Do you take insurance?
No. Carte engagements are paid directly. We’re an independent advisory layer, not your treating physician of record. Your existing insurance continues to cover the doctors, tests, and procedures we identify and coordinate.
Do you write prescriptions?
We don’t, in most engagements. Your local treating physicians do, with our analysis informing their decisions. (At the MD Directorate level, in select states where we hold a professional corporation, treating-physician arrangements are possible.)
How is this different from a concierge doctor?
A concierge doctor is your access layer — same-day appointments, longer visits, a phone number that gets answered. We are your accuracy layer — the team that makes sure the most important medical decisions are the right ones. We work alongside good concierge practices, not against them.
How is this different from a virtual second opinion service from institutions like The Cleveland Clinic?
A virtual second opinion is a single transactional consult — useful, but bounded. Our Forensic Review begins with the same kind of question and goes deeper: re-evaluation of the primary data, multiple specialist consultations, and a 15–40 page written analysis. Our memberships extend that work over months or years.
Do you just hand over an analysis, or do you make the recommendations actually happen?
We make them happen. Carte is built around the principle that analysis without execution is half the work. Stewardship and MD Directorate include the implementation work — making appointments, briefing specialists, coordinating across institutions, closing follow-ups — as part of the engagement. For Forensic Review, we assess whether the follow-through can be completed in a bounded 3-month Execution Program (typically $5,000–$10,000, depending on scope) or whether the case calls for the ongoing coordination of Stewardship or MD Directorate.
If I already have a treatment plan from my doctors, will Carte just help me execute it?
Not automatically. A large part of what we do — whether in a Forensic Review or in an ongoing engagement — is stress-test the plan you’ve been given. That means reading the underlying data ourselves, checking whether the recommendation actually fits your specific case, and asking whether important alternatives were considered. If the plan holds up under that scrutiny, we’ll say so and help you carry it out well. If it doesn’t, we’ll tell you where the gaps are and what we would do differently. Carte’s value to the client is an honest read on whether the plan you have is the right one — not a rubber-stamp endorsement of a plan we haven’t examined.
What’s your view on peptides, naturopathic, and traditional medicine?
Open-minded without being naive. Some of these approaches are well-supported by trials, some by accumulated clinical experience, some by traditions that have outlasted multiple generations of medical fashion. We name the evidence honestly for each and recommend based on your specific situation. We are not categorical about either embracing or dismissing any class of treatment; we are pragmatic about getting results.
Are you the right fit for someone pursuing aggressive longevity optimization?
The clients who fit us want medicine to help them do the things they love, not to over-medicalize them. To that end, curiosity about changing science and trying experimental approaches when the conventional system is stuck are welcomed here. We may not be the right fit for someone looking for medical therapies to become the center of their daily life — an ongoing, elaborate protocol that occupies much of their attention and identity. Practices built around that approach exist. We work from a different starting point, one that treats pursuing health as a means to a fuller life rather than the end unto itself.
Can you help with my new cancer diagnosis?
Yes, selectively. Some cancer questions are exactly what a Forensic Review is built for — the choice between two treatment paths, contextualizing a pathology finding, whether a proposed regimen fits. Other cancer journeys, especially when the diagnosis interacts with other complex conditions, are the right fit for Stewardship or MD Directorate. There are also scenarios where your needs are better matched to one of our colleagues in the cancer space. When that is the case, we make the introduction and are glad to. Where your situation falls is the kind of question the first call is for.
Where are you located?
Carte is headquartered in DC, with a strong presence in California. We operate as a national advisory practice with clients in any geography. Most of the work happens by phone, video, and secure messaging — with your consent, we coordinate directly with the physicians and facilities local to you. When a case calls for in-person clinical work, we either orchestrate an in-person visit with the specialist we’ve selected for your situation, or one of our physicians travels to you.
How quickly can you start?
Most Forensic Reviews and Stewardship memberships begin within 1–2 weeks of the strategy call. Urgent situations can begin within 48 hours.