Primary care
The anchor question: who owns this patient's plan for three years? Every care map starts with an anchor, and the anchor is almost always an independent primary care physician. This roster is the membership seen from the patient's side: which members anchor which cohorts, and how a specialist or colleague finds one.
Status: Forming. The founding journal club cohort is the first draft of this roster. Members are listed only with their consent, after the confirmation call.
What the care maps need from an anchor
| Need | What it means in practice |
|---|---|
| Time | A visit long enough for a three-generation pedigree and a structured history. Every visit-one checklist assumes it. |
| Continuity | The same physician across all three cycles. A care map handed to a new clinician every year isn't a care map. |
| Ownership of the plan | The anchor writes the plan the patient carries, holds the surveillance calendar, and is the person specialists write back to. |
| A referral that asks a question | Every anchor referral states the question and the return date, so the specialist roster can be held to answering it. |
| A way to reach them | A direct route for the specialists, diagnostic centers and other anchors on the rosters, which independent practice already has. |
| Genetics literacy, not genetics training | Comfort ordering a panel or a genome with counseling support, reading a report with help, and knowing when to call on the genetics role. The journal club supplies this. |
Vetting criteria
Membership criteria, applied before listing and reviewed yearly.
- Founded or co-founded the practice, and more than half of its revenue comes from patients rather than payers. Direct primary care, concierge and hybrid practices qualify.
- Has attended at least three journal club sessions and presented or scribed once, so the roster reflects people who show up.
- Agrees to the principles of practice and the ground rules, including de-identification and the licensure boundary.
- Opts in to listing and states which cohorts they'll anchor, where they practice, and whether they're taking new patients.
How the roster is built
- Year one: the founding cohort, listed with consent after the confirmation call, each naming the cohorts they'll anchor. Early entries will cluster around the connective tissue and hereditary cancer maps, because those are the patients members already have.
- Year two: the second journal club cohort joins the roster. Anchors start cross-referring inside the network: an anchor in Denver and a specialist in Fort Collins, both on the roster.
- Year three: the roster is the referral fabric. A specialist with an unanchored patient finds an anchor here; a new member finds a mentor here.
Roster
Forming. Entries will show the physician, the practice and its model, location, the cohorts they anchor, whether they're taking new patients, and how colleagues reach them. Nobody is listed without consent, and nothing here is visible outside the members' area.