Protective & Security
Protective Operations
Medical contingency planning integrated into advances, executive protection, and travel-risk programs.
Medical Risk & Contingency Planning
Medical contingency planning for complex operations.
Physician-led planning for environments where distance, uncertainty, logistics, or limited resources can turn a medical problem into an operational problem.
Off the X provides medical risk assessment, evacuation planning, contingency development, and operational advisory for security firms, corporations, family offices, travel teams, and other organizations operating in complex environments.
Built for Complex Operations
Medical planning that fits the operation—not the other way around.
Off the X adds the medical layer to complex operations: facility selection, evacuation pathways, decision triggers, team capability, and physician-level advisory.
Engage Off the X directly, or integrate us into an existing security, travel-risk, operations, or crisis-management team. Subcontracted and white-label support is available for security and risk-management firms.
Where Off the X Fits
When medical access, logistics, or uncertainty complicate the plan.
Support can be built around a single movement, a recurring program, or an ongoing operating requirement.
Travel
Executive & Global Travel
Planning for itineraries where local capability, transfer options, or continuity of care may be uncertain.
Remote
Austere Environments
Planning where definitive care is delayed, limited, or operationally difficult to reach.
Events
Special Events & High-Profile Movements
Medical readiness where timing, crowd density, visibility, or logistics raise the stakes.
Private
Family Offices & Private Clients
Preparation for principals and families whose travel or activities warrant a higher level of planning.
Organizational
Corporate Operations
Medical risk planning for teams operating across locations, jurisdictions, or constrained environments.
For Security & Risk Firms
Add physician-level medical planning without building it in-house.
Off the X can integrate behind an existing protective, security, travel-risk, or crisis-management team—supporting the operation without disrupting the client relationship.
01 / RelationshipYour client stays your client.
We support your team and do not independently market to or pursue your client.
02 / IntegrationWhite-label when appropriate.
Briefs and advisory support can be delivered in a way that fits your existing service model and client experience.
03 / TempoBuilt for operational timelines.
Short-notice advances and mission-specific briefs can be scoped around the tempo of the detail when capacity permits.
04 / DiscretionNeed-to-know by default.
Confidentiality, NDA support, and disciplined handling of principal and mission information are integral to the engagement.
Capabilities
A medical planning capability built around the mission.
Focused support for a mission, route, principal, site, or operating environment—from advance assessment through evacuation planning and execution support.
01
Medical Advance & Site Assessment
Validate hospitals, EMS, routes, and local medical resources before deployment.
02
Medical Contingency Plans
Mission-specific plans with clear triggers, transport options, communications, and roles.
03
Medical Evacuation Planning
Ground and air evacuation options, receiving facilities, transfer pathways, and triggers.
04
Protective Medical Support
Physician-level planning and advisory integrated with the operation.
05
Travel & Remote Operations
Planning for travel and operations where definitive care may be delayed or uncertain.
06
Exercises & Plan Validation
Tabletops, rehearsals, and review to test the plan before it is needed.
A Defined First Engagement
Start with a Mission Medical Brief.
A focused, physician-built planning package for a defined itinerary, movement, site, or operation—designed to give the team a usable medical plan before wheels-up.
Mission Medical Brief
A concise operational medical plan
Typical scope includes:
- Primary and alternate facility identification with capability review
- Ground and air evacuation pathways
- Clear escalation and decision triggers
- Communications, roles, and physician advisory framework
- Concise, operationally usable deliverable for the team
Standard turnaround: 72 hoursExpedited support available
Matthew V. Speicher, DO, MBA, FACEP
Founder · Physician · Operational Planner
Experience
This is what we did before it was consulting.
Off the X was founded by Matthew V. Speicher, DO, MBA, FACEP, a retired U.S. Navy Commander, emergency physician, former combat aviator, and former White House Medical Unit physician.
During more than three years with the White House Medical Unit across two administrations, Dr. Speicher served as Chief of Contingency Operations and personally advanced and planned medical support for presidential and vice-presidential travel. That work included evaluating receiving hospitals, emergency medical capabilities, evacuation options, and contingency pathways before principals arrived.
His operational medical experience also includes deployments with U.S. Special Operations forces in Africa and South America, where distance, logistics, limited resources, and uncertain access to definitive care were part of the planning environment.
Clinical judgment informed by operational experience
- Former Chief of Emergency Medicine at Walter Reed National Military Medical Center
- Fellow of the American College of Emergency Physicians (FACEP)
- Retired U.S. Navy Commander
- Former F-14 Radar Intercept Officer and F/A-18F Weapon Systems Officer
- Operational experience in executive, expeditionary, austere, and high-consequence settings
The Off the X Approach
Get ahead of the point where a medical problem becomes a mission problem.
“Off the X” comes from the operational principle of moving away from the point of injury or vulnerability when it is safe to do so. Our planning philosophy applies that same mindset upstream: identify the likely points of failure, reduce exposure, and build the next move before it is needed.
01 / AnticipateFind the medical vulnerabilities before the mission begins.
02 / PrepareBuild practical options with clear triggers and realistic resources.
03 / ActMake the plan understandable enough to use under pressure.
Start a Conversation
Bring physician-led medical planning to your next operation.
Tell me the mission, route, traveler, principal, site, event, or operating environment. Off the X can support a focused medical advance, build a full contingency plan, pressure-test an existing plan, or remain available as physician advisory during execution.
Email Matt