wilson: Yes. 

[00:22:56] Sean Bruke: Is that not a model that, um, you know, other clinics are, are taking on or why is your clinics, why are they unique in that sense? Why aren’t more people doing this? I 

[00:23:07] Dr. Julie Wilson: mean, I think they would like to. It’s just. It’s just so hard, like, I think before you could run a, maybe 10 years ago, you could run a clinic with one doctor or two doctors, and you could be pretty terrible at business, and you would pay your bills, and you’d be fine.

[00:23:22] But, After the pandemic, it takes four or five doctors to do the same thing just to pay your bills, right? And getting four or five doctors to work together is very difficult, right? Um, it’s hard to run a business together. It’s hard to trust someone else with your money. It’s hard to agree on many different factors because there’s many ways to do everything.

[00:23:47] And I think these things have prevented the pandemic. People from moving forward. There is a doctor shortage, even for recruitment. It is really difficult. And then trying to get people to settle down means that you have to put in a lot of work yourself. Like when I recruit people, I have to answer their questions all day, every day, which I’m happy to do.

[00:24:07] I have to do their chart reviews. I have to train them a lot. When they get nervous about something, they can send the patient to me. Or if they have questions about contracts, I answer them. And it could be just like. hours and hours and hours of work doing it. I’m happy to do it. But a lot of other doctors, they’re already so on the edge of their ability to function.

[00:24:25] They can’t add that onto their work schedule to be able to get someone or multiple people to help them with their practice. COVID has made things, or since the pandemic, it’s been very expensive. I would say costs have doubled. But our pay hasn’t doubled, right? So our overhead hasn’t doubled. So you, you have to be quite good at business and doctors are classically terrible at business.

[00:24:46] We don’t have much training. We don’t think about it. So, um, perhaps we’ll start to see more business people come into the business of clinics, but then that has its own problems because they don’t understand the realities of medicine. And They may want to and there probably will end up being some collaboration between some business people and some doctors to get both perspectives But this is all still relatively quite new all of these changes and it just hasn’t occurred yet 

[00:25:15] Sean Bruke: And it sounds like that culture of building a supportive work environment giving more flexibility Reducing some of the barriers and really creating like that back office support.

[00:25:26] Yes is what It’s a lot 

[00:25:31] Dr. Julie Wilson: of work to do that. You can’t just do it, right? It takes so much work to do that. You have to be able to build a culture with a back office, too, right? You have to give them a sense of purpose that, you know, letting them know you’re really important. If you make a mistake, somebody’s cancer could die.

[00:25:48] get lost and then they may not hear about it, right? If you do a great job, you might make someone’s day. If you do, if you help someone navigate the pathways of medicine from, you know, the initial making an appointment to getting to this specialist or getting to their surgery or just getting their medicine, or just making them feel better about what’s going on that day, that’s, that’s half of what we do, really, right?

[00:26:12] And. That is done mainly by the front desk staff, right? 

[00:26:17] Sean Bruke: And that’s that sort of team approach and mentality, which is so great to hear. Uh, I’d like to kind of talk a little bit about the future of primary care, um, and get a better sense of, you know, you’re somebody who. is at the forefront. You’ve wanted to be, you know, invited and participating in different um, approaches or strategies that the government might want to roll out.

[00:26:38] So I’m curious from that perspective, where do you see and what are your predictions for the future when it comes to family medicine? 

[00:26:44] Dr. Julie Wilson: I’m very hopeful. A lot of people can’t believe it, right? Because a lot of people in medicine are quite down right now about the situation, right? But um, because I see how our clinic is growing and people are positive when they’re in a positive environment, I think That other people are going to pick this up.

[00:27:01] And that’s one reason I like to do things like this podcast or, you know, um, write articles on LinkedIn or just. You know, when we win our awards like Outstanding Workplace of the Year or for our Stevie Awards for Outstanding Workplace and um, Best Companies for the Development of Women’s Careers.

[00:27:18] Sean Bruke: There’s a lot. I know, I’ve seen the list. There’s a lot. 

[00:27:21] Dr. Julie Wilson: But I like it because I want people to copy me. I don’t want to be the only business out there doing this. I want people to say, oh look, she’s done it. We could do it too. I want everyone to do it. Maybe not necessarily copy everything I’m doing, because there’s many ways of doing a good job, but say, it’s possible.

[00:27:37] We can fix this. We can do this together, because we’re frustrated. It feels hopeless when you’ve been trying, and the things keep changing, and you don’t have the funding, and everyone’s upset. Yeah, it feels so hard, right? And people have this sense that things are getting worse and worse, and then they want to give up.

[00:27:53] But, because I have seen that things get better with the people I’ve been working with, the Divisions of Family Practice, the Primary Care Networks, the Ministry of Health, everybody’s working really hard. There have been a lot of great initiatives that will improve things. So, firstly, they’re expanding allied health, which will really help.

[00:28:10] Before, I used to have the time to talk to people. suture together anybody who cut themselves and coming off the street, counsel them about their diet or just counsel them about their mental health. Now I don’t necessarily have time for that because there’s just an overload of patients but now we have a dietician and a counselor in our clinic and an occupational therapist and a chronic disease nurse who can sit with a patient for an hour and talk to them about their diabetes.

[00:28:31] So that’s really helpful. They’ve started the nurse practitioner program. Now there’s always some competition between different types of medical professionals but definitely by adding that in. We are, um, really re improving the teamwork in primary care, but also getting more patients attached to a primary care provider.

[00:28:53] And they’ve, uh, they’re going to be building a new medical school at Simon Fraser University. That’s just in British Columbia alone, so we only have one medical school at UBC. So that will improve the team. And have more people trained in medicine, therefore more doctors. And finally, and this may sound crazy, but we didn’t really let in foreign doctors, even if they were Canadian, born and raised and trained in a first world country like Australia or the UK or the us.

[00:29:19] They weren’t easily allowed back in the country. It was considered almost impossible. Not exactly impossible, but almost impossible. So now we’re letting a lot of these people come home, plus a lot of other people who are not Canadian who want to move to Canada. So this is really helping. I’m finding that I’m getting a lot of, Recruits from around the world because Canada is a great place to live right now.

[00:29:41] Our pay, which has also been improved by the British Colombian government. Um, thank you, by the way, uh, that has made a big difference for especially other places after the pandemic have had. You know, their health system crumbled too. Their pay didn’t get better, their conditions got worse. They look here, they say, well, the pay is better, the conditions are improving, maybe I should move there.

[00:30:05] And now we’re seeing a lot of people, particularly from the UK, come here. So my prediction, to get back to your original question, is that I think in approximately five or so years we won’t perceive this family medicine or primary care crisis in the same way. It’ll be probably still hard to switch between doctors, right?

[00:30:23] You will be able to, but most everybody should have a primary care provider. 

[00:30:28] Sean Bruke: Right. So it sounds like the work has been done. It’s just a matter of time now for some of those systems to increase the number of doctors or nurse practitioners where somebody can be attached to a care provider. 

[00:30:39] Dr. Julie Wilson: Well, part of the policies have been changed.

[00:30:41] The work has to be done because for example, for someone to come from the UK, someone still needs to sponsor them. Right. And then someone needs to monitor them and they still need training and then I have to, they have to send reports to the provincial government showing that they’re still up to snuff, etc.

[00:30:55] So that’s work too that a lot of family doctors, they may want to hire these people, but they may not have the energy at this point because they’re so overworked. So that is a barrier, but at least there’s not a policy barrier preventing it from happening at all. 

[00:31:08] Sean Bruke: Gotcha. Well, there’s certainly, like I said, coming back to your perspective, hope on the horizon.

[00:31:16] Yes. Um, there’s innovative ways in which you and the rest of your team at the clinics are doing to improve, obviously, patient care. When it comes back to the nurse practitioner, the doctor, what advice do you have in terms of like tips for maintaining work life balance? 

[00:31:36] Dr. Julie Wilson: I would say don’t forget about work life balance, right?

[00:31:42] It’s easy to get really caught up in guilt, what you feel like you should be doing, how you could be doing it better, what other people are doing, and also easy to get worried about the money. But, um, in the end, it all comes with time. Find a team that you feel like works with you, and if that team doesn’t work with you, Don’t burn your bridges, but maybe find another team or try and improve that team, try and do some quality improvement.

[00:32:05] And make sure that quality of life and work life balance are built into your workplace. It’s not just something that you do once you leave work, it should be built into your workplace itself. 

[00:32:14] Sean Bruke: Hmm. That’s such a different mindset, slightly different wording and, you know, thought process. Profound, I would say, like different when it comes to impacting that.

[00:32:26] Dr. Julie Wilson: Yeah, thank you. I mean, I, I just truly believe it because if you’re miserable when you leave work, you’re going to be miserable when you get home until maybe you, you de stress from work, but de stressing from work, yeah, that’s, things will happen to us on occasion, but if that’s a regular thing, then I think you should find a new job.

[00:32:42] And I don’t mean that you should find a new career. You don’t have to quit being a family doctor. A lot of people have done that. Saying, I’m not going to be a family doctor. I’m going to do Botox now or something like that. I don’t mean that. But maybe find a workplace or change your workplace so that doesn’t happen on the regular.

[00:32:58] Sean Bruke: Amazing. Well, these have been such great tips and it’s been so welcoming to hear your perspective on how the future of healthcare and what clinics can look like moving forward. I’m curious as we’re wrapping up the conversation here today, for any new doctors out there, Um, is there any sort of guidance or word of advice that you might want to offer them here?

[00:33:24] Dr. Julie Wilson: I think just be proud of yourself, proud of what you do, and feel the joy in whatever it is you can, right? Feel the joy in taking care of your patients, or any, you know, how well you’ve written that note that day, or, uh, how you enjoy things with your colleagues. We have a great job, and there’s a lot of external factors that are making it a not great job.

[00:33:48] But just focus back at that core. What led you there? What makes you feel happiness and feel enjoyment? And then try and spread that on. I think that this new generation of doctors, I see them. They’re hopeful. They’re kind. They’re sweet. All my medical students just so lovely. Um, and I just I think we should not lose that beautiful, almost naive happiness that we start out in medicine with.

[00:34:16] I think that if you can retain as much of that as you can, you will change the lives of all your patients and all of your colleagues and, and your own, right? Just don’t get too bogged down. Just focus on what brings you joy. 

[00:34:30] Sean Bruke: Such great words of advice and thank you so much today for coming on the show, Dr.

[00:34:34] Wilson. We appreciate you giving up your time and Um, and sharing some of the learnings that you’ve had along the way, um, and also inspiring the next generation of doctors. So thank you for coming in today. 

[00:34:45] Dr. Julie Wilson: Oh, thank you so much for having me. This has been wonderful. Thank you. 

[00:34:50] Sean Bruke: Thanks for listening to this episode.

[00:34:52] Be sure to visit the links in the show notes for resources and supports from the Care for Caregivers program. If you’re interested in sharing your story on the Care to Listen podcast, please reach out to us at careforcaregivers. ca forward slash podcasts. And don’t forget to follow us on your favorite podcast platform to be notified when new episodes are released.

[00:35:10] Thanks again for joining us and see you next month.