Hey Doc,
Ten mistakes in the report below. I made most of them.
New tech and new protocols get the attention. There are a thousand posts a week on them. The hard work happening on the ground is less clickable. The sweat, the tears, the wins nobody sees. Foundations, reputation, team.
Part of why it stays quiet is that the conversation is hard. It takes humility, self-awareness, and a willingness to say what you got wrong with your name attached.
So I asked. Twenty-six doctors answered, in the open. I compiled it into a field report below. It is a work in progress, and that is the point. If we want a standard for longevity medicine, we have to put this out and let others build on it.
Our certification learners also told us they wanted to study alongside their own specialty. So we are opening the first CLD cohort for dermatologists. Just reply to this email if that is you.
As always, Happy Sunday.
Dr. David Luu, Founder, longevitydocs.™
PS. Built the technology. Built a complex product. Built a multi-offering. Built a place. Maybe I should not have. I learned from all of them. We were building something that did not exist yet. Happy to give back now. These are the photos from that time.
One story a week for physicians moving into longevity medicine (part 2).
Mistakes to Avoid When Building a Longevity Practice
A field report from 26 physicians.
What 26 physicians would do differently
Longevity medicine has a growing clinical literature and no operational one. Physicians opening practices have no published standards, no pricing benchmarks, no model comparisons, no software evaluations, and no account of what the first eighteen months actually cost.
So we collected one. Over the course of a week we put a series of questions to physicians in the member chat on longevitydocs.ai and let them answer each other in the open. Twenty-six responded on the record, from two months in practice to twenty-three years.
Ten mistakes came back often enough to treat as the operating reality of the field rather than one person’s bad luck. Insurance does not pay for this work. Most physicians underprice at launch. The payment model decides how you practice, not just how you get paid. Capital gets spent before demand exists. Service lines get added before any of them are good. Paid marketing loses to the physician’s own voice. Income tied to time caps the practice. Access given without terms is the most common boundary failure. No software does the job, so everyone runs workarounds. And systems get built only after something breaks.
One condition sits under all ten. Longevity medicine is an emerging field. Cardiology has had since 1949, when the American College of Cardiology was founded, to build its benchmarks and its guidelines. We are starting to build it for longevity medicine.
We know the medicine. We are still learning the business.
Published work in longevity medicine covers what to measure and what to prescribe. It says nothing about the conditions the medicine gets delivered in.
So every physician entering the field solves the same problems from scratch. What to charge. Whether to take insurance. Membership or fee for service. Which software. When to hire. Each one solves it alone, pays for the errors alone, and never finds out what anyone else learned.
Nobody has asked the people who know.
Community-sourced field report
Questions were posted in the member chat on longevitydocs.ai over the course of a week. Physicians answered in an open thread, visible to each other, and were told their answers would be quoted by name, with the option to stay unnamed.
Questions covered early mistakes, what they would build differently from zero, technology, and operations.
Twenty-six physicians contributed. Experience ranged from two months to twenty-three years. Settings included solo boutique, concierge, membership, hybrid fee for service, and pre-launch. Quotes are verbatim, trimmed only for length.
Ten mistakes, in the order they cost you money
Ten mistakes recurred across respondents.
Expecting insurance to pay for longevity testing
Underpricing at launch
Letting your payment model decide your medicine
Spending on space and equipment too early
Building every service line at once
Spending on paid marketing instead of your own voice
Tying your income to your time
Giving away your access without boundaries
Waiting for the perfect EMR
Waiting to build systems until you need them
1. Expecting insurance to pay for longevity testing
Steven Murphy named it as his first error in exactly those words. Every respondent who addressed insurance had made the same one.
Murphy rebuilt his around three moves: explain why the patient should pay for it, identify where insurance legitimately covers something based on a medical diagnosis, and make clear you will be a good steward of their spend. “That built a trusting Sherpa relationship where I could then navigate the ship for best labs at best prices.”
His constraint: “Don’t expect to be able to spend this much time with a patient and have insurance pay for your time.”
Jijoe Joseph found the more dangerous version, which is partial coverage.
“I got insurance wrong by assuming that ‘usually covered’ was good enough. About 1 in 8 patients could still get a surprise $4,000 to $5,000 bill.”
He negotiated pricing at roughly 80% off retail, then built his own panel and folded the cost into his plans so pricing was predictable upfront. Partial coverage is worse than none. It moves unpredictable risk onto the patient, and the surprise lands on your relationship.
Melissa Loseke has been cash pay since 2012 and is the only respondent looking the other way. She sees parts of this work drifting toward coverage and says the open question is “determining when to start utilizing insurance again.” She already uses insurance for prescriptions where she can.
Key Insights
Be transparent on coverage from the first visit
Partial coverage is the trap, not cash pay
Price so nothing surprises the patient
Watch reimbursement, some of this work is drifting toward coverage
Your call depends on size, ethos, scale, treatment mix, patient base
2. Underpricing at launch
Near-universal. The regret is not the number. It is that the number is hard to change later.
Melissa Loseke: “I should have started pricing higher. Most of my colleagues would chastise me for how little I charge. And that’s harder to walk back now.”
Shah Ahmed, one year in, correcting it now: “I know I will lose people but I undervalued myself for a year.”
Jijoe Joseph, past it: “You’ll be surprised how many stay after the price increase.”
Steven Murphy offers the bridge for anyone who cannot wait on revenue. Price the practice where you intend to sustain it and fund the ramp elsewhere. He points to Medicare work in short term rehabs and SNFs, “where there is zero overhead.”
Key Insights
Set the price you intend to sustain, from patient one
Raising it later is harder than starting there
Fewer patients leave than you fear
Need cash early? Take low-overhead work outside the practice
Do not discount the core offer to fill the calendar
3. Letting your payment model decide your medicine
The most consequential finding came from a physician who changed her model to fix her medicine.
KeriLyn Bollmann spent twenty-three years with the underserved and underinsured before moving into longevity practice. On fee for service she says
“I was nervous to ask people to come back (and pay money), so instead I would see them, do some testing, give them some supplements, and then they would feel lost for next steps.” She moved to concierge to ensure “consistent follow up, so people felt like we were moving the needle.”
Fee for service made her reluctant to ask patients to return. That reluctance removed follow-up. Without follow-up, testing produces confusion instead of care. She changed the payment structure to restore the clinical loop.
Julie Doyle reports the same from the other side. Unlimited portal messaging, same-day replies.
“I would not have been able to offer this outside a membership structure... I’m never feeling like answering messages or responding to patient questions is uncompensated time.”
Jijoe Joseph gives the timeline. He ran both.
“Membership was slow for almost two years. Fee for service kept the lights on.” New patients are now membership only.
His planning note: “Whatever overhead you estimate, double it.”
Key Insights:
Not a payment decision, it decides how you practice
Membership funds follow-up and continuity
Fee for service optimizes the encounter
Pick the one that fits the medicine you want to deliver
Check it covers overhead and pays you properly
4. Spending on space and equipment too early
Shah Ahmed lists renting space and buying equipment “thinking I would do so many things” among his first-year errors.
Steven Murphy on sequencing: “Make money first, assess patient needs and then buy one thing at a time.” He also names the pressure that produces bad capital decisions. A patient told him she loved him but got more at another practice. “That stung, but good business is not reacting to every sting with bad economic decisions.”
Shoma Datta-Thomas bought devices she did not need and says she should have hired admin help earlier. The equipment was the wrong purchase. The person was the right one.
Ahmed’s counterfactual is the cleanest alternative on record:
“If I could go back I would literally just open a PLLC, rent a desk somewhere, and do some light organic marketing and social content.”
Key Insights:
Start lean, buy one thing at a time, after demand is proven
Hire the person before the device
Shiny object syndrome is expensive
Patients pay for trust, outcomes, access: ask whether the purchase delivers any of those
5. Building every service line at once
Jijoe Joseph named this as his number one:
“Every vertical adds equipment, staff, training, marketing, and management complexities before demand is proven.”
Mark Dukshtein gives the number:
“Trying to add too many services at once instead of being really good at 2-3.”
Shoma Datta-Thomas found demand somewhere she had not planned for. She expected more GYN minor procedures. “Patients were begging for good hormone therapy.” Her rule is to iterate the menu on observed demand, fast.
Daniel Kessler applies the same logic to case selection:
“Start with something solvable that gets the patient results quickly. Do not start with the complex cases.”
Jonathan Stegall puts the boundary around who rather than what:
“Don’t try to be everything to everybody. Define your ideal patient avatar and go after them.”
Key Insights:
Narrow the offering to what you are good at
Listen to your patients, measure traction before adding
Every added service adds equipment, staff, training, marketing
Start with solvable cases
6. Spending on paid marketing instead of your own voice
Melissa Loseke would cut all of it:
“Word of mouth and just doing a great job with patients is all you need.”
Shah Ahmed ran the comparison inside his own practice without intending to. He spent $20,000 on local ads. His social account reached 17,000 followers “despite zero formal strategy and completely erratic posts.” His conclusion:
“Now imagine if I took the 20k in local ads and put that into a real social team instead.”
Twenty thousand dollars of advertising underperformed inconsistent posting by the physician himself.
Jonathan Stegall states the principle:
“You don’t need perfect videos or perfect social media posts. The public wants your authenticity, not your perfection.”
Key Insights:
Your voice outperforms paid ads and costs nothing
Patients choose a physician, not a clinic
Raw beats polished content
Word of mouth is still the strongest channel
Spend on the work before the ads
7. Tying your income to your time
Jonathan Stegall: “Don’t tie your income to your time. Put systems in place early so that other people in your practice are doing the heavy lifting.”
Jijoe Joseph states the target:
“a business that can keep working even when the founder takes a step back.”
Shah Ahmed is inside the problem and says so. Compensation directly tied to time with patients. He is announcing memberships and building workflows an APP or nurse can run.
What he wishes he had: “a ‘business’ partner... someone to look over my shoulder and help me avoid silly mistakes.”
Ladi Ilkhani reduces it to three instructions: “Ask for help and take it. Delegate instead of trying to do it all myself. Billing consistently.”
Katie Rybak on the spending decision underneath:
“I wouldn’t be so afraid to spend the money on quality staff. They are everything to a successful practice.”
Haleem Mohammed:
“I wouldn’t do it alone. Easy way to burn out. I’d find a group of like minded killers with no ego who live and breathe medicine.”
Key Insights:
If you only earn when you are in the room, you are the ceiling
Ask for help and take it
Delegate before you are drowning, not after
Hire good staff early, train them, keep them
8. Giving away your access without boundaries
Shah Ahmed identifies the asset: “People are paying to sit down and talk to me. The value is the physician.” Which makes the rest harder to explain. Ladi Ilkhani:
“I also would protect my ‘time,’ something I never thought we could put more value on. Shouldn’t have given out my cell so easily.”
Melissa Loseke changed her number over it.
“I changed numbers because of this. Most had little respect for my time or awareness.”
Sarah Lacarrubba would define roles, ownership, and accountability from day one:
“Set clearer boundaries and trust more slowly. In the beginning, I blurred the lines between being a boss, mentor, friend, and business partner, and I was too generous with trust, titles, and credit.”
Key Insights:
You are the asset, protect the time and the access
Set expectations at visit one, not after they slip
Give out a practice line, not your cell
Define roles, ownership, and accountability before anyone is a partner
9. Waiting for the perfect EMR
Lisa Menuet, opening a practice soon, asked the simplest question in the thread: does anyone have an EMR they love?
The answers describe a category that has not been built.
Haleem Mohammed says his most used app is not his EMR.
“Doximity Ask is probably the most used app in my entire phone... helps me organize my thoughts, create notes, my social post captions are fact checked on there and I use the dialer to do telehealth video visits.”
Tatiana Zeballos gave the most complete account. Solo boutique practice on SimplePractice, valued for one thing: app-based messaging that feels like texting, with “no emails directing patients to a portal, repeated logins, password resets, or other EPIC-like friction.” As she adds services she needs lab integrations, e-prescribing, wearables and high-risk merchant processing without losing that.
“Essentially, I’m looking for the unicorn: SimplePractice ease plus a more robust longevity-medicine EMR.”
She has tried Charm, Practice Better, OptiMantra and Elation. She is evaluating Ultralight Health and SigmaMD, with Ultralight the current front-runner.
Bismarck Cadet on Ultralight: “awesome and continues to improve.” Mohan Muvvala runs Hint Health core and clinical, and rates the marketplace integrations and the responsiveness of the team.
Steven Murphy names the system hardest to change later. “It’s really hard to switch EMRs.” Choose for patient communication and documentation from day one. Retention runs through it.
Salomé Masghati answered the question the way the market should find most interesting. Does she have an EMR she loves? “Yes, the one we created ourselves.”
Maloes Zadeh diagnoses why none of it resolves. What is missing is “a truly integrated longevity platform that brings together labs, imaging, wearables, lifestyle data and longitudinal trends and translates them into clinically meaningful, evidence based actions.” Measurement is solved.
“The real challenge is turning all that data into better clinical decisions rather than simply generating more dashboards.”
Key Insights:
No full integrated EMR is built for this field yet, do not delay technology implementation
Choose for patient communication and documentation first
Expect to migrate, so keep your data portable
Measurement is solved, interpretation is not, that layer is still you
10. Waiting to build systems until you need them
Jijoe Joseph put it first on his list.
“Businesses last when they have repeatable processes, and revenue that doesn’t depend on the founder doing everything. The goal is building a business that can keep working even when the founder takes a step back.”
Jonathan Stegall on timing: put systems in place early
“so that other people in your practice are doing the heavy lifting.”
Shah Ahmed is building his now, retroactively: firmer systems for simple workflows “that an APP or nurse can follow for me.” What he wishes he had had is a business partner. “Someone to look over my shoulder and help me avoid silly mistakes.”
Shoma Datta-Thomas disagrees, and specifically. Her first lesson from running a boutique practice:
“NO consultants! They could never value every hard earned dollar I brought in myself the same way.”
Both are right about different people. A partner with skin in the game is not a consultant billing hours.
Janaan Arfeen, new to the field, asked the room the question this section exists to answer:
“I would appreciate if the leaders and pioneers in this field can share their wisdom and guide newbies in establishing systems.”
Key Insights
Build the process before you need it, not after it breaks
Write down anything an APP or nurse could run without you
Repeatable beats heroic
A partner with skin in the game is not the same as a consultant on retainer
If the practice stops when you step away, you built a job
Ten mistakes, one cause
Most of the conversation in this field is about protocols. Which peptide, which panel, which AI tool, which automation. Useful, but small. None of it decides whether a practice survives.
The decisions that do are the ones in this report. What you charge. Whether you take insurance. Membership or fee for service. What you buy and when. Who you hire. What you delegate. A physician can have every protocol right and still close, because the strategic decisions were made blind.
And they are made blind. There are no benchmarks, so most price low and learn years later. There are no guidelines, so each physician invents the scope, the panel, the follow-up cadence. There is no infrastructure, so one wrote her own software and the rest run workarounds.
Some of that is writable and should be written. Fee ranges by model and market. What an EMR has to do. How long membership actually takes to gain traction.
The rest is not. Judgment, taste, and strategy do not compress into a benchmark. Knowing when to raise your price, when to say no to a patient, when to hire, when to stop adding services. That comes from experience, and from watching other physicians make the same calls and say out loud how they went.
Which is why a thread beat a study here. Shah Ahmed is correcting his pricing in public while Jijoe Joseph, who has already done it, tells him more patients stay than he expects. That exchange is not data. It is judgment being transferred, and it is the only way this kind of knowledge moves.
“Money is the least of it. I just want to be BETTER. More efficient. More high value for my patients.” Shah Ahmed
Limitations
Respondents were self-selected members of a single professional community and are not a random sample of physicians practicing longevity medicine. The sample skews toward United States practice mainly and toward solo and small-group settings. Responses were given in an open thread where participants could read each other, introducing possible convergence. All figures are self-reported and unverified.
This is not survey data and should not be cited as such. It is the collected operational experience of practicing physicians, which is a different thing and, for a physician about to open, a more useful one.
What this field still has to build
This field is early. Nobody in this report had a map when they opened, and it shows in what they got wrong.
What closes the gap is not more protocol content. It is benchmarks, so a physician knows what to charge without guessing for two years. It is systems, so the first eighteen months are inherited instead of reconstructed. It is technology built for this work rather than borrowed from another specialty. And it is continuous learning between physicians, because judgment and strategy do not come from a document. They come from watching a colleague make the call and say how it went.
That last part is the one we can do immediately, and it is what this report is. Twenty-six physicians answered a question in the open so the next physician does not pay for the same lesson alone.
Next week: The Ecosystem Checklist
Thank you to the longevitydocs members who answered in the app
Shah Ahmed, Janaan Arfeen, Katy Bernstein, KeriLyn Bollmann, Bismarck Cadet, Shoma Datta-Thomas, Brenda Dintiman, Julie Doyle, Mark Dukshtein, Ladi Ilkhani, Jijoe Joseph, Daniel Kessler, Sarah Lacarrubba, Melissa Loseke, Salomé Masghati, Lisa Menuet, Haleem Mohammed, Steven Murphy, Mohan Muvvala, Jontel Pierce, Laura Preece, Katie Rybak, Jonathan Stegall, Christine Watson, Maloes Zadeh, Tatiana Zeballos.
This conversation happened inside the network. The next one will too. Physicians only, applications reviewed.
This report describes the experience of individual physicians. It is not legal, financial, or medical advice, and nothing here should be taken as guidance on billing, coding, or corporate structure in your jurisdiction.
Go deeper on one concept every week from the LongevityDocs Lexicon. Longevitydocs Lexicon
Red Light Therapy
Definition
Red light therapy, more formally photobiomodulation (PBM) and previously known as low-level laser therapy, is a noninvasive form of phototherapy that uses wavelengths in the red light (620-700 nm) portion of the visible spectrum and the near-infrared (700-1440 nm) spectrum. [1] It is often administered through low-level lasers or light-emitting diodes and is applied to a range of dermatologic and nondermatologic conditions. [1] The field, sometimes known as photobiomodulation, has broadened over time to include light-emitting diodes and other light sources beyond lasers, spanning many wavelengths in the red and near infrared. [2]
How it works
Photons from red and near-infrared light are absorbed by endogenous photoreceptors including mitochondrial cytochrome c oxidase, whose activation modulates ATP production, generates reactive oxygen species, and alters intracellular calcium levels. [1] Red to near-infrared light can stimulate complex IV of the mitochondrial respiratory chain (cytochrome c oxidase) and increase ATP synthesis, with light absorption by ion channels releasing calcium and activating transcription factors and gene expression. [3] It is hypothesized that inhibitory nitric oxide can be dissociated from cytochrome c oxidase, thereby restoring electron transport and increasing mitochondrial membrane potential. [4] The modulation of ATP, reactive oxygen species, and calcium promotes activation of signaling pathways that contribute to downstream effects on cellular proliferation, migration, and differentiation. [1]
Evidence & status
An evidence-based consensus of an international multidisciplinary panel concluded that photobiomodulation is a safe treatment modality for adult patients and that red light PBM does not induce DNA damage. [5] The same consensus judged PBM an effective treatment option for peripheral neuropathy, androgenic alopecia, wound ulcers of multiple etiologies, decubitus ulcers, pain from diabetic foot ulcers, and acute radiation dermatitis. [5] A systematic review and meta-analysis of 22 randomized placebo-controlled trials with 1063 participants found that low-level laser therapy significantly reduced pain and disability in knee osteoarthritis, with no adverse events reported. [6] A separate systematic review and meta-analysis of randomized controlled trials found that low-level laser therapy significantly reduces pain and disability in lower-extremity tendinopathy and plantar fasciitis in the short and medium term, though long-term data were not available. [7] There is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis in patients undergoing radiation therapy for head and neck cancer, chemotherapy, or hematopoietic stem cell transplantation. [8] In a meta-meta-analysis of myopia control strategies, repeated low-level red-light therapy demonstrated clinically significant effects on slowing both axial length elongation and spherical equivalent refraction progression. [9]
Why it matters
PBM is generally well-tolerated and safe, with erythema being the most common and self-limiting adverse cutaneous effect. [1] More than 50 years after its discovery there is still no agreement on the parameters and protocols for clinical application, and the wide range of applicable parameters has in some cases led to contradictory results. [10] Effective therapy depends on treatment parameters such as fluence, treatment duration, and output power, and cells or tissues with higher numbers of mitochondria tend to respond to lower doses of light than those with fewer mitochondria. [1] [10]
Community knowledge
Brain Applications
Dr. Neil Paulvin includes red light in his brain-optimization stacks, favoring red light helmets while noting that the more effective devices are costly and typically require at least a three-day-a-week commitment, whether used at home or in-office, and pairing them with more portable options such as mini red lights for travel A.
Skin And Hair Applications
Dr. Amanda Hill has found red light caps such as Revian to be a helpful adjunct in androgenic alopecia, explaining that they increase nitric oxide, which locally reduces the conversion of testosterone to DHT through reduced 5-alpha reductase activity without side effects, and likely also help via their anti-inflammatory effect B.
Dr. Saranya Wyles acknowledged some utility for at-home red light, microcurrent, and RF devices but stressed that consistency of use, daily versus twice weekly, drives the difference in results, and that sunscreen remains the single strongest skin-longevity intervention on the market C. At the Cannes Summit 2025, the Skin, the Next Longevity Frontier talk introduced Cell Bioprint, a five-minute proteomic diagnostic that estimates skin biological age and predicts future skin concerns, offering a complementary way to track outcomes from interventions such as red light therapy H.
Mechanism
Dr. Giovanni Campanile described photobiomodulation, that is, red light therapy, as affecting mitochondria throughout the body even when applied peripherally, and recommends pairing a red light panel with regular sauna use D.
References
Rooms
A. My Brain Longevity Stack to Type A Patients: Dr. Neil Paulvin
B. ROOMS: Dr. Amanda Hill : The hair loss protocol, how to prevent and reserve hair loss
Summit
E. Peptides from Research to Practice — Dr. Craig Koniver
F. Gene Therapy Demystified — Dr. Patrick Sewell
G. Cellular Optimization: Is It the Future of Medicine? — Dr Elizabeth Yurth
H. Skin, the Next Longevity Frontier — Vania LaCascade
Mastermind
C. The SkinSpan Stack — Dr. Saranya Wyles
Faculty Lectures
D. Unlocking Secrets of Heart Health — Dr. Giovanni Campanile
1.Maghfour J, Ozog DM, Mineroff J, Jagdeo J, Kohli I, Lim HW. Photobiomodulation CME part I: Overview and mechanism of action. J Am Acad Dermatol · 2024
2.Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng · 2012
3.Salehpour F, Mahmoudi J, Kamari F, Sadigh-Eteghad S, Rasta SH, Hamblin MR. Brain Photobiomodulation Therapy: a Narrative Review. Mol Neurobiol · 2018
4.Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol · 2018
5.Maghfour J, Mineroff J, Ozog DM, Jagdeo J, Lim HW, Kohli I, Anderson R, Kelly KM. Evidence-based consensus on the clinical application of photobiomodulation. J Am Acad Dermatol · 2025
6.Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JM. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open · 2019
7.Naterstad IF, Joensen J, Bjordal JM, Couppé C, Lopes-Martins RAB, Stausholm MB. Efficacy of low-level laser therapy in patients with lower extremity tendinopathy or plantar fasciitis: systematic review and meta-analysis of randomised controlled trials. BMJ Open · 2022
8.Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, Bossi P, Chilles A. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol · 2022
9.Zaabaar E, Asiamah R, Kyei S, Ankamah S. Myopia control strategies: A systematic review and meta-meta-analysis. Ophthalmic Physiol Opt · 2025
10.Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. J Biomed Opt · 2018
Longevity Medicine Certification for Dermatologists
Our CLD learners told us they wanted to study alongside their own specialty. So we built one, starting with dermatology.
Dermatologists see skin aging every day. Patients come in for the surface and want the inside treated too. They ask about biomarkers, hormones, GLP-1s. This cohort teaches how to apply longevity medicine in a dermatology clinic, on the patients already in front of you.
Board-certified dermatologists only. Applications close September 15.
Mastermind: Skin, Bone & Muscle
October 24, 2026 • New York City
Faculty: Amanda Hill, MD - James Peyer, PhD - Saranya Wyles, MD, PhD, - Elizabeth Yurth, MD and more.
Biological clocks validated as trial endpoints, reshaping longevity drug development
A Nature Medicine study shows epigenetic aging clocks are sensitive enough to detect biological responses to longevity interventions in living humans within trial-feasible timeframes, not just stratify risk in observational cohorts. That distinction matters for regulators and trial designers who’ve debated whether biological age metrics can substitute for hard endpoints like mortality or disease incidence, this closes the evidence gap needed for accelerated approval pathways in aging medicine. Nature Medicine
Semaglutide’s cardiovascular benefit may run partly through inflammation, SELECT sub-study finds
A pre-specified secondary analysis of the SELECT trial found semaglutide cut hsCRP by 37.8% over 104 weeks versus placebo in patients with cardiovascular disease and obesity but not diabetes. Patients with baseline hsCRP ≥10 mg/L had 2 to 4 times the risk of major cardiovascular events, cardiovascular death and all-cause death versus those under 2 mg/L. The hsCRP drop showed up within 4 to 8 weeks, before major weight loss and even in patients who lost none, and modeling suggests reduced inflammation accounts for roughly a third of semaglutide’s cardiovascular event reduction. Circulation
Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.
PHARMA
A Cancer Vaccine Worked For Melanoma
Merck and Moderna’s mRNA vaccine hit in Phase 3. Intismeran plus Keytruda kept melanoma from returning and delayed spread to other sites. No numbers yet, it came out as a press release. The magnitude we do have is from June: a smaller five-year study where the combination cut recurrence or metastasis by 49% against Keytruda alone.
The vaccine encodes up to 34 mutations from the patient’s own tumor. Melanoma is the easy case, loaded with mutations, so the immune system finds it. Lung, bladder and kidney trials are running. That is where we learn whether this is a melanoma result or a cancer result.
TECH
Whoop Expands Labs to Non-Members
Whoop announced it is making Advanced Labs available without a membership for the first time, and adding Grail’s Galleri multi-cancer early detection test to the offering. Whoop will hold your daily biometrics and your bloodwork under one app. They already do video visits and pull your records. Prescriptions come next?
WEARABLE
Happy Sleep Raises $75m for Sleep Apnea
Happy Sleep raised a $75 million Series A led by ARCH Venture Partners and OpenLoop to build out its AI-powered home care platform. The company’s FDA-cleared Happy Ring is the first smart ring approved for multi-night sleep testing, diagnosing obstructive sleep apnea and insomnia in as few as three nights at 98% accuracy. Nearly 80% of Americans with sleep apnea remain undiagnosed.
HEALTHCARE
Bone Health Is The Next Big Category
Cardiovascular had its decade. Then metabolic. Then hormones and sleep. Bone is next, and prevalence has nothing to do with it. More than 60 million US adults over 50 have osteoporosis or osteopenia. Most are never diagnosed. What changed is that patients are starting to ask. Medcity
AI
Network Bio is Building a General Medical Intelligence
Network Bio is training AI models on biological data broad enough to work across diseases rather than one at a time. The pitch is a single model that can answer quantitative questions about any condition: detect it earlier, find the biomarkers, point at a more personalized therapy.
Every doctor should be a longevity doctor
longevitydocs.™ is the vetted network of longevity doctors - 1,000+ doctors. 68 countries.
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very relevant for me right now! thank you