Rose · Theory of Constraints · Working Plan

Rose Constraint Plan

The full logic chain from goal to launch: Goal Tree, Current Reality, the conflict we evaporated, the Future Reality Tree with its negative branches, and the sequenced project plan with decision gates. One rule governs everything here: work the constraint, and only the constraint.

Anchored Aug 23, 2026 Launch Oct 1, 2026 (async) HRT lane Dec 15, 2026 (buffer → Jan 15) Capital req. ~$1.2M total

Step 1 · Goal Tree

The destination, stated so it can be tested

Read top-down with necessity logic: in order to have the Goal, we must have each Critical Success Factor. Every entity is a state of being, not an action. The model (v10, being updated to v11) is the gold standard for all numbers.

THE GOAL — By Month 12 from launch, Rose is a profitable, exit-track telemedicine company in menopausal metabolic health: ~$13M+ first-year revenue, ~12,500+ active patients, EBITDA-positive by mid-year, powered by a completed $1M+ raise — with the $300K already raised preserved as buffer.

THE GOAL $13M+ Y1 · exit-track · $1M+ raised CSF-1Compliant care machine CSF-2Acquisition engine CSF-3Retention holds LTV CSF-4Capacity scales CSF-5Cash + exit-ready books
The five conditions without which the Goal is arithmetically or legally impossible. Arrows read: "in order to have the Goal, we must have…"
CSF-1

A legally compliant care-delivery machine is operating

  • 5 Axis agreement signed — doctors, Rx software, pharmacy (async lane)
  • Own HRT doctor network built & trained (Trevor & Gabriel)
  • Protocols documented and legally reviewed
  • DEA posture maintained (flexibilities → special registration)
CSF-2

The acquisition engine delivers at target CAC

  • CTV at guaranteed $300 CAC (terms papered)
  • Meta ~$300 CAC; Google $700 → $500 → $250
  • Podcasts booked Oct, air at HRT launch
  • TikTok organic farm operating
CSF-3

Retention holds the LTV math

  • Async ~16-mo lifetime; HRT ~48-mo; ≤4% blended churn
  • App live as the retention driver (NC — off critical path)
  • Refill / follow-up ops frictionless
  • Async intake flags HRT-eligible patients for upsell
CSF-4

Clinical & fulfillment capacity scales with growth

  • Clinician supply grows with patient count
  • Pharmacy ship times hold as volume 10×s
  • Support at ~$5/patient/mo
CSF-5

Cash never goes below zero; books are exit-ready

  • $300K buffer preserved; raise to ~$1.2M total before Nov commit
  • Spend gated on CAC actuals (G2)
  • Clean records, KPIs, cap table from day one

Step 2 · Current Reality → Step 3 · The Cloud

The constraint was a decision loop — and it broke

Holding the Goal Tree against reality on Aug 23 exposed seven gaps, and every cause-and-effect chain converged on three root causes: the unsigned 5 Axis agreement, capital frozen as buffer, and a deck that contradicted the model. They interlocked — can't spend before signing, won't sign before raising, can't raise on a falsifiable deck. The constraint wasn't money or a vendor; it was an unresolved decision loop. Two of three root causes died by decision: 5 Axis signs Mon Aug 24, and the buffer no longer blocks spending. The third — the deck — is now the single gate on the next $100K.

A · GOAL $13M+ Y1, exit-track B · Launch & scale NOW clock started Aug 1 C · Protect the LTV math 30% HRT · 48-mo lifetime D · Launch async-only peptides/GLP-1 via 5 Axis D′ · Wait for HRT lane own network, not built CONFLICT — evaporated bad assumption: "scaling before HRT breaks LTV"
The cloud evaporates on three facts from the model itself: async is already 70% of acquisition; HRT mix converges if the lane opens by Month 3–4; and 50% of patients stack both therapies — so async launch feeds HRT, it doesn't detour from it.

Step 4 · Future Reality Tree

Six injections that produce the goal

Read bottom-up: if injection, then effect. Each was checked for negative branches — the side effects are listed in the risk watchlist, each with a mitigation task in the plan.

InjectionEffect it produces
I-1 Sign 5 Axis (Mon Aug 24) with continuity terms reviewedAsync care is deliverable: doctors + Rx software + pharmacy
I-2 Model v11 + deck rebuilt (<12 slides, disruption-led, injectable-testosterone story, aligned numbers)$100K closes in ~14 days; raise credibly continues to ~$1.2M total
I-3 September build month: brand / site / funnel live on 5 Axis rails; intake flags HRT-eligible patients from day oneAds have somewhere to send patients Oct 1; upsell list accumulates from the first patient
I-4 Oct 1 launch, async-only: $45K spend (Meta $10K · CTV $25K · Google $10K)First revenue in October; channel CACs proven before real money deploys
I-5 Nov $350K → Dec $400K, committed only through Gate G2 (CAC actuals + capital in hand)Patient base compounds toward the 12-month goal — the back-loaded months do the work
I-6 Trevor & Gabriel build the HRT network in parallel; podcasts booked Oct, air at HRT launch (~Dec/Jan)HRT lane opens Month 3–4; flagged async patients convert on day one; blended LTV reaches $5,365

The economics under the committed media plan

Channel-level CACs (CTV guaranteed $300 · Meta ~$300 · Google $700 → $500 → $250) blend to roughly $343 → $309 → $293 over the first three months — higher than the model's $240, but payback stays under ~3.3 months against $103 contribution per active month, and LTV/CAC holds near 17×. Directional 12-month simulation (to be confirmed by model v11):

MoAd spendNew patientsActives (end)RevenueNet cash flowCumulative cash*
Oct45,000~18018020K−94K306K
Nov350,000~1,2301,400180K−364K−58K
Dec400,000~1,5102,860484K−285K−343K
Jan~410,000~1,5604,300814K−168K−511K
Feb~408,500~1,6105,7401.14M−27K−538K ← trough
Mar~417,500~1,7107,2201.47M+110K−428K
Jun400,000~3,93014,2402.84M+655K+887K
Sep400,000~1,61018,1604.03M+1.27M+4.29M

*Cumulative cash shown from a $400K start ($300K raised + first $100K). 12-month revenue lands near $20M+ — comfortably past the goal — but the plan is cash-negative to a trough of ~−$538K in Month 5. Total capital required: ~$940K for a zero floor, ~$1.19M to keep a $250K floor. This is why the $1M+ raise target and Gate G2 exist: the Nov $350K commit is only made with ~$1.2M total capital secured.

Step 5 · Prerequisite Tree → Project Plan

The sequenced plan, with gates

Every obstacle became an intermediate objective; the objectives are sequenced on the critical chain. Only four things are on the critical path to first revenue — everything else runs parallel or waits.

SEPOCTNOVDECJAN Capital Launch engine Paid media HRT lane Product model v11 + deck → $100K → raise to ~$1.2M (by G2) sign 5 Axis → onboarding · funnel · site · CTV contract · creative $45K proof$350K$400K → scale med director · recruit · train · legal/DEA · malpractice OPEN Dec 15buffer → Jan 15 app ships when ready (off critical path) · TikTok farm · team hires G1 G2 G3 G4
Five workstreams, four gates. Solid bars are committed work; the dashed bar is the HRT buffer. Gates G1–G3 are go/no-go decisions; G4 is the DEA regulatory checkpoint on Dec 31.

Week by week

WhenWhatOwner
Mon Aug 24Sign 5 Axis. At signature: confirm implementation timeline, continuity/exit terms, onboarding checklist. Kick off onboarding same week.Max
Aug 24–28Model v10 → v11: October anchor, committed media plan ($45K/$350K/$400K), channel CACs, capital requirement (~$1.2M).Max + Claude
Aug 25–31Deck rebuilt from v11: <12 slides + appendix, led by the injectable-testosterone disruption story (not CAC), 5 Axis CEO off the advisor slide, slide-14 HRT claim corrected to own-network build, DEA posture kept.Max + Trevor
Sept 1–7Close the next $100K with the corrected deck (9 investors already in diligence). Raise continues toward ~$1.2M total — hard deadline is G2 (Oct 28).Max
Sept (all month)Build month. 5 Axis onboarding: intake, prescribing workflow, pharmacy routing, payments end-to-end. Brand/site/funnel live with tracking; intake flags HRT-eligible patients. CTV deal papered — the $300 CAC guarantee's exact terms in writing. Ad accounts, pixels, creative. TikTok farm setup. First team hires ($40K/mo staged).Max + Idan
Sept (parallel)HRT workstream kickoff: medical director search, DEA-registered physician recruiting, training program (Gabriel's clinical education), telehealth-testosterone legal review, malpractice, injectable pharmacy sourcing.Trevor + Gabriel
G1 · Sept 26Launch-readiness gate: funnel converts end-to-end, payments live, tracking verified, creative approved, CTV contract signed. Pass → launch Oct 1. Slip tolerance: Oct 15 drop-dead before podcast booking cascades.All
Oct 1LAUNCH Async lane live. $45K: Meta $10K · CTV $25K · Google $10K. October is the proof month — expectation set with co-founders and investors: ~150–200 patients is success, not a flop.Max
Early–mid OctBook podcasts (SHE MD, Well Beyond 40, Everyday Wellness, Bossticks) for Dec/Jan air — 4–8 week lead times put booking on the critical path even though airing waits for HRT.Max
G2 · Oct 28Scale gate for Nov's $350K: (a) blended CAC ≤ ~$325 actual, (b) total capital ≥ ~$1.2M, (c) 5 Axis fulfillment SLAs holding. Any miss → hold spend flat, fix, retest in 2 weeks.All
Nov$350K spend (CTV $300K on guarantee). HRT network finalized: physicians credentialed & trained, protocols legal-reviewed, malpractice bound.Max / T+G
G3 · Nov 25HRT go/no-go: network ready, DEA rule status confirmed, podcast air dates locked. Pass → open Dec 15.T+G
Dec$400K spend. HRT lane opens Dec 15 (buffer to Jan 15). Podcasts air. Flagged async patients get the day-one HRT upsell. App retention features live before Month 3 if ready.All
G4 · Dec 31DEA flexibilities expire. If the Special Registration final rule isn't in effect: switch to fallback (in-person referral partners, per deck posture) without pausing the async lane.T+G
Jan 2027 →Scale per model v11. Monthly constraint review: "where is the constraint now?"All

Negative Branches

Risk watchlist

DEA timing collision — flexibilities expire Dec 31, 2026, the HRT launch window

Fourth temporary extension runs through Dec 31, 2026; Special Registration final rule still pending. Mitigation lives inside the HRT build: special-registration readiness, in-person referral fallback, monthly rule-status check (G4). Owner: Trevor + Gabriel.

Cash trough of ~−$538K in Month 5 under the committed media plan

The plan needs ~$1.2M total capital for a $250K floor. G2 exists so the $350K November commit is never made on hope. If the raise stalls, spend holds at October levels — the goal slips, the company doesn't.

"Guaranteed $300 CAC" on CTV — structure unknown

$300K/month rides on this guarantee. Get it papered in September: pay-per-acquisition vs. make-good/rebate, attribution definition, caps, and exit rights. A make-good refunds media; it doesn't refund the month of runway.

Single-vendor concentration — 5 Axis is doctors, software, AND pharmacy

One dispute or failure hits all three at once. Mitigations: continuity/exit terms reviewed at signature; the own HRT network build doubles as the hedge; CEO removed from the advisor slide (decided).

Proof-month optics

$45K at ~$343 blended CAC ≈ 130–180 patients in October. Set that expectation with co-founders and investors in advance so a controlled proof month never reads as a miss.

The Constraint Moves

Where the bottleneck goes next

A constraint broken is a constraint relocated. The monthly review question is always the same: what single factor most limits the rate of reaching the goal right now?

PeriodLikely constraintWhat "exploit & elevate" means then
Now → SeptIntegration & build time (5 Axis onboarding, funnel)Daily standups on the build; nothing else gets founder attention
OctCapital (the G2 requirement)Raise is the CEO's #1 job; everything else delegates
Nov → JanHRT clinician capacity + regulatory postureTrevor & Gabriel's network build; G3/G4 discipline
2027Acquisition cost / market responseChannel diversification, podcast flywheel, retention → LTV elevation