San Francisco Two levels of membership, built on the same foundation: one physician who holds your whole history, the time to act on it, and a team arranged around your priorities.
The practice is limited to ten patients.
Both levels provide direct access to Dr. Sanger and coordination with your specialists. Comprehensive includes more physician time, faster responses, a wider home-visit range, and additional services, including physical therapy.
Physician time means time spent on your behalf: visits, research, advocacy, documentation, referrals, coordination, and letters. Testing counts are annual allowances, not a schedule; each test is chosen for the question it needs to answer.
| Service | Retained$45,000 per year$3,750 per month | Comprehensive$60,000 per year$5,000 per month |
|---|---|---|
| Physician time and coordination | ||
| Dedicated physician time | Up to 60 hours a year | Up to 100 hours a year |
| Specialist care | Coordination with your specialists by phone and email; Dr. Sanger can join key specialist visits by video | All of Retained, plus priority scheduling, with appointments arranged on your behalf |
| Home and after hours | ||
| Home physician visits | When needed, within 45 minutes’ travel | On request, within 90 minutes’ travel |
| Home services | Mobile blood draws | Mobile blood draws, plus home nursing such as vaccines or infusions |
| After-hours phone | Direct to Dr. Sanger, with partner physicians as backup | |
| After-hours visits | Discounted membership in a 24-hour concierge urgent-care service in major US metropolitan areas | |
| Communication | ||
| Messaging | Secure portal and email, plus dedicated secure text and phone with Dr. Sanger | |
| Typical response time | Within 4 hours on weekdays | Within the hour on weekdays |
| Extended team | ||
| Nutritionist | 2 visits a year | 4 visits a year |
| Trainer and exercise physiologist | 2 visits a year with each | 4 visits a year with each |
| Physical therapist | Not included | 2 visits a year |
| Concierge pharmacist | Included, with next-day delivery | Included, with same-day delivery |
| Included testing: annual allowances | ||
| DEXA body composition | Up to 4 a year | Up to 6 a year |
| VO₂ max | Up to 2 a year | Up to 3 a year |
| Continuous glucose monitoring | Up to 8 sensors a year | Up to 12 sensors a year |
| Home sleep study | Up to 2 a year | Up to 3 a year |
| Omega-3 index | Up to 2 a year | Up to 3 a year |
| Spirometry and grip strength | Up to 8 a year | Up to 12 a year |
| Whole-genome sequencing | Once, with ongoing reanalysis | |
| Additional screening | Discounted whole-body MRI (Prenuvo) | An annual multi-cancer early detection test |
| Blood draws | Mobile blood draws; laboratory processing billed separately | |
The relationship begins with reading and listening, then settles into a steady cadence: a few issues at a time, with the whole picture reviewed every year.
Before we meet
Records are gathered from the physicians, hospitals, and laboratories you have seen. Dr. Sanger spends several hours reviewing them before the first visit: notes, results, imaging, medications, and the reasoning behind past decisions.
First visit · 90 minutes
A long conversation about your history, your concerns, and what you want from the relationship. Together you set the initial priorities and identify what is missing, including any short-term testing needed to fill the gaps.
About a month later · 90 minutes
With new results in hand, a second long visit turns the initial priorities into a concrete plan: what to try, what to watch, and when to look again.
At least quarterly · 60 minutes
Scheduled visits focus on one or two significant issues, so each receives sustained attention rather than a line on a long list.
Throughout the year
Routine, brief telephone or video check-ins keep the plan moving, with direct access whenever something changes.
Once a year
A step back from current issues to the whole picture: screening, risk, and priorities for the year ahead.
The practice is based in San Francisco and serves the Bay Area. Virtual care is possible for patients in California and New York.
Dr. Sanger usually becomes your primary physician. If you already have one you value, he can work alongside them and your specialists.
Direct phone access continues while you travel, and members have discounted access to a separate 24-hour concierge urgent-care service in major US metropolitan areas.
San Francisco Bay AreaVirtual care possible for patients in California and New York
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