Clinical programs

Four structured programs. One integrated institute.

These are the programs the practice runs as cohesive clinical arcs — not isolated visits. Each is built around the same model: a primary clinical lead, an integrated specialty team, a documented protocol, and a structured cadence of follow-through.

The practice runs four structured programs in addition to general primary, gastroenterology, and specialty care. Each program is documented end-to-end — eligibility criteria, baseline workup, intervention arc, follow-up cadence, and exit criteria — which is what lets the clinical team deliver consistency across providers and what gives members a clear picture of what they are committing to.

All four programs accept both insurance billing and cash-pay concurrently — we are a hybrid practice. The membership tier covers the integrated coordination, the extended visit times, the dietitian and program-staff support, and the after-hours reach. Where the program touches procedures (imaging) or compounded prescriptions, the billing and consent flows are disclosed before the member commits. Nothing in any of the program arcs depends on a member adopting a particular dietary pattern or worldview; the practice is plant-forward by orientation, not by ideology.

Program 01

Lifestyle Reset

Plant-forward metabolic and lipid intervention for members with elevated cardiovascular or metabolic risk.

Who it serves

Members with measurable cardiovascular or metabolic risk who want to address the upstream drivers before — or alongside — pharmacological management. Typical entry profile is an LDL above 130, an A1c in the 5.7 to 6.4 prediabetic range, central adiposity, or a documented family history of premature cardiovascular disease.

What is included

  • Initial 60-minute consultation with Dr. Sadeghi covering full history, dietary pattern, and goals
  • Advanced lipid panel including ApoB and Lp(a), inflammatory markers, comprehensive metabolic panel
  • Registered-dietitian counseling — session count determined per case based on clinical need
  • Plant-forward menu protocol with weekly check-ins via secure messaging
  • Repeat labs at 90 days and at 180 days with comparison reporting
  • Optional pharmacology coordination (statin, GLP-1, or other agents) where indicated

What members can expect

Most members on protocol see measurable lipid improvement at the 90-day repeat and continued improvement at 180 days. The program is not a diet plan; it is a clinical intervention with documented endpoints. Members who prefer dietary change as an adjunct to medication are accommodated; members who want to substitute lifestyle for indicated medication go through informed consent with Dr. Sadeghi about what the evidence does and does not support.

Insurance + payment

This program accepts both insurance billing and cash-pay concurrently — we are a hybrid practice.

Data + consent

Lab results and chart notes are stored in the practice's HIPAA-protected electronic health record. Members may revoke dietitian and clinical-team sharing through the patient portal at any time without affecting their membership status.

Duration
6 months
Provider lead
Dr. Sadeghi + RD team
Eligible tier
All membership tiers
Program 02

Hormone Optimization

Evidence-led HRT for perimenopausal, menopausal, and andropausal members.

Who it serves

Members in the perimenopausal, menopausal, or andropausal transition seeking structured evaluation and, where appropriate, hormone optimization. The program is built around current evidence on the risks, benefits, and individualization of HRT — not around bioidentical pellet marketing or population-level scare narratives.

What is included

  • 60-minute intake with Dr. Sadeghi covering symptom history, prior treatment, and risk factors
  • Comprehensive baseline labs — sex hormones, thyroid, fasting metabolic panel, lipids, inflammatory markers
  • Cardiovascular risk evaluation as a precondition for estrogen-based protocols
  • Individualized HRT protocol — oral, transdermal, or where indicated, injection — with documented rationale
  • Follow-up labs at 3 months and 6 months, with protocol adjustment
  • Annual re-evaluation as long as the member remains on protocol

What members can expect

The conversation begins with symptoms members actually have — sleep disturbance, cognitive fog, libido change, mood, vasomotor symptoms, body composition shifts — and ends with a protocol Dr. Sadeghi is willing to sign her name to. Members for whom HRT is not the right answer are told that, and offered the alternative interventions the practice supports.

Insurance + payment

This program accepts both insurance billing and cash-pay concurrently — we are a hybrid practice.

Data + consent

Hormonal lab results carry standard PHI sensitivity and are stored in the practice's HIPAA-protected electronic health record. Compounded prescriptions, where used, are written to pharmacies the practice has vetted; the pharmacy relationship is disclosed at consent.

Duration
Ongoing
Provider lead
Dr. Sadeghi
Eligible tier
All membership tiers
Program 03

Executive Cardiovascular Health

A high-resolution annual physical and cardiology arc for members with elevated career or familial risk.

Who it serves

Senior executives, founders, and members with elevated familial cardiovascular risk who want a more thorough annual physical than the standard primary-care visit can deliver. The program is designed to surface the things a 15-minute physical misses — particularly subclinical cardiovascular disease, where intervention years before symptoms is the highest-leverage point.

What is included

  • One-hour annual physical with extended history, full physical exam, and biometric screening
  • Advanced lipid panel including ApoB, Lp(a), inflammatory markers, fasting insulin, HbA1c
  • Coronary calcium score (CT coronary calcium) as the baseline subclinical risk measure
  • Optional CT coronary angiography or carotid intima-media thickness for higher-risk profiles
  • Stress test or fitness assessment matched to the member's baseline activity
  • Cardiology consultation where indicated, with same-week scheduling for in-house members
  • Personalized risk-reduction plan with quarterly check-ins through the year

What members can expect

The deliverable is a written cardiovascular risk profile with a five-year projected event risk, the specific contributors to that risk, and a documented intervention plan. Members who value early subclinical detection typically renew the program annually as the anchor of their concierge year.

Insurance + payment

This program accepts both insurance billing and cash-pay concurrently — we are a hybrid practice.

Data + consent

Imaging results from the calcium score, CTA, or carotid studies are stored with the originating imaging center under their HIPAA framework, with copies in the practice's electronic health record. Members consent separately to imaging given the radiation profile of the CT studies.

Duration
Annual
Provider lead
Primary care + cardiology
Eligible tier
Concierge + above
Program 04

Mental & Cognitive Wellness

Integrated mental health and cognitive longevity support across the membership year.

Who it serves

Members experiencing the sleep, mood, attention, or cognitive changes that often accompany midlife and which traditional primary care frequently under-addresses. The program also serves members with no acute presentation who want to monitor cognitive health proactively, particularly those with family history of dementia or with vascular risk factors that compound cognitive risk.

What is included

  • Initial 60-minute mental health intake covering history, sleep, substances, prior treatment
  • Validated screening instruments — PHQ-9, GAD-7, AUDIT, sleep questionnaires — at intake and quarterly
  • Brief cognitive baseline (MoCA or equivalent) for members 50 and above, repeated annually
  • Sleep evaluation and home sleep study where indicated
  • Coordinated psychiatric medication management where appropriate, with monthly check-ins on titration
  • Therapist referral through a vetted in-network panel, or in-house brief therapy where offered
  • Lifestyle interventions — exercise, nutrition, alcohol — integrated with the rest of the program

What members can expect

Mental health work is slower than the metabolic programs. The deliverable is not a number on a chart but a member who is sleeping better, thinking more clearly, and noticing the difference. The program is structured to make that progress visible and to catch the smaller signals that, left alone, become the larger ones.

Insurance + payment

This program accepts both insurance billing and cash-pay concurrently — we are a hybrid practice.

Data + consent

Mental health records carry heightened sensitivity under federal and California privacy law. The program follows separate consent flows for sharing with other practice providers, and members may direct that mental health notes remain segregated from the general chart.

Duration
Ongoing
Provider lead
Mental health program team
Eligible tier
All membership tiers

Not sure which program fits?

The new-patient consultation is where program candidacy gets matched to actual need. Schedule a Charter call first, or take the readiness scorecard to size the practice's fit.

Schedule a Charter call Take the scorecard

or call our office line · (949) 404-4444