I visited the Fountain of Youth several times as a child. St. Augustine, oldest city of European origin in North America (1565), is full of tourist attractions directed primarily at children, from the Old Jail to Potter’s Wax Museum, to the remarkable Castillo de San Marcos. The latter is the only one that still has legs, so to speak, but the Fountain of Youth is still there, with archaeology to prove something about the site. And it has worked in at least one case. So far, I am not dead. Yet. And I really don’t feel that old, most of the time.
In the twenty-first century, the search for the Fountain of Youth has morphed into the Longevity Movement. The most famous longevitist among us is probably the tech bro Bryan Johnson, who has turned his multi-million dollar quest to live forever [1] into a business and public persona (see this Business Insider story and Netflix trailer; no Netflix in this house, so I have no idea if this film is worth the trouble).
Major health care institutions are getting into the business now, including Northwestern Medicine, Weill Cornell, and the Mayo Clinic, as explained in this article by Sarah Todd from STAT News, Can you live longer for $5,500? Longevity Clinics are the buzzy new trend at nonprofit hospitals (no archived version yet):
I was walking briskly on a steep treadmill, wearing a mask that evoked the villain Bane from “Batman.” Prince crooned back-handed compliments over an iPad speaker to keep my energy up, promising I had to be neither rich nor cool to be his girl. Every so often, the woman standing next to me asked me to point at the color-coded sheet ranking my state of exertion from 1 (roughly, “I could do this all day”) to 10 (“I not only hate this but am about to keel over if you don’t slow this thing down”). The goal was to get to 10. Pushing myself to achieve difficult physical goals does not come naturally. I can’t go on, I thought. I went on.
This was the VO2 Max test, which shows how efficiently the body uses oxygen (“V” stands for volume, “O2” for oxygen) and is considered medicine’s most accurate measure of cardiorespiratory fitness. It was the last in a barrage of assessments I’d undertaken at a shiny longevity clinic affiliated with Northwestern University — part of a $5,500 annual package.
The Northwestern longevity clinic opened in July 2025, to be followed by Weill Cornell, and the Mayo Clinic. Weill Cornell has two tiers for their longevity clinic ($12,000 and $7,500). The original Mayo Clinic in Rochester, Minnesota, charges what it can to insurance, which means that out-or-pocket costs vary. I suppose a member with a so-called platinum health plan will have lower co-payments. The Mayo Clinic in Jacksonville, Florida, opened a longevity clinic that costs a mere $45,000 a year.
It is not too difficult to understand the allure of these clinics, which remind us of those far off clinics in Switzerland and other exotic locations that promise health. As the author puts it:
The clinics have what may be an even more rare and tantalizing offering in the U.S. health care system: compassionate, leisurely, collaborative conversations with health care professionals who give tailored personal advice on how to overcome the real-world obstacles that get in the way of exercising, eating well, prioritizing sleep, and doing all the other things we know are good for us.
Who does not want this, which should be common medical practice, absent the “leisurely” part? This, of course, is also the promise of functional medicine practices, where self-paying clients are counseled at length in comfortable earth-toned offices on what is preventing them from meeting their obvious but, alas, unrealized potential. As we have noted here before, the term for functional medicine that works is just plain “medicine.”
Among the tests Ms. Todd had at the Northwestern clinic in addition to her VO2 test were several that would reveal her biological age, something she could then compare with her chronological age to see how she was doing. We can leave aside for today if biological age is real. [2] These tests include a DEXA scan to measure visceral fat, muscle mass, and bone density and an electrocardiogram to check out her heart. Her aortic and femoral artery pulses were compared to check the stiffness of her arteries. Ms. Todd was also subjected to parts of the Montreal Cognitive Assessment, which was designed to identify early signs of dementia. An olfactory test measured whether she is aging too rapidly. All through this pleasant, for the most part, diversion her comfort was paramount since she was a paying customer instead of patient. Of course, the comfort of the patient should also be paramount whether the patient is paying or not.
Questions remain, however. Is all this necessary? Does this approach measure something called biological age? Do the customers – not patients – benefit from their experience? Or are these clinics getting ahead of established science? At Mayo-Jacksonville, the head of that clinic, Pamila Brar, “described its approach as ‘more open to being evidence-informed rather than evidence-based’ compared to its Mayo Rochester counterpart.” Evidence-informed? When “evidence-based medicine” is used, the question “Whose evidence for what purpose?” should follow. When “evidence-informed” is used, it is past time to go elsewhere. Having had close colleagues at the Mayo Clinic in my former life, this strikes me as just sad. Dr. Brar is undoubtedly a wonderful internist. But digging a bit beneath the surface of the article in STAT News:
Pamila K. Brar, M.D., is the medical director of the Longevity Program at Mayo Clinic in Florida’s pioneering new Longevity Center. As medical director of the Longevity Program, Dr. Brar will create and implement a strategic vision for a best-in-class longevity practice while managing clinical care for patients. She will engage with subspecialty thought leaders throughout Mayo Clinic to refine the program. Her role also includes educating the key stakeholders about the field of longevity medicine and contributing to development of an evidence-informed educational and research effort.
Before joining Mayo Clinic in February 2025, Dr. Brar served as senior physician at Human Longevity (HLI) in San Diego, California, having been with the company since its inception in 2015. She joined HLI as founding medical director where she oversaw the development of a precision preventive health platform and its evolution into a membership model for longevity practice while serving as the principal investigator of the research protocol. [3] While at HLI, she also served as chief medical officer of the trailblazing J. Craig Venter Institute in La Jolla, California. In addition to her clinical practice at HLI, she focused her attention on external relationships with corporations and business partners and was a spokesperson for the platform.
Prior to her roles at HLI, Dr. Brar had a solo concierge medicine practice in La Jolla (average home value, $2.4M) and served as the president of the American Academy of Private Physicians (Facebook link). Her previous research efforts have been directed toward precision prevention (see Note 3). Ultimately it was her love for science and innovation as well as the business of empowering patients that led her to the world of precision medicine longevity. (my selected keywords in bold font)
As Sarah Todd notes in the article, Longevitism is a departure for these august medical institutions. No serious person would dispute the utility of these medical tests if there were a reason for them. But:
The concern among medical experts is that incidental findings come up in 15%-30% of all diagnostic imaging — masses, aneurysms, and other abnormalities that are unrelated to the initial reason the scan was done. That can lead people to undertake costly, invasive treatments and interventions, like biopsies, that don’t actually improve their lifespan, said Matthew Davenport, a radiologist at Michigan Medicine who co-wrote a viewpoint published in JAMA this spring criticizing the practice.
“It is not straightforward to say, just because we diagnosed something, that means that someone’s life was improved,” said Davenport. Early detection is important for some kinds of cancer, like breast cancer and colon cancer. But there’s debate about screening for others, like low-risk, early-stage prostate cancer, in which early detection may not help people live longer lives.
Similar concerns apply to early-cancer detection blood tests that are options at Weill Cornell and Mayo, Davenport said. The diagnostics firm Grail sells a blood test for $1,000, but critics worry both about the prospect of unnecessary and expensive biopsies and endoscopies and that the tests may miss some cancers, giving patients false reassurance.
Why are these hospitals betting on longevity?
Vikas Saini, a cardiologist and president of the health care-focused think tank Lown Institute, said that the decision to offer whole-body MRIs is a prime example of how the bar for evidence-based medicine can slip even at prestigious, trusted institutions. “You think you’re going to be judicious,” he said, “but the gravitational pull of trends, culture, headlines, money, all that — it distorts thinking.”
Yes, this does distort thinking. But this kind of thinking is also normal in our distorted society, in which medicine is a money-making proposition, especially in the form of Longevitism:
Thanks to rising public interest in longevity, the industry — estimated at $5.3 trillion (UBS, 28 March 2025) in annual sales in 2023 — is projected to reach $8 trillion in global annual sales (UBS, 5 September 2025, but “Article is expired”) by the end of 2030, according to UBS. Such soaring demand makes cash-pay longevity clinics a potentially lucrative move for hospitals.
Potentially lucrative, indeed. To paraphrase Senator Everett Dirkson (1896-1969) of Illinois, who probably did not say about mere billions, “A trillion here, a trillion there, pretty soon you’re talking real money.”
Still, to the extent that this focus on Longevitism has any value and utility, it is the implicit recognition that preventive medicine is the best medicine, the practice of medicine that “helps patients avoid problems before they start.” But this will work only in a society that values a healthy population, and we are far from that. Achieving that goal is a political problem, instead of a medical problem. Rich people already outlive not-so-rich people by 8-10 years on average. When Walmart has walk-in Longevity Clinics that are covered by universal health care (physical, mental, dental) that is no-cost at the point of delivery, we will have made progress.
And in any case, this obsession with longevity will not necessarily save you from that bolt from the blue. Bryan Johnson, despite all his biohacking, recently announced that he has autoimmune gastritis, a disease that destroys the lining of the stomach. For this, there is no known cause and no effective treatment. His condition puts him at risk of vitamin B12 deficiency and stomach cancer. And contrary to what he says, this unfortunate turn of events is unlikely to be a consequence the junk food he ate in his younger years. May he use his wealth and monomania to help find an answer for him and everyone else.
The precision medicine that comprises longevity is currently as real as polywater. In the meantime, remember to eat well, sleep well, and “take exercise” regularly as my grandmother (1910-1996) would have put it. That is your surest path to a good, long life. Finally, may you, gentle reader, live all the days of your life, as it comes and as you make it, instead of wasting time fretting that the end of same is as inevitable as human folly, now and forevermore.
Notes
[1] The weirdest excrescence of Longevitism I have found, so far, was covered here in a discussion of The Future Loves You: How and Why We Should Abolish Death by Ariel Zeleznikow-Johnston. Abolishing death is as likely as abolishing human folly.
[2] In preparation, as part of a longer discussion of the science and philosophy aging in this modern world.
[3] Pamila K. Brar has one entry in PubMed, from 2026, online before publication: Biological markers of aging across the menopause transition: current evidence. She is the ninth of ten authors and the Conflict-of-interest statement is most interesting. “Whose evidence for what purpose?” immediately comes to mind. That there may be biological markers of aging associated with menopause is somewhat unsurprising. Her lack of previous citations makes it likely that no results from the HLI research protocol mentioned in her Mayo biography have been published.