Heart disease. Diabetes. Dementia.
The three diseases that determine most of how you live the second half of your life.
The FontaineMD Method is a preventive practice that addresses the root causes of these diseases through comprehensive heart and metabolic health evaluation, and precision hormone optimization.
The Problem
The standard physical was not designed to find these diseases early.
Heart disease, type 2 diabetes, and dementia do not begin the day they are diagnosed. They begin twenty years earlier, in quiet biology — arterial plaque accumulating without symptoms, insulin rising years before glucose ever moves, and metabolic and hormonal shifts that no annual visit is built to catch.
The typical physician visit is a brief encounter measured in minutes, anchored to population reference ranges that flag a problem only after it has matured. By the time a number falls outside "normal," the disease has often had two decades to develop. Reference ranges describe the average patient. They were never meant to describe your future.
What is missing is direct measurement, time, and the clinical judgment to interpret early signals, not wait for disease. That gap is the reason this practice exists.
The Method
Three systems. One integrated evaluation.
Heart disease, diabetes, and dementia share a small set of biological drivers. The FontaineMD Method evaluates and manages the drivers of all three in parallel. We measure then manage and prevent disease.
Vascular & cardiovascular health
- Carotid intima-media thickness (CIMT) and plaque
- Advanced lipid analysis including Lp(a)
- Vascular inflammation markers
- Bale-Doneen prevention method
Metabolic & insulin health
- Fasting insulin & HOMA-IR, OGTT
- InBody body-composition analysis
- Personalize nutrition using CGM
- GLP-1 & metabolic therapeutics
- Exercise and sleep optimization
Precision hormone optimization
- Testosterone in both men and women
- Menopause, perimenopause, PCOS
- Thyroid optimization
- Symptom-led titration
- Physician-directed dosing
- Prostate health and sexual function
thE difference
What we do differently.
| Retail / PCP/ Telemedicine | The FontaineMD Method | |
|---|---|---|
| Vascular imagingSeeing the artery | Rarely offered; risk inferred from a lipid number | In-office carotid ultrasound (CIMT) imaging the artery wall and plaque directly |
| Prevention frameworkThe model | Generic guidelines, reactive treatment, hormone adverse or not skilled in optimization | Treat multiple risk factors, not just lipids. Individualize treatment for prevention including heart attack and stroke risk reduction. Hormone optimization as an integral part of prevention. |
| Metabolic careInsulin first | Glucose & A1c after the fact. Too late by time intervention begins | Fasting insulin, HOMA-IR, InBody, OGTT, CGM, GLP-1 & nutrition plan. Optimize prior to disease |
| Cognitive baselineBrain health | Not assessed | Montreal Cognitive Assessment as part of the baseline |
| Treatment approachPhilosophy | Algorithm-driven, one-size protocols | Root-cause, arterial disease-led, physician-directed titration, early intervention |
| Who sees youContinuity | Rotating providers, minutes per visit | A physician who knows your data and stays with you |
Philosophy
We treat the patient in front of us — not a population average, and not a reference range.
— On clinical judgment
Measure what matters
Treat root causes, not numbers
Stay clinical, not algorithmic
Aim for the next thirty years
In-office carotid ultrasound — direct measurement of the artery wall.
If there is plaque, you have atherosclerosis which needs to be treated.
- In-office carotid ultrasound — we measure the artery wall directly, assess for plaque, in the room as part of your consultation. If there is plaque, you have atherosclerosis which needs to be treated
Where to begin
Two ways into the practice.
Pathway A
Cardiometabolic Evaluation -
The comprehensive entry into the practice. A single visit that measures and evaluates the systems that drive heart disease, diabetes, and dementia.
- In-office carotid ultrasound (CIMT and plaque)
- InBody body-composition analysis
- Sleep apnea screening
- Resting 12-lead EKG
- Montreal Cognitive Assessment
- Advanced cardiometabolic and hormone lab panel
- Personalized prevention strategy
Pathway B
Hormone Optimization
A focused program for patients whose primary concern is hormone health. Limited in scope, but may still be your most comprehensive evaluation yet.
- Advanced cardiometabolic and hormone lab panel
- Carotid plaque screening
- Hormone optimization with symptom-led titration
- Physician-directed treatment
- Physician-directed treatment
Begin with the evaluation
What you measure early determines what you can change later.
The Cardiometabolic Evaluation is the first step and the foundation of every plan we build. It is where root-cause prevention begins.
Schedule Your Evaluation