Longevity Clinics: Finding Balance Between Science and Marketing

When I read the recent New York Times article about high-end longevity clinics, I was reminded of a conversation I had with a couple from Florida. They had flown into the Maryland area where my integrative medicine practice is, specifically to ask about full-body MRIs as a preventive health measure.

"I'm sure they pick up cancers occasionally," I told them. "But about 20% are false positives, and in medicine, you have to follow up on those findings."

This means another MRI in a few months, the mental anguish of waiting for results, appointments with specialists, and more tests. Each step in this cascade has its own cost—not just financial, but emotional and temporal as well.

The True Cost of "Peace of Mind"

The New York Times story highlights individuals paying upwards of $20,000 annually for comprehensive screenings and personalized health recommendations. Some of these patients describe the experience as being "turned inside out" to look for potential health issues. While this thoroughness can feel reassuring, it often leads to what we call "incidentalomas"—findings that would never have progressed to affect someone's health but, once discovered, can lead to unnecessary interventions.

As Dr. Deborah Korenstein of Mount Sinai notes in the article, we often hear anecdotes about lives saved by extensive screenings, but we don't see the much larger number of people who undergo testing without meaningful benefit—or worse, experience harm from the cascade of follow-up procedures.

Finding the Balance

As an integrative medicine doctor, I focus on what makes the most meaningful difference to health and longevity. Before considering expensive and unproven therapies like hyperbaric oxygen or plasma exchange, I encourage patients to master what I call the "Four Pillars" of health:

1. Nutrition: The food choices you make daily have the most profound impact on your long-term health

2. Movement: Regular physical activity supports virtually every bodily system

3. Sleep: Quality sleep is essential for cellular repair and cognitive function

4. Mental Resiliency: How you manage stress and maintain social connections directly affects physical health

   
   

These foundational elements cost little to nothing yet offer proven benefits for extending not just lifespan but healthspan—the portion of life spent in good health.

When Advanced Testing Makes Sense

There are certainly situations where more extensive testing is warranted. If you have a strong family history of certain conditions, particularly early-onset diseases, the risk-benefit calculation changes significantly.

For example, someone with multiple first-degree relatives who developed colorectal cancer before age 50 would absolutely benefit from earlier and more frequent screening. In such cases, specialized tests like the Grail blood test (which screens for multiple cancers) or targeted imaging may be appropriate.

I do have patients who choose comprehensive annual screenings because they value the information, regardless of actionability. As one patient told me, "I just want to know what's going on inside." That's a valid personal choice, provided they understand the limitations and potential downsides.

The Question Worth Asking

I think the most insightful comment from the Times article came from Joe Nevin, a 78-year-old who runs a seniors ski program. While dismissive of the term "longevity," he nevertheless asked a fundamental question: "How do you know you're healthy?"

This gets to the heart of what medicine should be about. Rather than pursuing an ever-lengthening list of expensive tests and treatments, we might be better served by defining what health means to us personally and focusing our efforts there.

If you're able to engage in activities you enjoy, maintain meaningful relationships, and function well physically and mentally—isn't that a more meaningful measure of health than a battery of tests showing the absence of disease?

Moving Forward Thoughtfully

Before diving into expensive longevity programs, consider starting with optimizing those four pillars. If you're sleeping poorly, eating a diet heavy in ultra-processed foods, sitting most of the day, and chronically stressed, those are the areas where intervention will yield the greatest returns.

Once you've established those foundations, you'll be in a much better position to evaluate whether additional screenings or treatments align with your health goals and values.

The true path to longevity isn't found in a hyperbaric chamber or plasma exchange. It's found in the daily choices we make about how we eat, move, rest, and connect with others. Get those basics right first, and then we can talk about what’s next.