In concierge medicine, the doctor is always “in,” available instantly for check-ins between check-ups, but the conversations they are having in those check-ins and check-ups are changing. Longevity has transformed the concierge medicine equation, making the relationship less about being well now and more and more about staying well 20 years from now.
In turn, concierge doctors are transforming how the longevity markets manifest around the globe. With Johns Hopkins Carey Business School finding the number of concierge and fee-based primary care practices rising from 1,658 practices in 2018 to 3,036 practices in 2023, the path from high-end private care to longevity-focused medicine, their capacity to influence the future of longevity has never been bigger.
Tom Blue, who consults with the private care world through his OvationLab.com agency, calls longevity the biggest thing that’s happened in concierge medicine since he began following private practices in the late 1990s. Back then, the patient population was paying for the access. “They were willing to buy your cell phone and some extra attention,” he says.
Now, Blue says, they want an outcome with that attention. They want testing. They want interpretation. They want a partnership. And they are ready to spend money on it. “When I got started with concierge medicine, the most expensive practice, and I mean it was mind-bogglingly expensive, was a practice called Private Medical that used to charge $25,000 a year. Now there is a practice charging $200,000. And you can spend more than that if you want to go get some stem cells and other things on top of it.”
Dr. Ron Primas isn’t billing $200,000, but he sees the same drive. The Manhattan doctor says younger patients are filling his appointment book, many of them researching longevity science on their own before they come in the door. “I have a bunch of tech bros that are in their 40s who are patients and they say they are looking for longevity,” Primas says.
Much of what the concierge doctors are advising their patients comes from the same preventative playbook Primas and others preached for years, but now Primas employs a different set of tools and tests that focus on the longevity elements. He might start with a genomic scan to find risk factors. From there, he would employ the Horvath aging clock to analyze DNA methylation and then move on to metabolomics and proteomics. “That gives a good snapshot of where people are, and then from that point I use that as a learning tool, and I educate my patients and say, ‘Hey, this is where we need to make some changes.’”
The patients run through testing again six months later to see which changes worked.
Dr. Jennifer Timmons, a Southern California MD whose practice focuses on longevity at timmonswellnessmd.com, says her toolkit features “advanced labs” that would be far from routine for patients in insurance-covered care. That testing might include ApoB and Lp(a) tests for cardiovascular risk, genetic testing, hormone testing, micronutrient and microbiome testing, all utilized “to really understand more of what's going on in each individual's body.”
A typical doctor might recommend the standard 10,000 steps, but Timmons has her patients doing VO2 testing that was once available only to elite athletes. “In longevity medicine it's much more personalized, and we are able to tailor those recommendations to that specific person so that people can work smarter, not harder,” she says.
Such testing, in addition to the pharmaceuticals, supplements and additional services longevity-focused concierge doctors prescribe, becomes a primary and ongoing entry point to longevity for affluent early adopters. Blue says many concierge doctors include subscriptions to testing services like BioScope.ai in their plans. “You don't do a Bioscope and then walk away from it the next month. This is an asset that grows and evolves with you. It's very sticky,” Blue explains. While the longevity-curious consumer might be Googling for local longevity clinics or calling a full body scan company they saw on social media, concierge medicine patients are steered to services by their doctor. They are already motivated enough about their health to sign expensive subscriptions with their doctors that can make the extra testing and services look like an à-la-carte add-on.
The relationship between doctors and services like BioScope.ai is what makes “the delivery of multiomic personalized medicine feasible and scalable,” Blue says.
Primas sees the appetite for advanced testing every day. It’s not older patients dealing with the diseases of aging. It’s people who want to avoid those diseases entirely. “You're having single guys that now want to optimize their health. They have good jobs and they want to spend money on their health and be proactive.”
Not every concierge doctor is creating relationships with testing clinics that market longevity or outfits offering DNA scans. Dr. Ken Redcross services a wellness-motivated patient roster in New York, but he’s not prescribing high-tech tests. Patients are seeking the tests on their own. “People are bringing you their brain scans and full body scans,” he explains.
Redcross doesn’t always know what to tell his patients about the results, but he can still tap into the tests to drive new motivations around healthy lifestyles. “I love it when they bring it through because it allows even more discussion and education.”
Other doctors, Redcross says, might be eyeing revenue opportunities more closely. “I have buddies who have different practices, and they kind of partner with some of these companies,” Redcross says.
Some of the longevity conversations he and other concierge doctors are having with their patients, Redcross believes, were inspired by Dan Buettner’s Blue Zones book and Netflix series, but a lot of it is coming from a general buzz around healthspan. Wherever it’s coming from, he likes it. Redcross lists off “trust, respect, empathy, and communication” as the pillars of his practice. “Longevity fits all four of them perfectly for the things that I think matter most.”
It is in the concierge care relationship Redcross describes that the leading edge of the longevity market continues to evolve. The testing and services that find traction in the private medicine model are typically ones that will trickle down to a wider consumer pool. Investors, entrepreneurs and product developers need to watch the concierge quadrant closely.
Blue says the writing on the wall is clear. Concierge care is growing and it’s growing the longevity consumer base. “You've got more and more affluent people, and even semi-affluent people who are interested in longevity, wanting this type of medicine, and nowhere near enough providers to service them.”