Private practice
This domain is the network's membership, organized by what each kind of clinician brings to a care map. Its five cohorts are rosters of independent practitioners: the primary care physicians who anchor a plan, the specialists who see the patient and write back, the therapists, the counselors, and the resources around them.
Why this is a domain
The network's working premise is that independent practice, paid mostly by patients rather than payers, produces a different kind of medicine: longer visits, continuity, and a physician who answers the phone. Those properties are what make a care map possible. A plan with seven roles across three years needs someone who will still be there in year three.
Eligibility is deliberately specific. A clinician qualifies for this domain if they founded or co-founded their practice and more than half of its revenue comes from patients rather than payers. Hybrid practices qualify. Employed clinicians in large systems do not, not because their medicine is worse, but because the structure around them cannot make the commitments a care map asks for. Diagnostic centers are in domain 4, not here.
The five cohorts
| Cohort | Who it covers | Status | Slack |
|---|---|---|---|
| Primary care Who will own this patient's plan for three years? | DPC and concierge physicians and APPs who anchor a care map | Forming | #cohort-primary-care |
| Specialist Which cash-pay or hybrid specialists will see these patients, work with an anchor physician, and write back? | Cash-pay or hybrid cardiology, neurology, rheumatology, GI, endocrinology and others | Launch | #cohort-specialist |
| Therapists Which therapists know this condition, and will they report back to the anchor? | Physical, occupational, speech and pelvic floor therapists | Seeking a lead | #cohort-therapists |
| Counselor Who does the pre- and post-test counseling and the behavioral health work these maps need? | Genetic counselors, psychologists, psychiatrists and mental-health counselors | Seeking a lead | #cohort-counselor |
| Resource Who keeps the plan moving between visits: nutrition, navigation, community? | Dietitians, care navigators, patient advocates, social work, pharmacists, and the patient organizations that stay independent | Seeking a lead | #cohort-resource |
The primary care cohort is also where the journal club's membership lives: the founding cohort of six to eight physicians is drawn from it, and later cohorts of the journal club grow out of it. The specialist cohort supplies the one or two specialist seats in each journal club cohort.
What a roster in this domain contains
The same four parts as the diagnostic rosters: what the care maps need from this cohort, the vetting criteria, the current entries, and the build plan. The entries differ in what an anchor physician needs to know: specialty and subspecialty interest, which patient cohorts they will see, whether they take a referral from an independent practice without a system affiliation, how they communicate back, their cash price or price basis, and the member who vouches. Members opt in to being listed; nobody is listed without consent.
Vetting here is about behavior rather than credentials, which every clinician on the roster already has. The criteria that matter are that they see the whole patient, that they write back to the anchor, and that they do not reflexively refer on.
How this domain grows
Through the journal club. Every member who presents a case names the people they wished they could have sent the patient to, and every specialist who joins names the primary care physicians who send them the patients they want to see. The roster is the sediment of those conversations. Recruiting outside that process is possible but secondary; the network is built on relationships formed over papers and hard cases, not on a directory.
Patient organizations appear in the resource cohort on purpose and with a boundary: they are listed as community resources for care maps, they are never members, and the network takes nothing from them.