The Annual Reserve
A limited-seat medical partnership for the implementation, execution, and evolution of your health and meaning strategy.
Prerequisite: Completion of the Cornerstone Assessment. Strictly limited patient panel to ensure ICU-level focus.
Who Should NOT Apply
1. You mistake Information for Expertise.
In today’s world, information is available to everyone; expert clinical judgment is not. While we respect curiosity, if you trust a podcast over a physician, you're confusing entertainment with medicine. We don't co-manage care with amateurs.
2. You are looking for a Vendor.
If you're convinced that you possess the necessary expertise and are simply looking for a provider to prescribe what you want, order the tests you demand, or validate the claims you believe, you're looking for a vending machine, not a physician. We don't dispense; we practice medicine.
3. You're chasing the "magic bullet."
If you hope that a peptide, a supplement, or a gadget will save you from the anxiety of uncertainty or the discipline of work, RiverRock isn't for you. We experiment with the unproven when the risk is calculated and necessary — never just because it's trending.
4. You confuse Data with Insight.
Bloodwork is data. It isn't health. If you believe that optimizing a spreadsheet is the same thing as optimizing a human, you'll find our approach frustrating. We manage patients, not metrics.
What's Included
(After the Cornerstone)
I. Clinical Problem Solving & Prevention
The ICU Rigor applied to Primary Care
Dr. Z (Zain Hakeem) brings over a decade of experience treating "the sickest of the sick" in hospitals and ICUs across the nation. This level of clinical intensity is applied to your daily health—combining internal medicine expertise with Bayesian Analysis to solve diagnostic puzzles the standard medical system often misses.
EXPLORE RX-BAYES: THE DIAGNOSTIC APP DR. Z CREATEDAdvanced Procedural Interventions
- — Platelet-Rich Plasma (PRP): For joint/tendon injury, hair restoration, and aesthetics.
- — Osteopathic Manipulation (OMT): Full-spectrum musculoskeletal care.
- — Trigger Point Injections: AKA "Wet Needling" for chronic myofascial pain.
- — Precision Blocks: Nerve blocks and injections with ultrasound guidance.
- — Acute Care: IV fluids and medications administered as clinically indicated.
Neuro-Biological Training
- EEG Neurofeedback: Utilizing Myndlift for brainwave biofeedback aimed at anxiety, focus, and cognitive performance.
- Vagal Training: Resonance Frequency Breathing and Vagal Stimulator device integration.
- Medical Hypnosis: Clinical application for behavioral and neurological modulation.
Infrastructure of Care
- 60-Minute Consultations (Always on time)
- In-office Ultrasound, ECG, Spirometry & Bloodwork
- Rapid Specialist Access via RubiconMD
- Secure Threaded Chat Communication
- Custom Topic Research & Article Synthesis
- Clinical Telehealth Home Kit (BP, Oximeter, Ear Camera)
II. Longevity Optimization
Metabolic Re-Mapping
The Cornerstone Assessment creates the baseline. The Annual Reserve provides quarterly clinical-grade VO2 Max and metabolic efficiency retesting. We don't just set a plan; we demonstrate improvements and pivot the strategy as we find new metabolic limitations to address.
The "Big 5" Strategic Levers
We continuously track, optimize, and iterate on the five metrics most correlated with healthspan:
Longevity Curriculum
Membership includes unlimited, priority access to our weekly rotating lectures. These deep-dives explore longevity levers, emerging health research, and medical research methodologies, ensuring you understand the 'why' behind your protocol.
III. Meaning Optimization
MeaningSpan™ Curriculum
Unlimited access to weekly rotating lectures exploring the 10 Categories of Meaning—including Intimacy, Community, Legacy, and Discovery.
Private Meaning Coaching
One-on-one sessions focused on translating the curriculum into a personalized strategy that fits your unique life, identity, and current transition.
The Behavioral Intensive
An optional 4-month, high-touch coaching sprint. Designed for members ready to implement massive lifestyle changes with maximum accountability and clinical encouragement.