Peer-to-peer health management for medical professionals

The Knowledge-Behaviour Gap

This page exists because you're a physician who understands pathophysiology, reads the literature, and can diagnose metabolic syndrome or cardiovascular risk without effort.

You're also carrying more weight than you'd like, on medications you never properly attempted to avoid with lifestyle modification, sleeping poorly, and haven't exercised consistently in years.

The gap between what you know and what you do isn't ignorance. It's the same structural problem your patients face: no one is managing your health trajectory—including you.

Why Physicians Struggle as Patients

You're accustomed to being the expert. The idea of being on the receiving end of clinical advice—particularly from someone who may not fully understand the demands of medical practice—is uncomfortable at best.

Add to that:

  • Irregular working patterns: Long clinical days, on-call commitments, and unpredictable schedules that don't accommodate standard appointment times

  • Professional identity: Seeking help for metabolic or lifestyle concerns can feel at odds with your clinical role

  • Evidence standards: You've seen enough unproven wellness interventions to approach new offerings with appropriate skepticism

  • Discretion: You'd prefer colleagues didn't know you were addressing these issues

This programme is designed with those considerations in mind.

What’s Different Here?

  • You will work with Dr Marius Terblanche, a physician and clinical epidemiologist (MSc, PhD) whose background is in critical care medicine and evidence methodology.

    Dr Terblanche has spent significant time studying healthspan and longevity medicine as part of ongoing professional development, and applies the same principles to his own health. This isn't theoretical—it's work he's doing himself, under the same constraints and uncertainties.

    Consultations are structured as peer-level discussions: shared decision-making, literature provided for your own review, and an explicit acknowledgment that you understand the science. The focus is on why the gap between knowledge and execution exists for you specifically, and how to close it systematically.

    You will not be patronized. The conversation assumes medical literacy and focuses on practical application within your context.

  • You know the difference between RCT-supported interventions and speculative optimization. So do we.

    Every element of the programme is mapped to recognised evidence standards (NICE guidance, UK NSC criteria, published trials). We publish our clinical framework and appropriateness criteria.

    Examples of what we do:

    • Structured resistance training (clear mortality and morbidity benefit, strong evidence base)

    • Conservative lipid management with lifestyle intervention first, medications when indicated and appropriate (aligned with ESC/NICE)

    • Sleep apnoea screening and treatment where clinically warranted

    • Hormone assessment and optimisation where deficiency is demonstrated and symptomatic

    Examples of what we don't do:

    • Routine whole-body imaging (low yield, high incidentaloma burden)

    • Experimental interventions without adequate evidence

    • Biomarker panels with unclear clinical utility

    If you want the rationale for any recommendation, it's yours—with references.

  • You're likely on statins, antihypertensives, or both. You understand the evidence for these medications, but you'd prefer not to be on chronic therapy if lifestyle modification could achieve the same risk reduction.

    The honest conversation:

    Some physicians can reduce or eliminate medications with sustained lifestyle intervention—weight loss, structured exercise, dietary modification. Others cannot, because their cardiovascular risk or metabolic burden remains too elevated, or because sustained behaviour change proves difficult under real-world constraints.

    We will attempt it properly:

    • Baseline risk stratification and biomarker tracking

    • Structured exercise programme with appropriate progression

    • Nutritional strategy tailored to your working pattern and practical constraints

    • Medication tapering protocol with monitoring and with your full involvement in decision-making

    If it works, you reduce or stop medication. If it doesn't, we optimise the regimen and preserve your physical capacity. Either way, you've made a proper attempt at lifestyle modification under supervision, not as an unsupported resolution.

  • Your schedule is not predictable. You work long clinical days, cover on-call commitments, and often eat irregularly. Your patterns of activity vary considerably—sometimes on your feet for extended periods, sometimes largely sedentary.

    The programme accounts for this:

    • Flexible appointment times: Early morning, evening, weekend availability

    • Remote options: Video consultations for reviews when you cannot attend in person

    • Realistic behaviour change: Interventions designed to work within the actual constraints of clinical practice, not idealised scenarios

    • Nutrition strategy for irregular patterns: Managing eating when clinical commitments make regular meals impractical

    The plan must work with your actual working life, not an imagined version of it.

  • You would prefer colleagues not to know you're addressing health issues that might be perceived as "lifestyle problems."

    • Appointments can be scheduled discreetly

    • Communications via secure channels, separate from your professional email

    • No contact to your NHS trust or private practice without explicit consent

    • If coordination with your GP or specialists is appropriate, we do so only with your agreement

    This is managed on your terms.

What the Programme Actually Involves

The structure follows the same 12-month physician-led trajectory management as all members, but the tone and approach differ.

  • Clinical intake: We begin with a peer-level discussion:

    • Current health state, medications, established risk factors

    • Previous attempts at lifestyle modification (and why they didn't persist)

    • Your working pattern and practical barriers

    • Objectives: medication reduction? weight loss? sleep improvement? performance preservation for the next 10-15 years of clinical practice?

    Targeted investigations: You understand the rationale for every investigation. We don't bundle tests for marketing purposes.

    Core baseline typically includes:

    • Comprehensive biomarker panels: cardiometabolic (ApoB, ApoA1, Lp(a), lipid profile, HbA1c, hsCRP, fibrinogen), hormone health (thyroid, testosterone if appropriate, cortisol), nutritional markers

    • Imaging (evidence-based): CT coronary angiogram with calcium score if indicated by risk stratification; no routine whole-body CT

    • Physical capacity assessment: VO₂ max, strength testing, DEXA body composition, resting metabolic rate

    • Sleep assessment: screening questionnaires, overnight saturation monitoring, formal sleep study if apnoea suspected

    • Mental health screening: validated instruments for burnout, depression, anxiety (common in physicians, often unaddressed)

    Outputs:

    • BioStats Trajectory Report: Your current state, trajectory if unchanged, and priority areas for risk reduction

    • 12-Month Health Trajectory Plan: Prioritised, evidence-based strategy with focused 90-day execution plan

    • Monitoring & Review Framework: What we track, when we reassess, how we make adjustments

    Literature provided: You receive the evidence framework document and key references for recommended interventions. If you wish to review the primary literature, it's available.

  • Structured resistance training: For most physicians, this is central. Years of irregular exercise result in progressive loss of muscle mass and strength. The evidence for reversal through structured resistance training is strong.

    Why this matters for you specifically:

    • Preserves physical capacity for long clinical days and on-call periods

    • Improves insulin sensitivity and lipid profile (often sufficient to reduce medication requirement)

    • Addresses chronic musculoskeletal issues common in clinical practice

    Initially, we provide an individualised training programme with guidance on safe progression. The programme transitions to more independent execution with periodic review and adjustment. We monitor response through repeat strength testing and capacity measures.

    (We aspire to offer supervised training in the future as the service develops, but current delivery is structured programming with regular review rather than session-by-session supervision.)

    Nutritional strategy: Not prescriptive meal plans. A practical strategy for:

    • Managing eating patterns around irregular clinical commitments and on-call periods

    • Navigating hospital dining facilities and limited food access during long days

    • Balancing energy deficit (if weight reduction is an objective) with the demands of clinical work

    Dietitian consultation tailored to your actual constraints, not textbook recommendations.

    Medication adjustment (if appropriate): If baseline assessment suggests lifestyle intervention could reduce medication requirement:

    • Structured adjustment protocol with close biomarker monitoring

    • Shared decision-making throughout (you are involved in every change)

    • Clear plan for escalation if markers deteriorate

    Sleep optimisation: CPAP compliance if sleep apnoea is diagnosed, sleep hygiene adapted to irregular working patterns, consideration of pharmacological support if appropriate (melatonin, short-term hypnotics under medical supervision if indicated).

    Psychologist support: Available if relevant. Burnout, perfectionism, and work-related stress are common barriers to sustained behaviour change in physicians. If mental health affects your capacity to execute the plan, we address it.

  • The intensity of follow-up sits on a spectrum. We use three reference patterns—Guided, Active, Intensive—to illustrate typical oversight levels and establish pricing corridors.

    These are not rigid programmes. Your actual follow-up plan is agreed individually based on complexity, volatility, and preferred contact frequency.

    Guided-pattern oversight (typically quarterly reviews): Suited to stable physicians with good baseline adherence and fewer concurrent issues.

    Active-pattern oversight (more frequent touchpoints): Better for those with complex schedules, multiple medications, or higher baseline risk requiring closer iteration.

    Intensive-pattern oversight (frequent or continuous monitoring): For physicians with unstable biomarkers, significant health concerns, or complex medical situations benefiting from close supervision.

    Your level of oversight can be adjusted during the year if circumstances or clinical needs change.

  • We publish our clinical framework and appropriateness criteria. You can review the evidence base for any intervention we recommend.

    Key frameworks we align with:

    • NICE guidance for lipid management, hypertension, diabetes prevention

    • UK NSC screening criteria (we don't offer screening outside these)

    • ESC cardiovascular risk stratification

    • ACSM guidelines for exercise prescription

    • Relevant guidance for sleep disorder management

    If you disagree with a recommendation, we discuss the literature and adjust accordingly. This is shared decision-making. Plus we learn from the debate.

Fees and Commitment

Foundational Assessment and onboarding: £6,500

This fee is included within your overall annual membership—it is not charged separately.

Annual membership (indicative fee ranges including Foundational Assessment):

Guided-pattern oversight

- around £12,500/year -

Active-pattern oversight

- around £19,750/year -

Intensive-pattern oversight

- around £26,900/year -

Deposit and payment:

  • 25% deposit of the Foundational Assessment fee to confirm your place

  • Balance due after your first physician consultation

  • Annual payment or planned direct debit options dependent on follow-up cadence

12-month minimum commitment - same rationale as for all members: trajectory assessment requires time, and our business model depends on renewal when the programme succeeds.

Referral Network

If the programme proves effective for you and you wish to refer appropriate patients, we welcome that conversation.

We can provide:

  • Access to clinical protocols and evidence framework

  • Continuing professional development opportunities in this area if of interest

  • Referral arrangements for suitable patients

However, that's secondary. The immediate focus is your own health management.

How to Get Started

We are currently building a wait list of prospective members.

The process:

  1. Join the wait list – Express your interest and provide basic contact information

  2. Initial conversation – Once we are authorized to begin operations, we will contact you to arrange a preliminary discussion to assess mutual fit, answer questions, and determine whether the programme is appropriate for your situation

  3. Enrolment – If appropriate, you will be invited to begin with the Foundational Assessment

There is no obligation at any stage. The initial conversation exists to ensure the programme is right for you, and that you are right for the programme.