Modern healthcare has never been more capable. There are more specialists, more sophisticated diagnostics, more treatment options and, for those with the means to access private healthcare, seemingly endless choice. And that is precisely where a new problem has emerged.
— When something goes wrong, patients and their families are often expected to decide which specialist to see, which opinion to trust, which investigation is genuinely necessary, how urgently they need to act, and how all the different pieces of their care fit together.
The family becomes the manager of a project they were never trained to own.
Serenity Medical Fiduciary was created to take ownership of that complexity.
During a recent conversation with Xraised, Serenity co-founder Dr. Michael Averbukh described the problem through an unlikely analogy: Buridan’s donkey, the centuries-old philosophical thought experiment in which a donkey stands equally hungry and thirsty between hay and water but, unable to decide which need to address first, remains paralysed.
Modern private healthcare can create a surprisingly similar dilemma.
“Imagine you have a medical problem, and you have the means to access private care. You have endless options. Everything is open. You have a humongous number of doors that you know lead to something. You just cannot see the end of the corridor. This inability to decide what fits me paralyses me.”
Access, in other words, is not the same thing as direction. Having the ability to see almost any specialist does not tell someone which specialist they should see. Being able to obtain numerous opinions does not tell them which opinion to trust. And having access to excellent hospitals does not mean that anyone is taking responsibility for the medical journey as a whole.
That is the gap Serenity was built to address.
From Healthcare Concierge to Medical Fiduciary
Serenity’s model begins with a different question. Not what can we arrange for you, but what is actually in your best interest.
The distinction is fundamental. A traditional concierge can facilitate access. A Medical Fiduciary assumes a much broader responsibility: understanding the individual, seeing the whole medical picture, helping determine the appropriate path and remaining alongside the member as circumstances evolve.
Every Serenity member has a dedicated medically qualified case manager and access to primary care oversight. The relationship begins before a crisis occurs. The team learns the member’s medical history, family circumstances, concerns, preferences and priorities. Over time, that knowledge becomes increasingly valuable because every new decision is made within the context of what has come before.
“We get to know our clients before something happens,” Averbukh explained. “Whatever happens through the time, we are always one phone call, one email, one message away. And the client gets a one-pathway access to a case manager that knows them deeply.”
The objective is not simply to provide access to healthcare. It is to provide continuity, judgement and ownership of the medical journey.
The Human Being Behind the Medical Problem
That ownership also requires something that cannot easily be captured in a service specification. Trust.
Averbukh recalled a recent conversation with a Serenity member who was going through an extremely difficult period. He was not calling because he needed Serenity to identify the best surgeon or arrange another consultation. He simply told the team that he needed somebody to talk to. He needed, in his words, a hug.
Medicine is increasingly supported by extraordinary technology. Artificial intelligence will undoubtedly make information, analysis and elements of clinical decision-making faster and more sophisticated. But healthcare remains deeply human.
“The fact that somebody can expose that side of vulnerability towards a case manager who knows them shows how important the human side of the service is,” Averbukh said. “You can say it to GPT or Claude. But you will not get the hug in return.”
Serenity therefore combines clinical knowledge and modern technology with something much older: a trusted healthcare professional who knows the person behind the medical record.
A Culture Built Around Learning
The philosophy behind Serenity also comes from more than three decades of clinical and healthcare leadership experience. Averbukh is a fourth-generation physician whose career has included volunteering in an emergency department while still at university, ambulance work, treating patients in combat, internal medicine, teaching junior doctors and eventually managing hospitals.
Yet one of the principles brought into Serenity from that experience is not that experienced clinicians know everything.
“Each and every mistake that I made was a lesson,” he said. “This learning process made me a better physician, a better person, and a better manager.”
That philosophy has become part of Serenity’s internal culture: accepting that healthcare is complex, continuously learning and improving the way the organisation supports the next member. The goal is not perfection. It is to build an organisation that constantly becomes better at protecting the interests of the people who have entrusted it with their health.
The Right Door, at the Right Time
The consequences of fragmented healthcare are not merely administrative inconvenience. Choosing the wrong pathway can mean unnecessary consultations, duplicated investigations, conflicting opinions, delays and considerable anxiety.
Serenity’s role is to help identify the right solution for that particular person, at that particular moment.
“You need the right person to get you to the right solution within a timeframe that suits your clinical condition, suits your will, suits your own busy schedule,” Averbukh explained. “This is what we are trying to solve.”
That can involve clinical guidance, specialist selection, coordination between physicians, interpretation of recommendations, administrative support, insurance navigation or simply helping somebody understand what should happen next. The greater value comes from having one trusted point of medical oversight across all of them.
Treat Your Health the Way You Treat Your Wealth
People with complex financial affairs rarely wait until something has gone badly wrong before speaking to a trusted adviser. They establish the relationship beforehand. Their adviser understands their circumstances, objectives and tolerance for risk.
Yet healthcare is often managed in precisely the opposite way. People wait until something happens. Then, often while frightened, unwell or under considerable pressure, they begin navigating an unfamiliar system from zero.
Serenity believes health deserves at least the same degree of foresight and stewardship as wealth.
“Treat your health with at least the same seriousness that you treat your wealth,” Averbukh said. “Plan it. Sit with somebody who can support you through the journey. And then have this trusted person near you along the way, providing the best clinical advice and the best personalised advice to you as a human being.”
That is ultimately the idea behind Serenity Medical Fiduciary. Not another specialist. Not another directory of healthcare providers. Someone who knows you, understands the system, protects your interests and remains beside you when the decisions become difficult.
Because the moment something goes wrong should not be the moment you begin looking for someone you can trust.
About Serenity Medical Fiduciary Group
Serenity Medical Fiduciary Group is a clinician-led healthcare organisation operating across London, Lisbon and Barcelona. Founded in 2021, Serenity provides its members with dedicated medical case management, primary care oversight and continuous guidance through increasingly complex healthcare systems. Its Medical Fiduciary model is built around a simple principle: the member’s interests come first. Serenity was recognised by Healthcare Business Review Europe as a Top Healthcare Concierge Service in Europe for 2026
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