I do not sell supplements and I do not mark up labs. People sometimes assume this is a marketing position. It is not. It is a design constraint, and it is the one I would defend hardest.
Incentives shape advice quietly and constantly, without requiring anyone to be dishonest. A practice that profits from supplements will, on average, recommend more of them. A practice that marks up its labs will, on average, order more of them. The bias lives in the business model, not in anyone's character, which is exactly why good intentions do not remove it.
So I removed the conflict at the source. When the only thing a practice sells is judgment, the advice and the patient's interest finally point in the same direction. That alignment is not a feature I added. It is the whole foundation.
Sukhjit "Sarge" Takhar, MD, SM is a physician-scientist in evidence-based longevity medicine and Co-Founder and Chief Medical Officer of PrimaryMD.