I started Family Doctor in 2008 with a single clinic. More than fifteen years and 112+ clinics later, the lessons that matter most aren’t the ones I expected at the start.
Hire people who care more about the work than the title — then get out of their way. A network only works if the people running each clinic have genuine autonomy. The trick is to centralise the back office and decentralise the judgement, not the other way around.
Systems are a form of respect. Every hour a GP or practice manager spends fighting bad software, chasing compliance, or redoing payroll is an hour stolen from patients and from their own life. Building the boring infrastructure well is one of the highest-leverage things a healthcare company can do, even though no one writes headlines about it.
Be deliberate about capital. Growth needs funding, but the form of the funding shapes the company. We chose to stay doctor-owned and to fund expansion with debt rather than selling equity, because who owns you determines who you answer to. That’s a lesson I’d give any founder in a regulated, mission-driven field.
Stay close to the work. At scale it’s easy to drift into a world of dashboards and lose contact with what actually happens in a consulting room or at a front desk. I still practise, and I’m still personally involved in the practices we bring in, because the day you stop understanding the work is the day you start making bad decisions about it.
Fifteen years in, I’m more convinced than ever that the boring fundamentals — good people, good systems, patient capital, and staying close to the ground — beat any clever strategy. They’re just much harder to stick to.
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