The Roadmap
The Advisory plan: what I found, what matters now, what we are doing next, and what would change the course. I deliver it within 60 days.
The investigation
How I investigate, measure, and recalibrate.
I use the Meier Management System to turn a changing record into explicit decisions. The first three phases establish the course. The next three keep testing it.
Meier Management System
The six phases of a Management year.
Set up once
Benchmark
Establish baseline
Analyze
Form hypotheses
Engineer
Targets and protocol
Then every quarter
Execute
Act on the protocol
Measure
Update the evidence
Calibrate
Improve the next decision
↑ repeats
Feeding measure
- History and records
- Wearables and function
- Biomarkers: blood, urine, stool, saliva, and epigenetics
- Changing goals
- New concerns
Every system · Every quarter · Against your baseline
The written record
What I write down.
The Current State
The Management baseline after BENCHMARK, ANALYZE, and ENGINEER. It records the system, the priorities, and the first protocol.
Quarterly Healthspan Review
The written close of each Management cycle: what changed, what remains uncertain, and what I recommend next.
How I decide
Drivers, Goals, Targets, Levers: D-GTL.
Your history, records, goals, and results shape the working model. I form hypotheses about the Drivers, define Targets with numbers and sources, and select the Levers most likely to move them.
01
Drivers
The upstream factors and constraints.
What is shaping your current state?
02
Goals
The work, sport, family, or decade that matters.
What must your health keep making possible?
03
Targets
A measurable change with a number and source.
What number proves progress?
04
Levers
Medications, supplements, nutrition, training, sleep, and testing.
What is most likely to move it?
What arrives, and when
Everything is written down and lives in your portal.
Management
The Current State
after Benchmark, Analyze, and Engineer
Quarterly Healthspan Review
plus a live conversation, each cycle
3 · 6 · 9 · 12 months
Advisory
Roadmap
in a dedicated session within 60 days
Quarterly review
plus a written recap and an updated Roadmap
3 · 6 · 9 · 12 months
Management
The Current State follows BENCHMARK, ANALYZE, and ENGINEER. It contains your physiological model, first D-GTL map, priorities, uncertainty, and starting protocol. Each cycle includes blood, urine, stool, saliva, and epigenetics, then ends with a written Quarterly Healthspan Review and a live conversation.
Advisory
Your records, goals, and missing baseline feed a Roadmap within 60 days. Quarterly reviews follow with a written recap and Roadmap revision as new results arrive.
Testing access
Modern tools, selected for the question.
I select modern imaging, connected wearables, continuous glucose monitoring, and physician-ordered cash-pay testing according to the individual question and the evidence. Most of the advanced testing and tools I use are cash-pay and sit outside the usual insurance authorization pathway. This lets the investigation follow the clinical question rather than an insurer's coverage rules. Their data becomes part of the longitudinal record and my working model.
01
Cardiovascular
CT coronary angiography with Heartflow plaque analysis, coronary calcium, advanced lipids, ApoB, and Lp(a).
02
Imaging
Whole-body MRI, NeuroQuant brain volumetrics, and cancer screening.
03
Metabolic and inflammatory
HOMA-IR, hsCRP, and continuous glucose monitoring.
04
Gut, hormones, and omics
Gut and microbiome panels, fecal zonulin, hormone cascades, methylation, environmental toxins, and epigenetic age including DunedinPACE and peers.
05
Function
DEXA, VO2 max, and resting metabolic rate.
Labs and imaging carry no markup. Other third-party providers bill separately.
Reading results
How I read a result.
I read every value against three things: the laboratory range; your own baseline, where three results moving one way raise a flag before any single value does; and the related markers in the same system.
Trend before snapshot
A result can sit inside a lab range while moving in the wrong direction. Your baseline and the direction of travel carry more weight than a single reassuring label.
Risk tied to evidence
When I use a risk score or target, I pin it to the primary literature, state its limits, and separate an observed change from a plausible contribution.
Why this compounds
The goal is more healthy years.
Healthspan is the part of life spent in good health. In the United States, the average gap between healthspan and lifespan is 12.4 years. My aim is to protect function and compress the years lived in poor health.
Managed courseTypical course
Protecting that curve for one person requires a plan that stays current. Measured changes may be modest on their own. Their value compounds over time as the longitudinal record deepens and each decision carries more context.
Managed courseTypical course
Fit conversation · about 20 minutes
Tell me what you want to protect or improve.I'll tell you whether Advisory, Management, or neither is the right fit.