Beneath every Avina engagement sits a single accountable operator: the principal's Chief of Staff. The data centre. The single voice. The relationship that holds across the years.
What the role does
The day. Triage of every inbound that touches the principal. Coordination of clinicians and household. Quiet authorship of the day’s rhythm.
The week. Standing review with the principal. Standing brief to the family. Coordination of the four practices. Refresh of the plan against what changed.
The year. Authorship of the long arc. Movement between Avina’s four engagement states. Build of the bench around the principal: the right physician, the right counsel, the right companion, the right home, the right city.
Who the Chief of Staff is
The Chief of Staff is not a case manager. She is the most senior operator the firm fields. She has worked with principals for at least a decade. She has held quiet rooms in California, New York, London, Geneva. She does not appear on the website. She does not appear on the principal’s calendar as a meeting. She is the calendar.
One Chief of Staff per principal. No rotation. No shared coverage. The relationship is the work.
What sits beneath her
The Chief of Staff coordinates the four Avina practices, plus a curated network outside the firm: pain medicine, addiction medicine, psychiatry, primary care, surgical referral, legal counsel, family-office liaison, security, residence services, transport. Avina holds the contract. Avina holds the data. Avina holds the standard.
Engagement architecture
| Intake | The first thirty to sixty days. Chief of Staff embeds. Bench is built. Plan is authored. Companion daily. Physicians activated. Family briefed. 30 to 60 days |
|---|---|
| Active | The crisis window. Companion daily. Chief of Staff weekly. Coordinated clinicians. The principal is held while the work is done. As long as the case requires |
| Managed | The stabilised arc. Case manager and Chief of Staff fortnightly. Telehealth weekly. Companion as needed. The principal carries more weight. Three to twelve months |
| Steady | Maintenance. Chief of Staff monthly. Quarterly bench reviews. The relationship endures. The principal calls when they need to. Indefinite |
Begin
There is no booking page. No open diary. No intake funnel. A single enquiry form is read by the principal or her senior operator, and replied to within forty-eight hours.
The most senior operator
The Chief of Staff is not a case manager. She is the most senior operator the firm fields. She has worked with principals for at least a decade. She has held quiet rooms in California, New York, London, Geneva. She is the calendar, not a meeting on the calendar.
Read personally by the principal or her senior operator. Reply within forty-eight hours.