How the network works
Three parts: a journal club that meets, cohorts that organize what we learn, and a roster that turns it into referrals. It costs a member nothing but an evening a month.
The journal club
Monthly, virtual, 60 minutes, early evening Mountain time. One presenter, one paper or de-identified case. The run of the hour is fixed, so the time goes to the argument, not logistics.
| Minutes | What happens |
|---|---|
| 0–5 | Check-in. One line each: a patient, a question or a win since last time. |
| 5–20 | Presentation. The presenter summarizes the paper or case and poses two or three questions. |
| 20–45 | Discussion. The convener asks the standing question: where is the genomic signal here? |
| 45–55 | Practice translation. What does each of us do differently in clinic on Monday? |
| 55–60 | Close. Next presenter and reading confirmed. |
Presenter and scribe rotate. The presenter posts the reading at least a week ahead; the scribe posts a short summary within 48 hours. Literature sessions may be recorded for the archive. Case sessions never are.
Cohorts and care maps
A cohort is a defined group of patients, or of providers, inside one of five domains. Patient cohorts get a care map: the roles a patient needs filled, across three yearly cycles. Provider cohorts get a roster: who delivers what, vetted on the same criteria every time.
- Year 1, Establish
- Confirm or refine the diagnosis, get the baseline studies, stabilize what's urgent.
- Year 2, Treat
- Start and adjust treatment, coordinate the specialists, build the therapy plan.
- Year 3, Sustain
- Surveillance on a set calendar, reanalysis of genetic data, reassessment of the whole plan.
Every care map fills the same seven roles: anchor physician, genetics, specialists, diagnostics, therapies, behavioral health and nutrition, and community. The five launch cohorts and their maps are on the cohorts page. All five domains and twenty-five cohorts are on the domains page.
The roster
Specialists and diagnostic centers join a cohort roster on three conditions, checked before listing and reviewed yearly:
- A published or quoted cash price, before the visit or study.
- The work done as the anchor physician asked: the protocol requested, not the default.
- A note back to the referring physician, not only to the patient.
Rosters recommend. They never require, and no one is paid for a referral.
Cadence
| Meeting | How often | Format |
|---|---|---|
| Journal club | Monthly | 60 minutes, virtual, Microsoft Teams |
| General meeting | Quarterly | 60 minutes, virtual |
| Dinner or event | Every six months | In person, Denver first |
| Between meetings | Continuous | Slack workspace: readings, questions, cases, referrals |
Membership and CME
No membership fee. The convener covers the Slack workspace and the dinners for now. If that ever changes, members decide how, together, before anything is charged.
We're pursuing CME credit for the journal club through joint providership with an accredited provider. Until that's in place, sessions carry no credit, and we say so.
The founding cohort
Six to eight physicians, mostly primary care, with one or two specialists so referral paths form inside the group from the start. Founders commit to the first six journal clubs, then seed the next cohorts.