Upper, a natural-first medical system and technology marketplace based in Wilmington, is gaining momentum. 

Founded by CEO Sara Auld, a former fitness trainer and entrepreneur, Upper seeks to transform healthcare by building a network of local medical providers and offering patients a “natural-first” care plan designed to address the root causes of health issues.

“We created what is now just a natural-first medical system,” said Auld, “where before anyone goes to a traditional, drug-first doctor’s appointment, they can come to Upper and get their natural plan or prescription or option at no cost to hear that recommendation.”

Patients interested in a plan submit an intake form on Upper’s website and can speak with medical staff about a personalized care plan before deciding whether to pay for and begin the suggested care, which may include diagnostics such as labs and imaging.

As a natural-first system, Upper prioritizes avoiding pharmaceuticals and offers a range of options for those already seeking care or looking for lifestyle changes. Recommended plans could include homeopathy, vitamins and supplements, Auld said, along with lifestyle specialty care from registered dietitians, physical therapists or personal trainers. 

According to Auld, the company follows a fee-for-service model and says conventional care, including prescriptions, remains an option when needed. 

“You have options,” Auld said, “and to hear what that natural option is at no cost is certainly not going to make you worse or do you wrong.”

“You literally get what is essentially on a prescription pad, in a sense, all complimentary,” she said. “You only pay when you commit to care and decide to start attending any appointments.” 

The company’s technology and marketplace operations fall under Upper Health Inc., Auld said. Through Upper Medicine, the company contracts with a team of healthcare practitioners that currently includes registered nurses, a supervising physician, registered nurse doulas, a pharmacist and certified nurse midwives. 

Through a partnership with Port City Power Yoga, Upper also operates a midwifery clinic that provides full-term pregnancy care. The clinic is currently operating, though Upper is planning a launch event for Dec. 5.

“A lot of people think Upper is a wellness company. It is not. We are a medical company,” Auld said.

She added that the company aims to streamline communication among providers and services.

"We’re just bringing all of these resources together and creating a very streamlined process between all of them," she said, "from the physician to the labs to the personal trainer who’s never communicated with any of them on the other side of the city."

According to Auld, care is primarily in person in North Carolina, though some nurses can provide virtual care in other states through compact licenses and a physician authorization network.

Before founding Upper, Auld established Health Possible Inc. in 2017. The nonprofit, which grew out of her experience as a fitness trainer, provided financial assistance for wellness-related healthcare or what Auld calls “fitness as medicine” through a network of providers. 

Over time, the organization expanded to offer support for other natural-care services, including nutrition and mental health. 

In 2021, Auld received an initial $25,000 investment from a venture capitalist to take her idea into the for-profit sector. Upper follows the same model as Health Possible and shares the same goals: making natural-first medical care more accessible. 

So far, the company has been operating largely on sales, Auld said. She sees an opportunity to continue expanding the business and to replicate Upper’s model in other regions. She hopes to expand the company’s provider network across cities and eventually partner with universities to train future providers.

“If we can do that in any city, all across the country, your care is always local,” said Auld, “and Upper is essentially completely transforming care at a national level.”