She is worth $7.8 billion.
She has never sold a single share to cash out. And she plans to give away 99 percent of it. When Judy Faulkner once asked her children what they needed most from her, they answered the way most kids do. Food. Money. Security. The things that make life feel safe. She shook her head.
“No,” she said. “You need roots and wings.” Roots to ground you. Wings to lift you. Everything else is just details. Decades later, at 82 years old, Judy Faulkner is quietly building those same two things for millions of people she will never meet. And she is willing to bet $7.7 billion that it matters.
Her story does not begin with wealth or power. It begins in a basement. In 1979, in Madison, Wisconsin, Judy started a tiny company called Human Services Computing. She had $70,000 borrowed from friends and family, two part-time employees who trusted her, and a massive computer that filled the room. She programmed it herself, line by line, hour by hour.
Her idea sounded simple. Make medical records follow the patient. She had seen what happened when they did not. Files locked in cabinets. Information trapped in incompatible systems. Doctors forced to guess. Patients lost in the gaps. But one moment made it personal.
Her husband Gordon, a pediatrician, had treated a young girl for years. When the family moved just 75 miles away to Milwaukee, the girl fell ill. At the new hospital, doctors could not access her records. They did not know her history. They did not know how fragile her condition was. By the time the pieces came together, it was too late. She died.
The next morning, Gordon was broken. Judy went back to her basement and made a decision. If she could prevent even one family from living through that kind of loss, she would dedicate her life to it.For nearly two years, her small team built software that could allow hospitals to share patient records across systems. It took two more years to convince skeptical administrators to trust it. She kept going anyway. That basement project became Epic Systems.
Today, Epic manages the medical records of more than 325 million patients. It supports roughly half of all hospital beds in the United States. The company brings in about $5.7 billion a year. And Judy Faulkner still runs it, showing up to work every day on Epic’s 1,670-acre campus in Wisconsin, a place filled with storybook architecture and playful design. One executive once described her as a mix of Bill Gates and Willy Wonka.
But here is what truly sets her apart. She never cashed out.She refused venture capital that would have pushed profit over patients. She refused to take Epic public and submit it to quarterly earnings pressure. She refused to sell to the highest bidder. “Why be owned by people whose main interest is return on equity?” she once asked. While other tech founders chased IPOs, yachts, and headlines, Judy kept writing software and solving healthcare problems. In 2015, she signed the Giving Pledge, promising to give away at least half her wealth. Then she went far beyond it. She pledged 99 percent.
In 2019, she and Gordon launched the Roots and Wings Foundation, named after that long-ago conversation with their children. The mission is simple. Give people roots like food, shelter, healthcare, and education. Give them wings like opportunity, stability, and hope. In 2020, the foundation gave $15 million to 115 organizations. By 2024, it had grown to $67 million across more than 300 nonprofits. Her goal is $100 million per year by 2027. She is doing it methodically, selling her Epic shares back to the company and directing nearly every dollar into giving. Out of hundreds of billionaires who have pledged to give, only a few truly do it while they are alive.
Judy Faulkner is one of them. She has never taken personal profit from her shares. Every dollar beyond her salary goes back into the world. Into healthcare access. Into education. Into families who need a chance to stand steady and rise. In an age where wealth often chases rockets, headlines, and ego, Judy chose something quieter and far more lasting. She built a company that helps hundreds of millions of people receive better medical care. She built it without surrendering her values. And she is ensuring that nearly all of her fortune continues that work long after she is gone. She could have walked away rich decades ago. Instead, she is still in Wisconsin. Still working. Still thinking about patients she will never meet.
This is not just a business success story.It is a blueprint. A reminder that wealth does not have to be about accumulation. It can be about impact. About service. About choosing roots and wings over yachts and applause. Her legacy will not be measured in billions kept.It will be measured in lives saved, children educated, families supported, and futures made possible. Her children asked for food and money. She taught them something better.
And now she is giving the world the same lesson.
… Epic is the dominant player in electronic health records. That’s because it kind of invented electronic health records. But the company requires more explanation, because writing about American health care without Epic is like performing Hamlet without Hamlet.Highly recommend Josh's book.
Epic was founded by Judith Faulkner in a Madison, Wisconsin, basement in 1979. Faulkner is now in her eighties and is still the CEO. She’s not a recluse, but she does very few interviews, so I’ll quote from a 2022 podcast she did with Bill Frist, the former US Senate Majority Leader and a heart and lung transplant surgeon. Frist gushes over Faulkner, as he should. She’s one of the most remarkable American women almost no one has ever heard of.
Faulkner was raised in Cherry Hill, New Jersey. Her father was a pharmacist and her mother was, for a time, the director of the Oregon affiliate of Physicians for Social Responsibility. Judy was a math major at Dickinson College when she took a summer job at the University of Rochester’s particle physics department, and her life’s work presented itself. “I had never seen a computer,” Faulkner told Frist. “They gave me a Fortran book and a week of access on the computer, and at the end of the week they said I was a good programmer. I’ve never figured out why anybody needs more than a book and a week.”
While she was getting her master’s in computer science at the University of Wisconsin, a professor asked Faulkner if she could help develop a system to track information over the course of a patient’s life. Everything at the time was written in Common Business-Oriented Language (COBOL), which meant a change to a patient’s record required a change to the source code of the whole database. Faulkner used a different language—MUMPS (Massachusetts General Hospital Utility Multi-Programming System)—to get around the problem. “I put the patient at the center and all the data around the patient.”
With seed money from friends and family, Faulkner started the company that would ultimately become Epic Systems. For its first twenty years, Epic expanded slowly but inexorably—into billing, scheduling, and almost everything else at the convergence of patients and the health-care system. In 2000, Epic rolled out MyChart, patient-facing software that’s now used by 200 million people. A few years later the company did a $1.5 billion deal to service all of Kaiser Permanente. When the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act incentivized hospitals to adopt digital health records and penalized those that didn’t, Epic exploded. Google, Amazon, and others have tried to grab a piece of its market share, and Judy Faulkner has left them all in tears.
Epic now generates about $5 billion in annual revenue and is used by twenty-one of the top twenty-two hospitals in US News’s 2023–24 Best Hospitals Honor Roll. “We have about 26 percent of the hospitals [total], but we have about 46 percent of the beds,” Faulkner says in a charming flex. “Because we tend to work at the larger places.”
The company has never gone public, never taken outside investment, never acquired another company, never advertised, and is structured to prevent an IPO or acquisition after Faulkner’s death. Its headquarters are on more than a thousand acres in Verona, Wisconsin; you can book a tour of the working farm and themed office buildings—including a wizard campus inspired by the Harry Potter series and a partially buried conference center called Deep Space with a lobby based on Lord of the Rings. But the most telling detail about Epic is buried in this exchange:Faulkner: So if we have eleven thousand [employees], how many salespeople would you guess we have?Companies with $5 billion in revenue and seven salespeople are either really good or have achieved such dominance that they know customers have little choice but to buy their stuff. Epic is both.
Frist: I don’t know. I’d say very few but go ahead, tell me.
Faulkner: We have seven worldwide.
Part of Epic’s secret is that it’s mostly a closed system, which makes it fantastically secure and reliable—essential qualities when dealing with patient data and life-or-death hospital operations. But closed systems also lock customers in, leaving them at the mercy of whoever holds the keys. Most Epic clients are fine muddling along with Judy Faulkner’s twenty-five-year-old taste in design and usability. The problem comes when a hospital’s priorities—like sepsis prediction—don’t align with Epic’s, or when an outside vendor proves undeniably better at something Epic already does.
No one doubts Faulkner’s motives. She famously doesn’t care about money—she lives modestly and signed the Giving Pledge to donate her personal billions—and considers herself a guardian against companies with more predatory ambitions. Over the years she’s gotten better at listening to clients and allowing outside vendors to sync with Epic. But Epic has the right to charge fees to integrate vendors it doesn’t like, or deny them access entirely. An executive at a different hospital system described the process as fraught, like telling your brilliant, wealthy, and very powerful mother that you loved her Thanksgiving dinner but you’re going to order out for dessert.
All of this helps to explain why changing health care with AI is so hard. It’s not just about getting advanced technology to work, without error, in clinical settings with life-or-death stakes. It’s about professional cultures, government policies, entrenched stakeholders, money, rivalries, emotions. Human stuff. The code may be willing, but the flesh is often weak …
AI for Good: How Real People Are Using Artificial Intelligence to Fix Things That Matter by Josh Tyrangiel: Ch 6: “Sepsis” pp 117-120
The goal in medicine is to make more out of more. In the context of the vast computational capabilities of a model, information overload ceases to be a meaningful constraint. If I input a medical record, a genetic profile, the latest research on a specific cancer treatment, and the patient’s own description of their symptoms, the model can curate a response that synthesizes all of it. No human could hold that much information in working memory simultaneously.
The possibilities for healthcare are transformative. AI has the capability of synthesizing mountains of medical research and identifying potential treatment solutions that a busy clinician might never encounter. If we can relieve doctors of the burden of memorizing every new development, they would have more time to focus on the human side of medi cine, including listening, comforting, explaining, and being present with a patient in their fear and uncertainty.
In this scenario, the physician’s memory functions like a fixed map, limited in scope and inevitably outdated. The potential of AI is a dynamic web capable of curating and synthesizing information in real time, constantly updated, and infinitely patient. The human brings judgment, empathy, and the irreplaceable experience of looking another person in the eye. The machine brings everything else.
Nosta, John. The Borrowed Mind: Reclaiming Human Thought in the Age of AI (pp. 57-58). (Function). Kindle Edition.
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