Inside Wealth: A discussion on longevity with Private Medical founder

Welcome to Inside Wealth. I'm Robert Frank, CNBC wealth editor, and you are joining a special live stream, Ask Me Anything, and we will ask him everything with Dr. Jordan Schlane, the founder of Private Medical. Dr. Schlane, thank you so much for joining us. Great. Good to be here. >> So, the last time I saw you, you were half naked in Gestad, as one does. >> Well, I was in a sauna, but yes, >> in a sauna. So, uh, I think you were there for this was a Zoom call we had. I think you were there for some longevity conference. So, longevity is like the buzzword, the marketing word. They're putting it on everything now. There's longevity clinics, longevity drugs, longevity hotels. >> Um, what's what's did you learn at that conference and what are the sort of biggest trends right now you're seeing with longevity? >> Well, first I think it would be good to define what is longevity, right? I mean, everybody talks about it and I talk to a lot of people and I ask them, "What does longevity mean to you?" And I get different answers from everybody, which means that if everyone says thinks it's a different thing, then it means nothing >> cuz it's like at its base, it's just like, I want to live longer, right? [clears throat] They don't really want that. Like, >> well, yeah. Go hang out with a bunch of go hang out with a bunch of hundred year olds [laughter] and see how that feels. And and I don't mean that in a bad way because I I know a lot of 90 and 100 year olds and but they're struggling pretty hard because it's it's it's a lot of wear and tear and gravity and um so my definition of longevity just to to put it down is like how do you optimize or to optimize your physical and mental health >> uh for as long as possible with the fewest amount of interactions with the health care system. And I put that second part there for a reason because I think that right now everybody's in this mindset that more is better. I must do something and doing something's better than doing nothing. But I try to remind everybody that doing something carries a risk and a benefit. Doing nothing has a risk and a benefit. >> And what you don't want to do is do something with a greater risk profile than doing nothing. Well, we we see like I don't know if you follow any of these healthcare or fitness influencers on Instagram, it's like [clears throat] here's a hack and it's instead of a hack which is supposed to shorten and make things simpler, it's just adding all these things that people do, whether it's like the supplements they take, the things they eat, the the special workouts, the whatever. Um, so you're saying overall philosophically when it comes to health, people should think about doing less rather than >> Well, I think a good strategy is about like it's not just what to do, it's what not to do. And no one's in the mindset of doing nothing. I mean, Voltater, if I can go quote Voltater for a minute, the long time ago said that the art of medicine is to keep your patient in a good mood while nature takes its course. >> You know, so this is like an old ancient, you know, not ancient, but but [clears throat] it's good. So, so what did I learn at the longevity event? Um what I learned is that the uh science is moving uh forward, innovation is happening, but the social media is moving way faster and the influencers are moving way faster. Uh and they're promoting uh and talking about things like escape velocity. We're going to reach human escape velocity in x number of years. We're going to live to forever. And I I again like we said earlier, do you want to live forever? I mean some people might, but when you get that old like a lot of things break down and you know the basic bodily functions don't work. So, you know, there is a lot of I'm optimistic that there's a lot of things in the pipeline that affect, you know, catching cancer early and actually treating cancer or or any metabolic condition. But ultimately, what you really want to do is you need to know what your biology is telling you. So, you need some sort of baseline and you don't need to do like the everything scan everywhere all the time which people are doing. I think you need a like at private medical each person is their own universe of biology and we have to understand that universe of biology. We have to then understand their family and their behaviors and their universe of how they exist in the world and then you can develop a strategy for what to test, how are you feeling, what problems are we trying to solve. And what what problems we're trying to solve really is understanding [clears throat] what disease patterns are in your future, >> what risk profile you have. And >> and how do you know that? >> Well, so there's all these risk calculators that doctors have been using forever. So if I know your blood pressure and your heart rate and your cholesterol and various your blood sugar, I can predict your risk of a heart attack. That's the old model. The new model is go get a scan that actually looks at your heart and tells you how much disease you have. And then based on how much disease you have, put together a treatment strategy that can reverse it, stabilize it, or clearly prevent it from getting worse. So [clears throat] most heart attacks, most 99% of heart attacks are preventable if you have a strategy and you look, but you have to look and then you have to measure at the right cadence. And that's individualized. It's not one sizefits-all. And back to the [clears throat] influencers you were mentioning, I find that they're selling things. So, anybody who's selling you something, uh, they're making money off it and they're promoting it. It's a [clears throat] it's a bad faith. >> And and and just to tell people [clears throat] about >> the folks who sell things and your business model, ju let's step back and explain to people. Uh, you founded private medical how many years ago? >> 2002. So, >> 2002. Yeah. Uh, and this is this is you're kind of one of the OGs in the field. Um, explain a little bit about how concierge medicine works. What do you guys do? What do you pay for when you're a customer of private medical and >> a member? Not a customer. >> A member. Sorry. >> Um, and you know, is this like a growing part of medicine? Is there is there demand? [snorts] >> Uh, a lot of questions in there. Let me unpack that. So, the field of concierge medicine started when I started a long time ago. It was I felt like my soul was being crushed as a doctor because I was asked to do more with less. And primary care, which is what concierge medicine is, really is the tip of the spear of all things medicine. That's where it all starts. If you if you get a good primary care organized, you can, like I said, prevent, you can be proactive, you can do a lot of stuff. [snorts] And ultimately, all these doctors, so I left and jumped out of the system to start this thing called concier medicine. And everybody thought it was crazy, but ultimately we take care of a hundred individuals. Each doctor has a team. That team takes care of a hundred individuals and gets to know them incredibly well. We charge an annual fee. >> Yeah. >> Excuse me. And we don't um >> How much is that? >> Well, that's uh if you know, you know. >> Um >> Okay. I mean, >> well, so let me let me just say let me just say at one point we were the most expensive and now we're like probably like the not the least expensive. >> I mean, just for the audience out there, I've seen prices for you guys like at around4 or $50,000. So So just to give ballpark. I mean, it's around there. >> Yeah. So, the higher end ranges from probably 30 to I mean, there are people charging 250 and it's bananas. And I don't know what you get for two. >> You're kind of mid-range. >> Well, I the price is fair, but I think what we do is at as top shelf. We're we're I think the top >> So, what are you getting for that? So, what you're getting is you're getting a a physician who um knows you, who is putting together a strategy, who's advocating for you, who's there to pick up the uh phone if you wind up in the hospital, if you go to the ER. So, we we know your whole family. And we really kind of a protect you from the healthare system. That's probably the biggest thing by by bringing o bringing you over to the private medical, which is like a safe harbor and a private space where we don't share your data. We're not connected with all these systems. So we're [clears throat] very private and we have uh pediatrics, we have women's health, we have naturopathic. So I like to say it's it's kind of like a a family office for health. >> What's included in that? Like when you pay that annual fee, what's [clears throat] included in that? Like can I call you or visit as >> it's unlimited calls, visits, you know, research. I do a lot of research for people. I've got some patients with cancer now. I'm talking with five oncologists and I'm you know doing a lot of research on their behalf in the background so that when we meet the oncologists which I'm meeting tomorrow like I'm I'm fully aware me and the member have talked about it in advance and so we're walking in prepared knowing what we want to get out of this and what decisions we have to make now that's a cancer thing but then there's all the stuff with the longevity stuff where people are asking about peptides and all these other things and so like well let's look at the evidence. So ultimately what you get is you live your life cuz you've got a big amazing life. I will take care of all health medicine related issues and work in the background so that when we need to have a decision we're fully prepared to help you make that decision. And that's based on your risk tolerance and your risk profile. Some people want to do the most aggressive thing. Some people want to do the most conservative thing. [snorts] There's five different ways to do all of those things. Yeah. >> So once you get into the medical landscape, it's it's tricky. >> It's interesting cuz I see my doctor when I'm sick, right? I was like, I got to model, right? And and and uh >> what what you're saying is what you do is more sort of getting involved in someone's life in a deeper way than a doctor. Like is a concierge doctor more than just a doctor you call when you're >> Yeah, I mean I I kid with tongue and cheek that I'm 70% doctor. I've actually changed to 70% doctor, 15% psychologist, 10% rabbi, 3% hairdresser, [laughter] 1% tarot card reader, and 1% friend. >> 3% hairdresser cuz we tell our hairdresser everything [laughter] >> that you won't tell your your doctor or your psych. Exactly. They're truth tell. They hear everything. And so in order So I had a patient a long time ago didn't tell me that she smoked when she was younger. And when she was older, I didn't do a CAT scan surveillance because she didn't tell me she smoked. So, if you're a smoker, I do a different schedule of scans to evaluate your risk. And then we diagnosed her with um lung cancer. And she was really mad at me for like not diagnosing it sooner. And then her husband said, I I said, "But you told me you never smoked." And her husband was in the room with me and he's like, >> "Don't believe anything she said." >> Right? And I'm [laughter] like, "Well, that's too late. You you got to tell me everything now." Um we [clears throat] we have some great questions from uh people who are sent us questions and uh this person asks, "What kind of services should I get from a concierge doctor beyond what a primary care doctor would provide?" >> If you have like if you have a really I mean it sounds like >> the primary care doctor system is broken. So you sort of created one that's very expensive. Um Well, but but if you if you have a good what you think is a good primary care doctor, you can call when you're really sick. What do you do that's that's different from that? The better or better? >> Well, so you know, probably like like a wealth manager who when you call them about something in the market like >> they just lost a lot of money. >> Well, they but they know that you you were losing money before you lost the money because they're managing it. So, we know everything. We have all the context and the memory about your health. And so, when something arises and you freak out or you're concerned about something, again, this is if you wind up in a medical ditch, right? >> Right. We have all the context in the memory of your history and we then can immediately put together a SWAT team and act to solve that issue so that you get better the fastest and you get the best outcome and we're riding co-pilot with you every step of the way. >> But what you're doing is more preventative, right? I mean that's the that's the big head. >> I would say 80% of what we do is preventative and proactive and that >> which most people don't do. >> Most primary care well you said I see my doctor when I'm sick and so the health care system is built it's a broke fix model, right? when something breaks, I get it fixed. Yeah. And and what we're saying and what I've been saying for a quarter of a century is >> there's a way better way to do this, which is like, let's get in front of it. Biology is really predictable. If I know enough about you, I can see things coming a mile away. So, let's prevent you from ever going in the medical ditch. And so, that's what we spend 80% of our time doing. But we have a network of 4,000 experts that I've been building for the last 25 years around the country and around the world where I can get the top specialists on the phone to help organize [clears throat] your care in a way that is just unparalleled. >> Right. Right. And you have [clears throat] also an unparalleled client list. I mean, you never talk about who your clients are, but I know uh people who uh who know you well, they're clients of yours. You have a lot of the tech billionaires in Silicon Valley. You have a lot of the big hedge fund guys. um you take care of some of the wealthiest most successful people in this country. What are some trends or things that they do that everyday people don't do or what kinds of trends are you seeing with >> well you know it's >> very successful people [clears throat] >> they're very influenced by their peer group so that's thing one like we all are I guess but they are too and what I'm seeing a lot of is a lot of them are coming to me saying hey or they're telling me I'm doing peptides or I'm doing these things and and I will say >> so very wealthy people are doing peptides or they want to do them >> because they influence influencer community is really pushing this hard and so you know I will do the research and say do you know that there's like no evidence at all for peptides but I feel great you know and then I'm like a lot of this stuff is contaminated and if you're injecting yourself with things that are unproven unstudied no evidence they bypass your immune system because when we take things orally take a pill like your immune system like you just went straight into your body like you're gambling with your future self and you have so much to live for. [clears throat] Why would you do that? >> So, I find that I'm this strange voice of reason where they're like, I had really thought about that. Well, they're doing it, so I thought they did the homework. I'm like, they didn't do the homework. they heard it from their friend and it's this daisy chain of uh you know people saying that they and by the way I did a uh test on a vial of peptides uh and I sent it to a real professional firm and they found uh MDMA in it ecstasy and an herbicide and three industrial solvents. >> Yeah. But was this like a vial that [clears throat] you kind of just picked up off the street? >> No, this is from a reputable company that sells >> and why did you have a client wanted to take it? Well, a client and by the way, just just to go just to reframe what is a peptide like let's just let's let's get to that for one second then I'll tell you that story is a peptide is a bunch of amino acids connected together. GLP1s are a peptide. Insulin is a peptide. >> These other things that are >> peptide structures I would call them experimental molecules. I wouldn't call them peptides. I mean and so if you want to take an experimental molecule you're kind of gambling with your health. Now, if you gamble with your money and you lose some money, well, you can make some more money in the future, hopefully. But if you gamble with your health, you may lose some function in your future that you never get back. So, why would you do that absent evidence? I don't know why people are doing this. And so I feel like there's a worm mind worm out there that's getting people to think that I've got to do these things. But the truth is if you do a substance and it's got ecstasy in it and you feel great, you're going to go on Instagram and tell all your friends and then look at this guy. He's so happy uh and he's feels so great. I'm like yeah well if you do micro dose ecstasy [laughter] I think I think you're going to feel great. So so I think there's a lot of like beware and and be more thoughtful about what what you're doing. So I think a lot of people are asking me about these peptides or doing them and then I say can you just wait till the evidence comes out you're not going to miss out on anything. >> Yeah. >> And there's a lot of really great innovations in longevity looking at senolytics and uh and autophagy these and there's there is some early evidence on supplements that's promising. I think when people think about the [clears throat] wealthy and longevity, what's the guy Brian um >> Johnson? >> Brian Johnson, they think like that all wealthy people are like that, that they're spending millions of dollars a year on taking hundreds of supplements a day, that they want to freeze their brains, they stay out of the sun, like is that >> is that is that a life by the way? But is that like are are there any people actually like doing what he does to that extent when you think about wealth? >> No one's doing it at that extent. But people look at him as some sort of model >> even the wealthy. >> Oh yeah. Because he charges a lot of money for what he does now. He you know and and because he's spending $2 million on his health like well if he's spending 2 million what am I spending now? The truth is is like a lot of people spend millions of dollars on a piece of art or a yacht or and so you know I I would you know I'm not in the finance world but like I know that in the business world you say I'm going to devote x number of my revenue to marketing or x I have a budget of as a percentage of something. So, if you look at your net worth or you look at your life, like what percentage of that are you allocating to your health, right? >> And when you're super wealthy, like these numbers get ridiculous. >> And and if you're super wealthy, you're saying number one, what could be more important as a as a way to spend my money than my health? Number one. And number two, to your point earlier, more must be better. >> Yeah, more is not better. Definitely more is not better. And I think people the the more it comes in the in the form of diagnostics and therapeutics, right? Do do I do blood tests every week? Do I take supplements every day? >> And the answer is no. You, you know, you don't need to. The human body's been around for a long time. It does a really good job of staying alive and keeping healthy. I do think it's smart to measure some things >> and understand if you're super healthy and fit, you don't need to measure yourself all the time, right? I mean, you know, we we have these things called annual physicals that we check somebody every year. So, that's just a convention of the earth going around the sun once, like, let's check it when the earth goes around when we have a birthday. So that's kind of this arbitrary number. >> How often should people [clears throat] get their blood taken? Is that like the most important thing you should do every year? >> Uh well, everybody should get their blood test at least once a year. But if I do your blood test today and I find some abnormalities, I'm going to say I want to check this again in a month. I want to see if what the trend is. So you're really looking at trends. So if I check it in a month and it's the same and I check it in a month and it's the same, I'm not I'm done. I don't need to check it again in a month. And your your body is not wildly fluctuating. These these trends happen over time. So I've recently, you know, found a PSA in men that slightly is elevating. Yeah. I'm like, "Okay, I want to watch that trend because prostate >> like my my PSA is always high cuz I train a lot. I work out a lot and that that there's some correlation they think uh between like strength training, concentration training, and and a high PSA, but it's always high. So if just somebody just >> but if it's always high and it's so what we look at in PSA is the rate of change the velocity. So if it's you know mine's really low but it hasn't budged for for a very long time. But the people that you know PSAs just to talk about it because it's interesting for men is you know below four is historically below four is normal. But if you if you're at one and then the next year you go to two it just doubled right. Like >> check it again in a couple months. Don't wait another year to see if it doubles again cuz catching things early is always better. If it's always been at four, then it's not a problem. >> Exactly. But that applies to everything. But now people are measuring stuff where we don't even know what it means. >> Yeah. >> Like and so Right. And and so then they're my trend on this. And >> what about like these full body scans people [clears throat] are doing? It's like, ah, it's $500 to get a full And you get a lot of numbers. And it seems like, wow, look at all these numbers I get from this full body scan. Is that worth it? >> You know, for the people that just can't help themselves and they got to see inside their body as the cool new shiny object. We don't recommend it for everybody. Now, if one of our members wants to do it, we'll find but so just remember that that diagnostics, the MRI is meant to diagnose something, >> right? >> So now they're taking this tool where all the data is based on diagnosis and they're using it for screening, >> which is a whole different bioatistical and epidemiological universe, screening versus diagnosis. And so they've conflated these things and now and what we see is when people get these scans and if you get one once, great. If it's all normal, great. Like, you don't need to do it again. And but one guy that gets cancer caught, you know, uh from this, oh my god, everyone's got to get their cancer caught. But there are these there's blood tests now for cancer. And you know, Grail Gallery has a test. Um and you know, this is $700. It's a blood test. I think the scans are thousands. Uh Caris Biosciences, which is a publicly traded company. They they've been studying cancer for a long time. They're now launching a It's a couple thousand dollars, but it's I think it's more accurate or at least the early evidence shows that. So, if you're concerned about cancer, blood is better than scans. >> Yeah. >> Right. And all the oncologists will tell you that. >> Yeah. Yeah. >> But the you know, Kim Kardashian does a does a a you know, a a full body scan and tells everybody everyone's got to get one. So, there's this momentum in social media that you must do these things. So, they're interesting, but they're insufficient. And they and by the way, there's a lot of people that get these scans and it says you've got something, they freak out, then they got to get a biopsy. Oops. And then they got an infection, you know, and then you go down this medical safari. Yeah. >> And then you can wind up in a medical zoo is what I say. So you got to be careful. >> Speaking of medical zoos and safaris, I mean, people are using AI now as their doctor. I I think like the most common use as far as I can see anecdotally of AI is like, why is my elbow hurt? Why am I having a headache? Why is this happening? Is it possible I have X because I'm experiencing WI. So, so what do you think of there's a lot going on with AI and medicine right now? And I know you're really at the cutting edge of a lot of it. Um, but for most people, is it okay to use Claude to figure out what's wrong with you if you're not >> I think it's okay to use Claude to get some basic understanding because what happens is when somebody like you're living your life and then something hurts or something's swollen or something's red or you don't feel well, something's not normal. So when something's not normal, our brains usually go to the worst case scenario. Oh my god, what could it be? You know, and so then the longer you wait to get the answer, the more anxious you get. >> So, so then you start doing stuff. And so if Claude can provide you some framework of what it could be, what it couldn't be, and usually. >> Do you think it's accurate? Generally, >> it's generally pretty good. Uh the problem is is that unless it has like the full picture, right, >> it's not going to be that great. And it doesn't have context or memory. I mean, they're starting to get context to memory now with uh, you know, it remembers who you are and you can upload your medical records, but it's still missing like a whole other it's it's two dimensional. It's all paper. It's not the three-dimensional piece, which is what we do at Private Medical. We We know you. I mean, I can get a a threeword text from one of our members, and I know there's like a three paragraphs behind that. I already know what it means cuz I know them for so long. I know what that text means. >> And you know, have the context of everything that's going on in their health life. >> And I can say, "Look, don't worry about it." >> Yeah. Yeah. >> And they'll say, "Why aren't you worried?" I'm worried. I said I said, "You should be worried when I'm worried." And I know when to be worried. I I I have a constellation. I've got this pattern recognition and these horistics. And people say, "Well, doctor, you just think you're smarter than AI." I'm like, "Not smarter than AI." I'm not going to say that. But I use AI a lot. >> You know, there's open evidence. There's these a lot of tools for me to use to help me refine very quickly what you just said and how I should think about it. So I can very quickly So we we use AI at at our practice at private medical all the time and it saves doctors time and it clarifies things and it it reinterprets misinterpretations by people who went to Claude. >> So So it's it's it's helpful it's helpful for people to to get in there a little bit, but you really need a a a seasoned advocate to help you navigate it. Will there be a point at which an agent can actually act as my daily concierge doctor and and [clears throat] be preventative and be proactive? >> Stay tuned on that. >> Um maybe I mean it's a lot to ask. >> How would that work? Like it would it would it would have to have all my medical history, right? So I'd have to trust it to have all my medical history. >> Yeah. >> And then it would have to have some way of getting updated information on like what I'm doing, what I'm eating, how I'm sleeping, all that stuff. Yeah. I think I think there's a lot of people trying to solve that right now or the but the the I mean to me the world of AI in the world of consumer AI is you know there's a lot of people saying AI is going to replace doctors there's that's just the narrative. >> You don't think that's true? >> No. >> Does AI do a better do job than most doctors? >> No. So AI plus doctor is better than AI is better than doctor. So what you want is a doctor with AI. >> I see. And then you get the full force of because the the the I mean a lot of people think that diagnosing and treating is the problem. It's actually navigating the health universe. >> Okay. So I I had a friend whose kid had a seizure the other day and they called me what do I do? And they they went to the ER and everything was normal. I said you need to get an EEG. How do I do that? You need to see neurologist. Where do I find one of those? You know, and so these are the mundane things that people freak out about. But but I will say going back to longevity things because I want to touch on the we talked about it a little bit earlier before we got on on air is >> when you read something in the news there's a headline >> you know that then everybody goes oh my god I got you know but behind that headline a reporter found some article somewhere that like they imputed the story that they wrote bas >> talking about studies like saying drinking five cups of coffee actually prevents a heart attack those kinds of things right >> that's right right or or try this peptide because the but so there's a company called uh censica and they have a thing called Tessa newslink and uh any news article that you see you can put this had the link of the news article it will then go find the primary source and then it will do this like multiffactorial AI deep dive analysis of was that a good study what was it was it well organized did they have conflicts of interest are there you know are so and then you get like a little snapshot >> what's it called Tesla link Tessa Newslink. >> Tessa News link. So you just you you put the link in Tessa Newslink and it will tell you, okay, here's the actual study behind this headline, this >> and here's and here's a one-page report about how good >> how good that cuz that's what I never know. Like I'll even link to the study cuz I'm obsessed with like fitness and health and and strength training and nutrition, all that stuff. And I'll go to the study, but I'm not a I'm not a doctor. I'm not a scientist. I'm not an academic research. So I don't know. Was this a good study? I don't know. 30 people. Is that a lot? Is 600 people. Is that too many? Exactly. By the way, so this tells you this was a good study. Was it grade the study or something? >> Yeah, they grade it grades all of it on six different dimensions. And then, you know, going back to just the the the basics, I mean, >> a lot of people that are really focused on longevity are at like 96% of health and they're trying to get to 98 and they're going to spend all this time and money and energy on this 2%. And it's just like, hey, yeah, let's focus on the let's major on the major and minor on the minors and like what problem are we trying to solve here? And ultimately what we find is that you know in the longevity space like sleep's the most important thing in my book. Uh diet and exercise are the second most important thing. I mean sleep and good social interactions are there. And so most people don't get enough fiber in their diet. And so on the innovation front, there's a company that reached out to me with his PhD, developed this, he did a PhD on fiber. And he's got a company that like makes fiber like invisible in water and you can drink water and it's got fiber in it. And fiber feeds your microbiome. And fiber also is like acts as a natural GLP-1. And you know, humans used to get 60 grams of fiber a day when we had to chew before industrial food came in. And now we get like 10. And and that's really true. >> What should we get? >> We should get like 30 to 35. Most people are getting 10 g of fiber, 33 for five. And this is not just like some like would be nice to have. You're saying this to get 30 g of fiber is critical to your health >> and it's hard to do. So some people have to like eat like a bowl of fiber one cereal. Some people have to like take Metamucil. But this company called it's called One Dot Bio. I think that's the name of it. But >> they're they're going to launch a whole suite of of things. And I I think the science is really good. >> It may be more important than protein. You think? >> Yeah. So protein, you know, in the in the bro culture, like, you know, >> because I love protein. >> Well, a lot of people say >> 200 grams protein every day. >> Yeah. Well, well, if you're working out and you look like you work out, then you should eat protein. But if you're not working out, putting protein on your they have protein fries now. They have protein sodas. It's like, what is going you're just peeing it out, right? >> I mean, that's not doing you any good. So, it's really what you want is fiber >> more than anything else. I mean, obviously, you got to get your protein and your fats. >> So, I want to get to a question here. We have uh Harsh who is a Texas-based small business owner. He asks, "Besides diet, what is the one thing in someone's daily routine that can not only extend life but also maintain a good quality of life in later years?" That's a good question. >> Yeah. So, I would say uh sleep, like I just mentioned, uh my my my advice to people is if you set an alarm clock to wake up, stop doing that and set an alarm clock to go to bed because waking up naturally is your brain while you're waking up is is cleaning out all the junk from all the debris, from all the metabolic activity you did while you were awake. So, when you wake up naturally, you wake up because your brain has cleaned up all the stuff. The garbage men are done. So, if you wake up too early, the garbage men weren't done. And then that that accumulates over decades. This is an over decades thing. But you also feel better when you wake up naturally. >> I think we all know we need more sleep. We all know we don't get enough sleep. Um, but you're saying the answer is not to set an alarm. >> I'm saying, well, you can set an alarm in case you don't wake up in time, right? >> But like jarring yourself awake every morning from like this beautiful luscious thing that's restoring your brain, it's just not a good idea. Um, so I would say sleep to his question, sleep is one of the important things. Um, you know, alcohol, like I say, you should never drink alone, right? Um, and and so, but if you're gonna >> How many drinks are like Okay. >> Well, there's all these studies that show that like if you have three drinks a day, like you you are going to not live longer and live better. Like there's lots of problems there. But what I tell people is if you're going to drink alcohol, and a lot of people do, and I I have a drink also, is have a full glass of water before you drink. A full glass of water before you drink. And after you have your while you're drinking your drink, have another full glass of water. I mean, like I say, the solution to pollution is dilution and and alcohol is a good alcohol is a toxin and the more you have it concentrated, the more it causes damage. So, I think just being mindful of your alcohol consumption and sleep. And then the other thing is like there's a lot of people in our lives that give us headaches and they create drama. And if you can try to cut these energy vampires out of your life, um I call it social nutrition. You got to work on your social nutrition and your social fitness. A lot of questions about GLP1s, obviously. [clears throat] Um, Penny, a family office director in California, asks, "Are GLP1s uh not advisable for people over 75 because of muscle loss, or is a few months safe?" Um, asking for a friend. So, [laughter] >> of course. Yeah. So, >> what's your take on Jib? I mean, they seem to be like miracle drugs. >> They're they're pretty impressive. Are we going to find out in 10 years that there's actually some >> Well, we're in the third I mean to use a baseball thing cuz we're coming up to the postseason here. Like we're in the bottom of the third inning on GLP1, but so far like the the all the stats are really good. I mean, you know, are there some errors in the using the metaphor? Yeah. I mean, there some there's some vision issues that are coming up that are starting to surface. But the question was on a 75-year-old and the question is is like I know a lot of 75year-olds that are very strong and healthy and work out and live these active lives. I know 75 year olds that are frail and thin and you know and uh don't lead active healthy lifestyle. So the now if you're an obese 75y old right you're overweight and and you know then the GLP1s will lower your weight probably improve your metabolism improve your blood pressure improve a lot improve your risk of heart attacks and and and and strokes and dementia and everything else um but you will lose muscle and um I was at an event recently with all these people promoting GLP-1s and there [clears throat] was a not going to name names but there was a major pharmacy person on the panel ran a big national pharmacy company. I think it was the chief medical officer. And I raised my hand and I asked the question, "What's the downside of I mean, we're talking about all the upsides. What's the downside?" >> Right? >> And um you know, he was very political in his answer on stage because it was a lot of like very famous bigname people, but afterwards he came up to me at and he said, "Hey, listen doctor um I really appreciate the question, but like let me tell you the answer behind the scenes." I'm like, "What's that?" He goes, "We are seeing a lot of older people falling and, you know, buying, you know, and having injuries and so what's being kind of hidden is older people and GLP1s are having more falls because they're losing muscle >> because you lose muscle, you lose bone density, right?" Especially for women where bone density is an issue. When you start losing muscle, you lose bone density, right? And that's like >> but but one of the if you talk to Near Barzeli who's a friend of mine who studies centinarians at Albert Einstein in um here in New York he he would say that you know taking bisphosphinates is a known cure for longevity I mean for live longer which is bone health your bones get stronger. Now I don't think I'm telling everyone to take bisphosphinates because it's a real drug that that needs to be but if you have osteoporosis you take that. >> Yeah. Right. >> But the question is is if you if you're going to take a GLP-1 you you you have to be active. You have to so your bones get stronger the more you stress. >> Take it so they don't have to be active. >> Well, this problem but this is the problem. So you have to actually work out. You have to be active on GLP1s to to counterveil the effects of the muscle loss and the bone loss and and even then we don't know what the statistics there really are. But I would say that in general if you're if you're going to take GLP-1s and because of a metabolic problem you have you should do that. But and you should also engage in a program to do whether it's Pilates or yoga or just walking. >> Yeah, >> just do something. Yeah, you can lift a few weights, but don't just take the GLP1 and have that be the crutch because you will fall down. >> Um, in terms of a lot of questions here about concierge doctors and how to pick a concierge doctor. Um, again, there, you know, it's it's hard because you see some concierge doctors charging like $5,000. Yeah. and you see to your point some charging $250,000 and you're like I don't know if that guy's worth 200 or is this guy too cheap and I'm not I'm actually overpaying at $5,000. So when people are saying let's say they're they're fortunate enough to been successful they have an opportunity to be shopping around for concierge model um what's the checklist look like? So I, you know, having been around for a quarter century and being the first one to do this and have I have helped hundreds of doctors go transition from uh wherever they were to kind of a a membership model. We call it membership model more than concier because that that's got to like you know >> less nudity. >> It's less nudity. And by the way, when you go to concier they always say yes. And and so a a good membership doctor or private doctor will sometimes say no. Like it's not just yes. Sometimes you, you know, wealthy people, there's something called VIP syndrome where wealthy people get too much care- or they get too little care. They're either demanding and the doctor says, "Okay, yes, yes, yes, ma'am, yes, sir." Or they're intimidated and they don't want to like burden you with too many things, so they do less. So, you have to find the sweet spot, which means you have to be grounded in your ethics and your understanding of evidence. So going back to the question though is the first question is is um how many uh patients or members do you have per doctor? So we have a hundred we have some of the smallest we have the smallest number in the country. >> 100 patients >> but we have a whole team that surrounds those. It's very low. It's very low. Um and and a higher you know people can go up to 300 500 700. Once you start passing 800 you're looking like you're in the regular medical system. So if I'm talking to a concier doctor and they say, "Well, our rate patient ratio is like we have around 400 patients per doctor." That sounds like a lot to me. But you're saying that's not bad. >> I'm saying that most Kaiser doctors, if you know what Kaiser is, or most, if you go to any primary care doctor in New York City that that works at an institution, they have like 4,500 patients. What? >> Yes. >> It started off at 100 and then they said, "Next year, you're going to take 10% more." And it's been compounding. And and so one of the questions is is that that's the number. The other is how long have you been doing it? The third question is is you know where'd you go to school? You know you want to get the education piece right. Um you know the other ones like what hospitals are you affiliated with? You want to kind of want to get that landscape. I think one of the most important one is and at private medical our annual fee is what it is but we don't we make recommendations for all sorts of things but we make no money on any recommendation that we do. We have no financial interest and a lot of not a lot of but some of these concier doctors and a lot of them are getting bought now by private equity firms. and you're start, you know, do they have investors is the other big question because if they have investors then >> they're going to want to cash out at some point. >> Well, they're a they're going to want to cash out and b there's probably some motivation to juice the ibida, right? And so maybe I can order this blood test and you know I own the blood machine, so what cost me $2, I'll charge you 50 and 50 seems cheap, but the margin there is ridiculous on blood tests. So you really want to know, are they marking things up or do they have a financial gain on things that they do? Because the power of the physician pen is incredible. Could you ask him like what do you sell? Like what what's what are your financial incentives? Is that >> Yeah. I'm like if you know do you I mean why wouldn't you? You're you're entering a private contract with a private doctor. I mean if you go to a bank you should say what are your fees, right? You're not going to be shy about what their fees are. You should find out like what they what they charge and you know do they charge for vaccines and how much do they mark them up? You should know these things. It's a fair question. >> Yeah. And what about I mean there are people watching this probably say well it' be great to have Dr. Schlane and to be a private medical patient, they can figure out what's wrong with me before I actually get sick. But it's too expensive and this is a very high-end product. Is there a way that technology can bring what you do to well maybe not democratize it but at least to the more everyday people like you think with technology and AI with the power of those things to to really do things that only specialists could do before. Is there a way that concierge medicine can be broadened? >> Well, I would I would first say that you're starting to see more and more doctors join the the membership based community. And so I started 15 years ago something called the private physicians alliance, the PPA or the PPA. If you go to that website, >> that's a group of concier doctors. >> This is a group of vetted >> concierge doctors that like have to get apply and get accepted in and they're all around the country. So like private medical is in New York, we're in Silicon Valley, we're in Miami, we're in we're opening up in Greenwich. Uh next month we're, you know, we're in Los Angeles, San Francisco. So we're in the major metropolitan areas. Um now our network's extensive. But you know, if you're in Indianapolis or if you're in Tampa or if you're in Denver, like you want to find out, there are doctors. There's lots of concier doctors there. So I would before I go to the AI democratizing thing, which I think will come, I think I think that's going to there's a lot of people working on it. I think the first step is you don't need to be super rich to have a concierge doctor. First of all, I mean for our for our members, you know, we we are expensive, but we put together this incredible uh package, a suite of services that is just it costs a lot of money to build that thing. >> Um I mean, most of our expenses, our income goes to labor, >> right? >> It's not to technology. Um, and so I I would I would say like go find an advocate or someone in your community and the and the private physician alliance has got, you know, and that's grow and we're adding doctors in London and in Germany and so now around the world people are trying to jump on this bandwagon of how do I do great primary care because primary care is not expensive, >> right? You go to see an orthopedist or an eye doctor and you got a $2,000 bill. Most primary care doctors that you're seeing at your local whatever when they bill insurance, it's $100 a visit, >> maybe or less, >> right? It's not expensive. >> That's why a lot of primary doctors are becoming >> Yeah. Well, the Exactly. Exactly. It's just It's just I think doctors want You go into, you know, you do premed, so you do med school, you do residency. By the time you make your first dollar, you're like $350,000 in debt at least. You've spent 15 years of your life studying. And you get out and someone says you're going to make $100 a visit and you have to see 4,500 people and you have to do exactly what I tell you because I own you. And you're like, "That's not why I wanted to. I wanted to help people and now I'm just a vassel of of this medical industrial complex. So once you leave and go to the the membership or concierge model it's like >> it's like when the Simpsons when the clouds part it's like the sun comes out and it's like my god I can actually help people now and that's soul food for doctors. >> Well and I also love because your main advice today is something that everyone can do which is like take more fiber sleep more and don't take peptides until we know more about them. >> Yeah. Well, and also get get baseline >> take GLP1 ones, go to the gym. >> Yeah. And and get baseline testing also and and understand your trends, but don't obsess about your trends. Don't like, I got to get a blood test every every I'm looking at my blood sugar every 5 minutes. I'm like, calm down. Like, your blood sugar's been doing what's been doing for the last x number of years. Now, if you want to get a, you know, a Dexcom or whatever the uh the uh patch is to understand what your blood sugar does from time to time, well, then you should you should understand that bananas cause your sugar to spike and rice doesn't or vice versa. And then you can kind of modify your diet to map to how your body responds to different foods. That that that's a smart strategy and you can do it yourself. But don't freak out about your blood sugar went to this. I mean, I have people that like literally are looking at these numbers like like it's Robin Hood. Yeah, >> in their stock market or something, >> I'm sure. Dr. Slain, thank you for all your time today. Thank you for all your health tips. We really appreciate it. You bet.