Primary care, kept on the clock.
Chronograph is a small direct primary care practice on Duluth's West End. We charge a flat monthly fee, post our prices, take ninety minutes for a first visit, and answer the phone when you call. Every encounter is logged like a heat: timestamp, splits, debrief.
Lane assignments
Eight protocols, one panel.
A direct primary care practice doesn't need a service line — it needs a clinician who keeps reading. Each lane below is a protocol our team has rehearsed enough that we can hold its splits in our heads and tell you what's tracking and what isn't.
Cardiometabolic
Lipids, blood pressure, prediabetes, MASLD. Continuous glucose monitors when they earn their keep; statins when the math says yes; food before pharmacology where the math says maybe.
Musculoskeletal
Tendinopathy, low back, knee, shoulder. Office-based ultrasound, dry needling on Wednesdays, a working relationship with two physical therapists who actually return calls.
Mental health
SSRIs, SNRIs, the rest of the alphabet. Buprenorphine without theater. Half-hour visits as standard, not as concession; warm handoffs to therapy that we don't outsource to a portal.
Reproductive
Contraception across the board including IUDs and implants. Cycle troubleshooting. Pre-pregnancy planning. Miscarriage care without a chaperone of strangers.
Pediatric & young adult
Well-child from age 5 onward; transition-of-care visits at 18 and 22. Sports physicals, ADHD continuation, the conversations young adults dread but need once.
Perimenopause
Tracking, sleep, vasomotor, mood. Hormone therapy when indicated, against a backdrop of the 2022 Menopause Society position statement. Honest about what we don't know yet.
Sports & performance
Grandma's Marathon training panels, hockey concussion follow-up, Birkie skiers, North Shore trail-runners. Lactate testing once a season; gait video when it earns its scroll.
End of life
Palliative coordination with St. Croix Hospice and Solvay; advance directives written in plain English; house calls within Duluth city limits during the last fortnight.
Recent splits
The board, redacted.
A handful of recent encounters, scrubbed of identifying detail and filed by lane. Full case logs — methodology, splits, what went sideways, how it was caught — live on the splits board.
The membership
Flat fee, no insurance theater.
$95 per adult per month; $45 per dependent under 22; no copays, no claims. Keep your high-deductible plan for hospital, surgery, and specialists; we are the part of your care that should not require permission.
90-minute first visit
Long enough to actually take a history. Subsequent visits run 30–60 minutes; we don't book in 7-minute increments because nothing important fits.
Direct cell access
Your clinician's mobile number. SMS for short questions, voice for the rest. Median reply time, business hours: 19 minutes.
In-house labs at cost
Wholesale Quest pricing posted on the wall. CBC at $4.10. Lipid panel at $5.95. No mark-up; we list what we pay.
Generics dispensed on-site
Roughly 240 generic medications stocked at our acquisition cost. Lisinopril 20 mg: $1.40 for ninety. Sertraline 50 mg: $3.85.
Clinicians
Five people, one panel.
A primary care panel of five — three clinicians and two operators — capped at 480 members. Below cap and we breathe; above cap and the splits stretch. We keep below cap.
Elin Marek, MD
Founder · internal medicine · adult primary
Trained at the University of Minnesota, residency at Hennepin. Worked seven years at Essentia before walking out in October 2022 with the patient list and a borrowed photocopier. Reads Atul Gawande, Aldo Leopold, and the New England Journal in roughly that order.
Oren Vass, DO
Sports & musculoskeletal
Marquette undergrad, Des Moines DO, fellowship in primary-care sports medicine at Mayo Rochester. Two-time Birkie finisher. Carries the office point-of-care ultrasound himself and logs every scan in an OBS folder.
Jules Armitage, FNP-BC
Reproductive & perimenopause
Twenty years on the labor floor at St. Mary's Duluth before family practice. Trained in IUD insertion since 2008. Holds a quiet grudge against the way perimenopause is taught in nursing school.
Satya Nair, PMHNP-BC
Mental health · MOUD
Came to Duluth from a community mental health center in St. Cloud. X-waivered until that requirement disappeared in late 2022; now an unrelenting evangelist for buprenorphine in primary care.
Visit
Where we are. When we open.
A second-floor walk-up above the East Hillside post office, four blocks from the Aerial Lift Bridge. Free street parking on Garfield. The 23 bus from the Duluth Transit Authority stops at the corner.