Humans have – presumably – always strived to live longer and healthier lives. This is perhaps more possible than ever before – especially if you have enough money.
Think about the fountain of youth. Versions of the promise of a life-giving spring date to ancient Greek philosophers, with variations over the centuries. But the basic concept was: Find the source, drink its water, and you’ll be young and happy again.
Nowadays, people seem more inclined than ever to believe that there is a path to better health, longer life expectancy and improved healthspan – a term from the 1980s that suggests that quality of life and quantity can be more closely aligned.
Meeting this desire requires a growing longevity and wellness industry.
Typical of the science, in addition to doctors in traditional practices, is the growing number of concierge medical practices across the country that offer a wide range of services to those who can afford them. They started in the 1990s and have been expanding since then. You forego insurance and instead pay annual deductibles that can range from $4,000 to $45,000 or more.
The internal medicine or family medicine doctors who opened these practices are not necessarily better trained than the doctors who remained in the traditional insurance model practices. But they have chosen to see fewer patients, spend more time with them and provide in-house services – such as scans – that would otherwise have to be outsourced.
According to the Private Physicians Alliance, a membership group of concierge physicians, there are between 7,000 and 22,000 concierge physician practices in the United States today. That compares to nearly 400,000 insurance-based medical practices, according to the Bureau of Health Workforce.
Typically, a concierge doctor sees about 20 percent (or fewer) of the patients an insurance doctor sees. This patient has the doctor’s cell phone and has greater access to the doctor’s time.
The growing and expanding wellness industry has no entry criteria. So, aside from trained doctors, there is also room for those in the lucrative vitamins and supplements business, which has grown rapidly on the promise of improving health and longer lives. In 2024, the value was estimated at $192 billion. Dietary supplements can include tablets, capsules, powders, and gummies.
Medications are subject to strict review by the Food and Drug Administration and are prescribed by doctors. Vitamins such as D, B-12, and iron may also be prescribed to address specific deficiencies found during blood tests. However, supplements such as collagen, creatine and fish oils undergo less rigorous testing and are typically taken voluntarily and not prescribed by a doctor.
The FDA places more of the responsibility for their effectiveness on manufacturers. The American Medical Association has warned people not to place too much emphasis on dietary supplements, which the FDA treats as food rather than medicine. Supplements are often sold in monthly subscriptions and are often promoted by celebrity podcasters and influencers, who often generate income through sales.
Steve Mister, president and chief executive of the Council for Responsible Nutrition, a supplement trade group, said the average person spends $50 a month on supplements focuses more on long-established active ingredients such as vitamin D, Omega 3 and calcium.
While he worries about influencers who make promises that aren’t backed by science, he also objects to doctors who reject lesser-known supplements without understanding them. “They are suspicious of these products because they don’t learn about them in medical school,” Mr. Mister said.
Combining standard medications and nutritional supplements can be difficult – for both the patient and the patient Doctors.
“I had a patient who was taking a statin but decided to add red yeast rice as a supplement to lower her LDL cholesterol levels,” said Dr. Cari Dawson, who runs the Colorado Center for Medical Excellence, a concierge practice in Denver. “The problem was that she decided to take her statin every other day, and she was constantly taking a supplement that we don’t know what’s in it. She preferred red yeast rice to a statin that we had been studying for 30 years.”
Dr. Dawson said she often refuted what people saw online about statins and supplements, claiming the information had no scientific basis.
“There’s a lot of talk on the internet about statins,” she said. “Yes, about 5 percent of people get muscle soreness from it. We know that’s true. But 95 percent of people do well with this drug. And there’s the argument that everyone over 50 should take a statin to lower their cholesterol.” (Ultimately, she convinced the patient to stay on the statin, she said.)
“The FDA does not allow dietary supplement manufacturers to market their products as substitutes for prescription drugs,” Mr. Mister said. “I worry about misinformation all the time.”
Dr. However, Dawson said she understands where this search came from. “If there is someone who distrusts the medical system, they will always look for alternative treatments,” she said.
Dr. Anton Titov, founder of Diagnostic Detectives Network, is an opponent of dietary supplements, claiming that their proponents are driven by financial gains – and to exploit people’s distrust of institutions far beyond medicine.
“You can sell tons of supplements and vitamins. You have to see the patient to prescribe the statin. You can’t make money telling people to take the maximum dose of statins to improve their cardiovascular health,” he said of the supplement business. His practice finds experts in specialty areas to help clients resolve their often complex medical problems. He said he charged a flat fee of about $6,000, which increases if more experts are needed or he needs to do more to match patients and doctors.
To go through the different approaches to longevity, a key question might be: How can I best invest money in my health so that I continue to live well in the decades to come?
Dr. Jordan Shlain, the co-founder of Private Medical Considered one of the first concierge doctors, he said the focus is similar for everyone, regardless of wealth. Aside from fatal accidents, there are four major causes of death: cardiovascular, neurological, cancer and metabolic, he said.
“Your genetics are crucial and they account for 50 to 70 percent of your longevity,” said Dr. Shlain. “Then you get to those basic things: sleep, exercise, diet and social nutrition. Sleep and social interactions are the most important things to focus on.”
To manage care through non-traditional medical practices, patients should expect different things at different prices. While the patient load in concierge practices is generally lower, the offers can be made even more individual.
Dr. Ramon Jacobs-Shaw, a Harvard-educated physician with board-certification in internal medicine and pediatrics, is a private practitioner, generally defined as someone who works in private practice outside of a larger medical system. From his base in Fairfield County, Connecticut, he makes old-fashioned house calls and doesn’t see patients in an office. The cost for him to focus on you is $25,000 per year.
“The hallmark of patient care is the doctor-patient relationship,” he said. “Right now it feels transactional. Health care shouldn’t be like that. It requires a relationship, and that takes time.”
Some concierge doctors are part of practice groups. MD2, which first opened in Seattle in 1996 and now has offices across the country, limits its doctors to 50 patients and charges $30,000 a year. Private Medical, run by Dr. Shain co-founded, charges $45,000 per year for each patient and serves just 1,500 families across six locations in California, Florida and New York. The Atria Health and Research Institute costs $60,000. The two locations in New York and Palm Beach have their own specialists, including cardiology, neurology and women’s health.
“What’s unique about our approach is that we focus on disease prevention holistically,” said Alan Tisch, co-founder and CEO of Atria Health. “We’re primary care and 15 other specialties. We’re also lifestyle and psychology. We integrate the most advanced technology in-house so we don’t have to send you out. And we’re here to keep you healthy, but we’re also responsible for providing you and your family with the best care if you get sick.”
Regardless of which medical practice one chooses, Dr. Titov said the two things everyone can do to promote longevity are to focus on their heart health and weight. “GLPs [not inexpensive injectable drugs for weight management] show that when people lose weight, all of these other problems disappear. So reach your ideal weight and then exercise.”
Dr. Aaron Wenzel, a former emergency room physician and weight loss doctor, runs a concierge practice in Nashville that focuses on overall wellness. He charges $10,900 per year. “When I was doing emergency medicine, I had the realization that the only people I had ever seen improve their health were removing excess fat from their bodies,” he said.
While GLPs make it easier today, he said his practice focuses on helping people optimize their metabolism. It’s hard work, so he sympathizes with people who seek supplements as an easier route.
“I see many people, regardless of their economic strength, attracted by the noise of the new. But their diet, their fitness, their relationships are fragile.”
This, he said, is where people spend the most time and money.