Frequently Asked Questions

Complete primary care, plus advanced diagnostics not covered by OHIP.

Your membership includes:

1. Access:
- 24/7 physician availability by text, call, or video
- Same-day virtual care for urgent matters
- In-office appointments within 48 hours
- A clinic without waiting rooms

2. Annual Executive Physical (3 to 4 hours):
- A panel of 75+ biomarkers
- Coronary artery calcium score (CT imaging)
- Carotid intima-media thickness ultrasound
- VO2max cardiopulmonary testing
- A 60-minute consultation with your physician

3. Private Specialist Network:
- Referrals to cardiology, endocrinology, dermatology, and other specialists within days
- Private specialist consultations included in your membership

4. Day-to-day Care:
- Prescription renewals, adjustments, and weekend refills
- Visits with our physicians for acute concerns such as strep throat, UTIs, and minor injuries
- Nutrition and exercise support
- Coordination of care across your providers
- Your full health record in one place, accessible to you

For most members, no. Our physicians serve as your family doctor.

Our physicians are licensed family physicians providing the full range of primary care: prescriptions, imaging requisitions, specialist referrals, acute illness visits, and chronic disease management.

The main difference is panel size. Each Plunge physician cares for around 500 patients, compared with 1,400-1,600 at a typical OHIP family practice. That allows for longer appointments and faster follow-up.

Because OHIP costs you something more valuable than money: time.

In the public system:
- 6 weeks to see your GP
- 8-12 months for a specialist referral
- 6-12 months for an MRI
- 10 minutes per appointment
- 8 biomarkers tested at your "physical"

At Plunge:
- 48 hours to see your physician
- Days for a specialist (we pay for it)
- Days for imaging (you pay the scan cost, we skip the queue)
- 60+ minutes per consultation
- 75+ biomarkers tested

You are not buying "better bedside manner." You are buying the removal of artificial scarcity. Time is the only non-renewable resource.

A standard Canadian physical checks CBC, electrolytes, creatinine, glucose, lipid panel (total cholesterol, LDL, HDL, triglycerides), TSH, and maybe HbA1c. That is 8-12 markers. It is a 1970s-era screening protocol.

We test 75+ markers, including:

Cardiovascular (the #1 killer):
- Apolipoprotein B — the actual atherogenic particle count (LDL-C misses 30-40% of high-risk patients)
- Lipoprotein(a) — genetically determined, causes 1 in 6 heart attacks, almost never tested by GPs
- Coronary Artery Calcium Score — direct visualization of arterial plaque via CT (not a "risk estimate"—actual disease)
- hs-CRP, IL-6, fibrinogen — inflammatory drivers of atherosclerosis
- TMAO — gut-derived metabolite linked to plaque instability

Metabolic:
- Fasting insulin + HOMA-IR — insulin resistance detection 10-15 years before diabetes diagnosis
- HbA1c with glycation gap — identifies glycemic variability masked by average glucose
- Adiponectin, leptin — adipose tissue dysfunction markers

Hormonal:
- Full thyroid panel (TSH, free T3, free T4, reverse T3, TPO/TG antibodies) — not just TSH
- Diurnal cortisol mapping — HPA axis dysfunction detection
- DHEA-S, pregnenolone, full sex hormone panel

Nutritional & Methylation:
- RBC magnesium, zinc, selenium — intracellular status, not serum (which is useless for deficiency detection)
- Omega-3 index — membrane composition
- Homocysteine, B12, folate, methylmalonic acid — methylation pathway function

This is not a "wellness panel." This is the evidence-based biomarker set for early detection of cardiovascular disease, metabolic dysfunction, and cancer risk.

Because these markers are not covered by OHIP and are not part of standard public-system screening.

Apolipoprotein B (ApoB):
Every atherogenic lipoprotein particle contains exactly one ApoB molecule. ApoB is a direct measure of particle number, the causal driver of atherosclerosis. LDL-C measures cholesterol mass, not particles. You can have "normal" LDL-C (3.0 mmol/L) and dangerously elevated ApoB (>1.2 g/L). This is called "discordance" and occurs in 30-40% of patients, whose standard cholesterol panel reads as normal.

The European Atherosclerosis Society and Canadian Cardiovascular Society now recommend ApoB measurement. Most family practices do not order it because OHIP does not cover it.

Lipoprotein(a) [Lp(a)]:
Lp(a) is genetically determined. You cannot change it with diet or statins. Elevated Lp(a) (>50 mg/dL) causes approximately 1 in 6 heart attacks and is one of the strongest independent risk factors for cardiovascular disease. The 2019 ESC/EAS guidelines recommend measuring it once in every adult's lifetime.

Almost no one in Canada gets tested. Our physicians order both for every member.

It is a CT scan that directly visualizes plaque in your coronary arteries. Not a risk estimate—actual disease.

Traditional risk calculators (Framingham, ASCVD) estimate your 10-year probability of a cardiac event based on age, blood pressure, cholesterol, smoking, diabetes. They are population statistics applied to you as an individual. They are wrong 30-50% of the time.

A CAC score shows you what is actually in your arteries:
- CAC = 0: Very low risk. No detectable calcified plaque. 10-year event rate <1%.
- CAC = 1-99: Mild plaque. You have coronary artery disease. Aggressive risk factor modification indicated.
- CAC = 100-399: Moderate plaque. High risk. Statin therapy, lifestyle intervention, possible advanced imaging.
- CAC ≥400: Extensive plaque. Very high risk. May warrant stress testing, cardiology referral, intensive management.

50% of first heart attacks occur in people deemed "low risk" by traditional calculators. Many of them would have had detectable CAC years earlier.

The scan takes 10 minutes, uses minimal radiation (~1 mSv, equivalent to a mammogram), costs ~$150-300. We include it in your annual assessment.

Measurable biomarker changes and early disease detection.

We do not sell "feeling better." We sell quantified risk reduction:

Detection:
- In asymptomatic executive physical populations, 8-15% have clinically significant findings requiring intervention (occult malignancy, significant CAC, undiagnosed arrhythmia, severe metabolic dysfunction). These are people who "felt fine."
- Elevated Lp(a) is found in ~20% of patients—most have never been tested.
- Insulin resistance (elevated fasting insulin, HOMA-IR >2.5) is present in 30-40% of "metabolically healthy" patients. This precedes diabetes by 10-15 years.

Intervention:
- ApoB reduction to <0.7 g/L (or <0.65 g/L for high-risk) using lipid-lowering therapy where indicated
- CAC progression tracking to monitor plaque stability
- Insulin sensitization protocols (carbohydrate modulation, time-restricted eating, pharmacotherapy where appropriate)
- Inflammatory marker reduction (hs-CRP <1.0 mg/L target)
- Hormonal optimization based on objective lab values, not symptoms alone

The goal is not to make you "feel optimized." The goal is to identify and mitigate the pathophysiological processes that cause heart attacks, strokes, diabetes, and cancer, years before they would be detected by symptom-driven conventional care.

Urgent: same-day virtual. Routine: 24-48 hours in-office.

We cap our patient panel at 500 per physician (vs. 1,200-1,400 for a typical family doctor). This is not a marketing gimmick—it is the fundamental structural change that makes access possible.

At 500 patients, your physician can:
- Spend 45-60 minutes per visit (not 8)
- Respond to messages within hours (not days)
- Know your history without reading your chart for the first time during the appointment
- Actually think about your case between visits

We do not have waiting rooms because we do not overbook. Your 10:00 AM appointment starts at 10:00 AM.

We book it within days. We pay for it.

In the public system, you wait 8-12 months for a specialist. That is not a healthcare system—that is a rationing system.

We maintain a private specialist network in the Toronto area. When you need a cardiologist, endocrinologist, dermatologist, rheumatologist, or other specialist:
1. We send the referral with complete records (not a one-line fax)
2. We book the appointment within days, not months
3. We pay for the private consultation as part of your membership

You do not navigate the system. We bypass it.

We coordinate it immediately. You skip the 6-12 month OHIP queue.

When you need imaging, we:
- Write the requisition
- Book the scan with private imaging partners (usually within 1-2 weeks)
- Review the results with you directly

The scan cost itself varies:
- MRI: $600-$2,500+ depending on body part
- CT: $800-$2,800+
- Ultrasound: $200-$500+

This is a pass-through cost to you—we do not mark it up. What you are buying is the absence of a 6-12 month wait for "elective" imaging that might show you have cancer.

Yes. We operate fully within the Canada Health Act.

The Canada Health Act prohibits charging for "medically necessary" services covered by provincial health insurance. It does not prohibit parallel private services for:
- Enhanced diagnostics not covered by OHIP/AHCIP (e.g., advanced biomarker panels, CAC scoring)
- Speed and access (reduced wait times)
- Extended physician time
- Private specialist consultations
- Concierge-style availability

We do not bill OHIP for members. We provide a parallel private service. This is the same model used by dozens of concierge practices across Canada, including those affiliated with major academic health systems.

Yes. For business owners, this is typically 100% tax-efficient.

If you have a Private Health Services Plan (PHSP) or Health Spending Account through your corporation or employer, the medical services portion of your membership is typically an eligible expense. We provide itemized medical receipts.

Consult your accountant for specifics, but for most incorporated professionals (physicians, lawyers, consultants, business owners), Plunge membership is a deductible corporate health expense.

Downtown Toronto.

Your annual physical and in-person visits happen at our clinic in downtown Toronto. Most ongoing care (messaging, prescriptions, follow-ups, sick visits) is handled virtually, which is faster for you anyway.

Blood collection is available through Dynacare and LifeLabs sites across the GTA. Specialized imaging (CAC, VO2max, etc.) is scheduled at our partner facilities in Toronto. We coordinate the logistics.

Application only. We cap enrollment to preserve access.

We do not have unlimited capacity. The business model depends on maintaining a 500:1 patient-to-physician ratio. When panels are full, we close enrollment until capacity opens.

Sign up to the waitlist. We will confirm availability in Toronto and schedule an introductory call.