The Business of Health: Building from the Ground Up
Notes on longevity, hospitality, real estate, and the reality of building a new venture in Portugal.
This is an educational, strategic perspective, not personal medical advice. Discuss any changes with your clinician.
Most health businesses are built backwards.
They start with a logo, a location, and a menu of services - then try to bolt on medical rigor, data, and operational discipline later. The result is what we all see and feel: fragmented care, perverse incentives, and rising costs in systems already consuming close to a tenth of national GDP.
We’re doing the opposite.
We are building a medically-led health and longevity venture in Portugal from the ground up: clinical protocols first, infrastructure second, brand last.
This publication is where we document that build.
Who We Are
We are siblings and co-founders with a shared background in the tech sector.
Our careers were shaped by a world that optimises for speed and scale. Our personal obsession has always been different: the question of how to add more high-quality, functional years to a human life.
At some point, those two tracks converged.
We decided to take the parts of tech that actually transfer - rigorous thinking, data discipline, systems design - and apply them to the most constrained domain we know: physical health.
We’re very clear on what we are not:
We are not here to “disrupt healthcare” with slogans.
We are not here to sell longevity fantasies.
We are not here to pretend that a complex, regulated system can be “fixed” with an app.
Health is a hard business: regulated, capital-intensive, emotionally loaded, and accountable for real human outcomes. We approach it with the fresh eyes of outsiders, and the responsibility of operators who have skin in the game.
The Space We’re Building
This is not a newsletter about “top 10 biohacks” or the latest health trend on social media.
This is a thinking space for people who care about the infrastructure of health.
You might come from:
Health tech or diagnostics
Real estate or hospitality
Investment or capital allocation
Clinical operations or healthcare strategy
What ties this audience together is not a job title, but a shared question:
How do you build health infrastructure that actually improves long-term outcomes - and still makes economic sense?
Some of the tensions we care about:
Tech vs. Clinical Reality
What happens when the software mindset (“ship fast”) collides with clinical risk, medical guidelines, and regulatory friction?Hospitality vs. Outcomes
How do design, service, and environment change adherence, diagnostics quality, and recovery - not just “patient satisfaction”?Portugal as a Laboratory
We are building in Portugal - but the underlying questions about regulation, capital, staffing, and operational discipline apply to anyone operating in a complex healthcare market.Innovation vs. Hype
How do you separate genuinely useful diagnostics and longevity medicine from noise, overclaiming, and unproven interventions?
Our Working Mental Model
The way we think about The Business of Health is a simple three-layer stack:
Biology & Diagnostics
What is actually happening in the body? Which biomarkers, imaging, and protocols meaningfully shift healthspan risk - not just create more data?Infrastructure & Experience
The physical space, workflows, and hospitality layer that either amplifies or destroys the value of the clinical work.Capital & Incentives
The business model, regulation, and ownership structure that determine whether good medicine can survive long enough to matter. Chronic disease alone is projected to continue as a major drag on GDP without better prevention and management.
Most failures in health ventures are not due to a missing idea. They come from misalignment between these three layers.
What This Publication Is (and Isn’t)
This is:
A build log: what we are learning as we design a medically-led longevity and diagnostics venture in Portugal.
A critical lens: where we dissect broken incentives, mispriced risk, and operational mistakes - including our own.
A repository of leverage points: regulators, operators, investors, and clinicians all have different levers; we want to map where they actually move the system.
This is not:
A medical advice column.
A catalogue of our internal blueprints.
A hype channel for “the next big thing” in health.
We will get things wrong in public. When we do, we will correct them in public.
Why Portugal, Why Now
Portugal gives us an interesting combination: EU-level regulation, a growing health and wellness tourism market, and a real estate landscape where long-term, medically serious projects can still be built.
We see it as a testbed for a simple question:
Can you build a clinically rigorous, economically sane, hospitality-grade health venture in a system that was not designed for prevention and longevity?
If the answer is yes here, the lessons travel.
What You Can Expect
Over time, you’ll see:
Deep dives on diagnostics and longevity medicine as a business: where the margins are, where the risk sits, and what actually improves outcomes.
Field notes from our own build: design decisions, missteps, regulatory puzzles, staffing questions, and real estate trade-offs.
Maps of incentives: who gets paid, for what, and how that shapes behaviour across tech, clinics, insurers, and hospitality.
The through-line: we care about mechanisms, not slogans.
Welcome to the Build
Substack has a long list of opinions on how to launch a publication. Ours is simple: start with the truth.
The truth is that building in healthcare is slow, expensive, and unforgiving - and that’s exactly why it’s worth doing well.
If you’re an operator, investor, clinician, or just someone who thinks deeply about the future of health infrastructure, we invite you to follow along as we build.
Welcome to The Business of Health.
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I’ll be following your content with anticipation, and with eagerness to learn ❤️🙌🏻
interesting😀