Human beings have presumably always aspired to live longer and healthier lives. Now this may be more possible than ever — especially if you have enough money.
Think of the Fountain of Youth. Versions of the promise of a life-giving spring date back to the philosophers of Ancient Greece, with variations over the centuries. But the basic concept was: find the spring, drink its water, and you will be young and full of vigor again.
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Today, people seem more inclined than ever to believe that there is a path to better health, greater longevity, and a longer healthy life expectancy.
To meet this desire, the longevity and well-being industry is growing.
On the scientific side, in addition to doctors in traditional practices, there are a growing number of premium medical clinics in all regions of the US that offer a wide range of services to those who can afford them. Created in the 1990s and expanding since then, they dispense with the use of health plans in favor of annual fees that can range from US$4,000 (R$19.6 thousand) to US$45,000 (R$221 thousand) or more.
General practice or family medicine physicians who have adopted these practices are not necessarily better trained than those who have remained in the traditional health plan-based model.
But they chose to see fewer patients, spend more time with each one and offer in-house services — such as imaging exams, for example — that would otherwise have to be outsourced.
According to the Private Physicians Alliance, a group that brings together doctors from these premium clinics, there are currently between 7,000 and 22,000 of these practices in the United States. By comparison, there are nearly 400,000 health plan-based physician practices, according to the Bureau of Health Workforce.
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Typically, a doctor in premium clinics sees around 20% (or less) of the patients than a doctor in the traditional model. This patient has the doctor’s cell phone number and greater access to his or her time.
The growing wellness industry does not have strict entry criteria. Therefore, in addition to trained doctors, there is also room for those working in the lucrative vitamins and supplements market, which has grown rapidly with the promise of improving health and prolonging life.
In 2024, this market was valued at US$192 billion. Supplements may include tablets, capsules, powders and chewable lozenges.
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Medications undergo rigorous evaluation by the Food and Drug Administration and are prescribed by doctors. Vitamins such as D, B-12, and iron may also be prescribed to treat specific deficiencies identified in blood tests.
Supplements — such as collagen, creatine and fish oils — undergo less rigorous testing and are generally consumed on one’s own initiative, rather than under a doctor’s prescription.
The FDA places greater responsibility for the effectiveness of these products on the manufacturers. The American Medical Association warned people not to place excessive reliance on supplements, which the FDA treats as foods rather than drugs.
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Supplements are often sold in monthly subscriptions and are often promoted by famous podcasters and influencers, who often earn income from these sales.
Steve Mister, president and CEO of the Council for Responsible Nutrition, a supplement industry association, said the average person spends $50 a month on supplements and tends to focus on more traditional ones with proven benefits, such as vitamin D, omega-3s and calcium.
While he worries about influencers who make promises without scientific backing, he also takes issue with doctors who dismiss lesser-known supplements without understanding them. “They are wary of these products because they don’t learn about them in medical school,” Mister said.
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Combining conventional medications and supplements can be complicated — for both patients and doctors.
“I had a patient who was on a statin, but she decided to add red yeast rice as a supplement to lower her LDL cholesterol,” said Dr. Cari Dawson, who runs the Colorado Center for Medical Excellence, a premium practice in Denver.
“The problem was that she started taking the statin every other day and took a supplement whose contents are not fully known. She chose red yeast rice instead of a statin that we studied 30 years ago.”
Dawson said he often debunked information people saw online about statins and supplements, arguing they had no scientific basis.
“There’s a lot of noise about statins on the internet,” he said. “Yes, about 5% of people will have muscle pain with them. We know that’s real. But 95% of people do well on this medication. And there are those who argue that everyone over 50 should take a statin to lower their cholesterol.” (She said she ultimately convinced the patient to stay on the statin.)
“The FDA does not allow supplement companies to market their products as substitutes for prescription medications,” Mister said. “I worry about misinformation all the time.”
Dawson said he understands, however, where this search comes from. “If someone has any distrust of the medical system, they tend to look for alternative treatments,” he said.
Anton Titov, founder of the Diagnostic Detectives Network, is against supplements and maintains that their advocates are driven by financial gain — in addition to exploiting people’s distrust in institutions far beyond medicine.
“You can sell billions in supplements and vitamins. To prescribe statins, you need to personally meet the patient. You can’t make money by telling people to take the maximum dose of statins to improve their cardiovascular health,” he said, about the supplement business.
His practice finds experts in specific areas to help clients resolve often complex medical problems. He said he charges a fixed fee of around US$6,000 (R$29,000), which increases if more specialists are needed or if there is a greater need to mediate the connection between patients and doctors.
To navigate the different approaches to longevity, a key question might be: What is the best way to invest money in my health to live well for decades to come?
Jordan Shlain, founder of Private Medical and considered one of the first premium clinic doctors, said the focus, regardless of wealth, is similar. Disregarding fatal accidents, there are four main causes of death: cardiovascular, neurological, cancer and metabolic, he stated.
“Your genetics are fundamental and account for 50% to 70% of your longevity,” Shlain said. “Then come the basic pillars: sleep, exercise, food and social nutrition. Sleep and social interactions are the most important aspects to prioritize.”
To manage care through non-traditional medical practices, patients should expect different experiences depending on price level. Although premium clinics generally have fewer patients, services can become even more personalized.
Some doctors are part of groups. MD2, which opened its first unit in Seattle in 1996 and now has offices across the country, limits its doctors to 50 patients and charges US$30,000 (R$147,000) per year.
Private Medical, founded by Shlain, charges US$45,000 (R$221,000) annually per patient and serves just 1,500 families in six units in California, Florida and New York. The Atria Health and Research Institute costs US$60,000 (R$295,000). Its two locations, in New York and Palm Beach, have in-house specialists including cardiology, neurology and women’s health.
“What sets our approach apart is our holistic focus on disease prevention,” said Alan Tisch, co-founder and CEO of Atria Health.
“We have primary care and 15 other specialties. We also work in lifestyle and psychology. We integrate the most advanced technologies in-house, so we don’t have to refer patients out. We’re here to keep you healthy, but we’re also responsible for providing the best care for you and your family when you get sick.”
Meanwhile, regardless of the type of medical practice chosen, Titov said two actions help anyone promote longevity: taking care of heart health and weight.
“Os GLPs [medicamentos injetáveis não baratos para controle de peso] are showing that several other diseases disappear when people lose weight. So reach your ideal weight and then exercise.”
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