How Superpower is Reimagining Preventative Health - Max Marchione

I think there's like a surprisingly high probability that just about everyone is going to be on a GLP-1-like drug. And I think that what's required is the cost to come down, which is happening, uh, the delivery mechanism to become more frictionless, i.e., swallow a pill rather than stab yourself with a needle, um, and the risk profile to be proven out, i.e., the downside risks are low, the side effect profile is, is negligible, and the upside risk is high. And I think all of those things in the context of peptides such as GLP-1 receptor agonists are going to play out.

Welcome to the Beyond Tomorrow podcast. Today's guest is Max Marchione, the co-founder of Superpower, a digital advanced clinic. In this episode, we're going to cover Max's upbringing in Sydney, his journey to co-founding Superpower in San Francisco, what Superpower has in store in 2025 with its 150,000+ waitlist, and also some key health tips, hacks, and strategies that you can implement this year as well. I hope you enjoyed the episode. Max, how you doing?

Great, Julian, excited to be here.

I'm really excited for you to be here as well. You've had a very interesting story. I always say your age, you're only 24 years old and you've already covered a lot in your short, shortish life so far. Max, give me 3 reasons why someone should tune in to this podcast and listen to what you've got to say.

If they want to learn what the frontier of medicine looks like and how the frontier thinks about living longer and healthier, that is something which we've spent hours and hours poring over at Superpower. Number 2, if they want a sense of where we think the future is heading, what the implication is of AI on healthcare, and what the implication is of everything else happening in the world, biotech, on healthcare. I think that's something we could potentially touch on. And then number 3, we're in the early days of building Superpower, but we're, we've built our waitlist to 140,000 people. We've built a viral brand. We've partnered with influencers with over 100 million eyeballs. Um, we've built a really talented team. Uh, our 6 founding members are all former, former exited founders. So I think there might be, uh, one or two learnings or battle scars from how we're going about things at Superpower as well that might be relevant to the audience.

Love a good battle scar. But let's, um, really interesting points. And I, I think the convergence of AI and healthcare is incredibly interesting and, and longevity as well. But I really want to touch on your story because as As you can probably tell from the accent, you are from sunny Sydney, right? How did a 24-year-old end up in San Francisco founding a startup that has already raised $6 million and, as you said, has a waitlist of 140,000 people already?

I got into healthcare because I went through a really challenging personal experience. Basically, from the age of 12 to 18, it would take me 3 hours to get to sleep every night. And I had no idea what was wrong with me. I had surgery, I was told to medicate for life, I spoke to 20 doctors and no one could really get to the bottom of it. So I started to become a huge health geek, buying the Gen 1 Oura Ring. I remember wearing a CGM when I was 16 and everyone making fun of me. And I ended up getting down to the bottom of my, what was wrong with me, and what it took was finding a 10x doctor. A doctor who practices a model of medicine that is so far in the future it hardly looks like medicine. And it made me realize there's this huge gap between the best of medicine, the kind of medicine that a Jeff Bezos is getting or an Elon Musk is getting, and what everyone else is getting. And for the past 10 years, I've believed that for as long as that gap continues to exist, someone or some company has to come along to close that gap. Um, and that core belief is what animates Superpower, right? That core belief that there's a better way of doing healthcare out there, there's a way of doing healthcare that's more up to date with the latest science, that actually looks at the whole person, that's data-driven, that focuses on helping someone maximize performance and maximize lifespan, actually prevent disease way in advance rather than just curing sickness. Those beliefs are what give us the conviction to go all in on creating the future we think should exist.

Super interesting. But how do you go about having that sort of thinking, that curiosity in your teenage years? Because I know you got your Oura Ring when you were what, like 16? That I don't think— I'm assuming that's probably the youngest anyone's ever bought an Oura Ring at. So clearly you had researched what the status quo was in Australia. You'd seen what the healthcare system was like and you realized there was no other option. Even at that young age. Is that correct?

I think I've always been curious and experimented and always wanted to learn and push things beyond the edge. I think I've always ignored a lot of the dogma and advice around me. The less interesting thing is getting an Oura Ring when I was 16. The more interesting thing was getting an Oura Ring one year after the company launched. Yeah. Right? And I think that a lot of people wait until something is consensus to think it's interesting. I've always been really comfortable sticking out from the crowd, facing the risk of being ostracized and criticized, to experiment, to explore, to be curious. And I think that in many ways curiosity is at the root of actually like taking action and taking risk. I think that I try to as much as possible think about what is objectively true versus what does the dogma of the world around us say is true.

Yeah, that sort of thinking is pretty popular in San Francisco, right? In, yeah, a few blocks down from where we're recording today. But in Australia, in the UK, we've got this tall poppy syndrome. I wouldn't— I would say it's, it's quite easy to feel ostracized if you're doing something that's different. Did you feel you were very much going against the grain when you were having these thinkings? Did you have your friends think, hey dude, this is a bit odd?

Uh, yeah, everyone used to make fun of me. Okay. I remember we used to have like morning tea recess break and everyone would sit down and I used to stand up in the group of people sitting down. And the reason I wanted to stand up is I'm like, well, I've been sitting all day long. I've heard standing is good for you, therefore I'm gonna stand up. And people thought that was the weirdest thing ever and would make fun of me for it. But I think I was high conviction enough in doing it. There's like, if you do it half-heartedly, then you become a point of mockery. If you do it full-heartedly, then it actually becomes kind of intriguing for people, and they start by making fun of you, and then they start by acting actually curious and trying to work out why you're doing it, and then they start by actually following you and realizing that maybe, maybe it's the right, right way of doing things. So it was definitely a— I think a lot of the things I did definitely put me in a position where people could make fun of me. But I think I did it in a way that was, um, in a way that I would make fun of myself as well, and in a way that was actually intriguing for the right kind of person.

Yeah. Um, so yeah, this like non-conformity, did your parents have any effect on it? Were they telling you to go for it, or were they thinking, Max, just be a, be a normal Sydneysider?

Uh, they used to make fun of me as well. They used to call me like Gadget Man or Maximizing Max. They used to joke that I'd get some weird like device or supplement or thing in the mail every single week. So I think that they made my life probably harder in this regard rather than easier. But they made it easier in a lot of other regards. And I think that what they did was really important because I think that there's this tension between Being independent-mindedness and isolating others, right? I think like being independent is important at the level of it helping you think through what is actually true and helping someone discover what is new versus just sticking with what is old. But there's a point at which independence starts to transition into isolating others, or it starts to transition into not actually having a feel for what is normal or a pulse on the mainstream. So I think it was really important that I was surrounded by a lot of very high EQ calibrated normal people because it meant that I deeply understood the mainstream as well as the frontier versus just being in a bubble of people where we're doing the, the unusual thing was normal.

Sounds interesting. And then you go to university, you're studying law, and you decide, hey, I'm just gonna drop out.

Correct. Law was a 5-year degree. It would take a lot of time. And I loved it. I actually really enjoyed law. I did well at it, but I didn't want to be a lawyer. And I didn't want to spend 5 years dedicating most of my time to learning something which was not closely enough related to the thing I actually wanted to do in the long term with my life.

So that conviction of what you wanted to do, like, when did you have this realization that being at the intersection of longevity, of health, of tech was your calling?

I knew I wanted to do my own thing from quite a young age. I think that the world around me pushed me away from that to an extent. I think the world in Australia is very much one which is a reversion to the mean culture. And on the downside, that's good because it means we lift up everyone. But on the upside, it's bad in that we cut down people as well. And that's the tall poppy syndrome you mentioned. So the world around me was very much saying, go into law, become a doctor, become a banker, that's what smart people do. And that was in antagonism to what I inherently authentically wanted to do, which was start something I deeply believed in. Yeah. There were around 3 things I deeply believed in with healthcare, probably 2 things I deeply believed in. One was creating a new healthcare system. And the other was creating new cities. And I think both of these started with very much an aesthetic belief that there's a huge gap between the current healthcare system and the current cities, and what both of those two things could look like in an ideal world. Doing either of those things is absurdly ambitious and absurdly hard, so the belief wasn't that I was going to do them in 5 years or 10 years. Instead, the belief is, let's say I have 100 years on Earth, can I do either of these two things in 100 years? And I think if you actually take a 100-year time span on something, or a 50-year outlook, right, you can actually start to rethink the level of your ambition. And you can actually start to think in terms of 50-year timelines versus 5-year timelines, or 2-year timelines, or 1-year timelines.

'Cause you're an all-star. Build beautiful things, physical and digital, that change the world. I just wanna like hone in a bit more, just, and then we'll jump onto the next section, but, Did you feel like you needed more like lived experiences or did you feel you were compounding at such a young age that you'd already experienced what you need to realize that the world needs to be built differently?

Everyone always says I need to do X before I do Y. Right? They always say I'm gonna do Z one day but first let me do ABC and I think most of the time we can skip all of those requirements and we can go straight to the thing we want to do. I think there's this tendency to constantly delay the thing we know we want to do by adding requirements, or adding caveats, or adding barriers in the way. So, that's the first thing I'd say. The second thing I'd say on this idea of build beautiful things, digitally and physically, which change the world, the core belief here is that utility and beauty go hand in hand, right? You're changing the world, but doing so with beautiful things. And I think that's actually not a common belief. I think the common belief is you have either utility, or you have beauty, right? You have aestheticism or you have functionality. I think it's really rare for people to actually think those two things go hand in hand. The mainstream narrative is that they're opposed. I think the more accurate view of things is that they're actually synergistic.

Mm.

And what I'm getting at here is that something with form can enhance the function, right? Something beautiful can enhance the utility. The first job I wanted was to be an architect, and I think part of the reason why is that in architecture, it's very well accepted that form and function go hand in hand. And I believe that that's true of the rest of the world. In healthcare, I believe form and function go hand in hand. Whereas today people think they're opposed. It's like, well, form, that's like wellness and aesthetics, and function, that's like sterile healthcare. But I think that does not have to be true. Cities, I think the same thing is true. People are like, well, this city is one which maximizes innovation, or it's one which maximizes happiness and health. But you kind of, the two go hand in hand. And again, I think that's not true. I think you can simultaneously maximize innovation, happiness, and health, and instead they're synergistic. So the core belief underneath this statement of building beautiful things that change the world is that beauty and utility actually go hand in hand. And if you believe that and build products according to that, you can, you can build far better products.

Let's fast forward to the US because I really want to talk about a healthcare system that's often described as a sick care system, one that is reactive rather than proactive. And I would say in many ways it's pretty ugly, right? Not beautiful. It's how do you meld the idea of building things that are beautiful, that function incredibly well, with a system that is pulling you in completely the opposite direction, full of hurdles, regulation, archaic systems, etc.? Is it a possibility as long as you have that kind of maniacal drive to make it happen?

I think it's totally possible. I think the main constraint is actually the belief around whether it's possible or not possible. I like the idea of if you put gas in a chamber, gas feels the size of the chamber, right? And I think the same thing is true of belief, right? What you can do is actually a function largely of what you believe you can do. And I think the belief, which is the pervasive belief in healthcare, has been that you can't build a more consumer-first health system that's more holistic, that looks at the whole picture. That's been the pervasive belief. And I think just by challenging that belief, we create a world in which we can start to have a healthcare system which is aspirational, which is consumer-first, which actually has products like we've come to know and expect from like Apple or Tesla.

But fast forward to sort of superpower being created. You're with two co-founders, you're building this platform. Was it quite clear what you wanted to build from the beginning, or did you guys ideate and pivot quite a few times?

I think we understood step A and we understood step Z, where we wanted to get to. I think every single step in between we did not have clarity around, and that's fine. I think where— what you need to know is the next step and the final step, right? And then I think we will— you work out everything along the way. I think I see this tendency of people trying to work out every single step ahead of time, and when someone tries to do that, it results in paralysis, and people don't actually take the first step. So we knew the first step, and then we worked out the rest of the steps in motion rather than sitting there and thinking about, um, things.

Let's go back then to the 10x doctor and how the 10x doctor you mentioned at the beginning was, or is, being inputted into step A. I'm assuming The 10x doctor was somewhere in step A, right?

So, the, yes and no. So I think what we believed is that there is a model of healthcare out there that some wealthy, like the wealthy people are paying hundreds of thousands of dollars for, and as a result are saying that that model is better. And the thing we saw is that we believed that model was better, but we also saw that access to it was not evenly distributed. So what we knew is that in the limit, that kind of healthcare would have to be evenly distributed. The arc of technology is taking what is accessible to a select few and making it available to the many. So we believe that that model of healthcare would have to become evenly distributed. We didn't know the exact path there.

It's interesting because you get a lot of longevity clinics right now, and let's say services that are very much catered to the incredibly wealthy. And the reason for that is there is a still a high price point for a lot of these services, and it's incredibly difficult to scale. Is that statement true? Is it difficult to scale?

It's surprisingly easy for high-end longevity clinics to sell the service of a really good doctor and have a doctor spend 50 hours with the patient getting to the bottom of things, collecting all of their data, analyzing all of their data, reading all of research. That's not scalable. The hard thing is how do you bring the cost of that down to zero? And that's a very complex technological problem. How do you aggregate all the data technologically? How do we interpret it technologically? How do you stay up with the latest research technologically? How do you connect the dots across everything you know about someone technologically? So it's a tough technological problem. And then this is tough systemic problem, right? How do you work with the supply chain? How do you underprice in any commodity? How do you, um, work with insurers? How do you try to drive the cost for free by finding a third-party payer? So the easy thing to do is launch a high-end longevity clinic like a lot of companies and people are doing. The very hard thing is to work with technology and complex systems to actually bring the cost of that to zero.

Do you think the US is one of the harder places to do that in? Do you think if you're doing in Australia or the UK it might be a bit easier?

No, it's way easier in the US because there's a lot of existing infrastructure we can buy. If you look at a company like Forward, which failed recently, one of the challenges for them is they started in 2016 where there was no infrastructure. So they had to build basically 20 companies in one. And then different parts of the software they had built turned into APIs that third-party companies provided. But now Forward had to maintain the existing software that they had rather than just buy a third-party software. We came along 8 years, 6, 7 years later and we could buy all of these things Forward had to build. And now we don't have to maintain 10 pieces of software. Instead, we just pay a small fee to the underlying software provider. This underlying software infrastructure to power digital health only exists at depth in the US. So for us to do what we're trying to do in other markets would be really complex because we'd need to raise 5 times the amount of capital and build far more. If we wanted to do it in a technology-first fashion.

So can you give us an example of what one of these APIs looks like and how does that integrate into the Superpower journey for a member?

So Forward had to build their own electronic medical record from scratch. We use Medplum, which is basically an open-source medical record that we can build on top of.

Gotcha.

Forward had to build their own nursing network from scratch to send nurses to people's homes. We plug into a third-party nursing network via API.

As we're now seeing the proliferation of AI and large language models and, and we're seeing it seeping into healthcare at incredibly fast rates, I think one of the key issues has been that there's been so much unstructured data and now you're giving an opportunity for an individual to have very personalized, a very personalized approach to their, their health outcomes, right? And to be a bit more proactive in what medicines they might need to take or what diet they may, they may change to. How will the opportunity of AI and everything that it provides help personalize your offering further and also just provide more opportunities for your members?

If you look at— so, so 10 years from now, doctors are not going to exist in the way they do today, and instead people are going to increasingly go to algorithms. And this sounds absolutely absurd, but the catch is that this already happens today. Like, if you have a health problem, what's the first thing you do? So you probably pull out your phone and you go to Google or you go to ChatGPT. And, um, right now that's, uh, people don't even think of that as an algorithm. They just do it. There are a billion Google searches every day related to health. Yeah. And this is in a world where Google knows nothing about you. It knows nothing about your data. It doesn't know that much about the latest medicine. It's like based off of WebMD and Healthline, and people still go to Google. Imagine a world where the algorithm knows everything about you. It has all of your data. It has all of your personal history, your family history, um, every interaction you've had with healthcare. Uh, it knows your preferences. And then imagine it knows everything about medicine. It knows everything about what the 10x, what these 10x doctors are doing. It knows, uh, uh, everything. It knows that the brains, what's happening in the brains of doctors and the best clinics around the world. It's up to date with the latest science in real time. In that world, um, you have an algorithm that knows everything about you, everything about medicine that is far, far better than Google. Or ChatGPT, or even your doctor. And 10 years from now, that's the world we're going to, we're going to be in. Practically today, there are microcosmic versions of that which impact how we build at Superpower. If we're looking at how do we take 3,000 pages of data about a patient and structure that into like useful insights and connect the dots across all of that data, that is a use case for AI, right? If we're looking at how do we stay up to date systematically with all of the latest research and connect what we've seen in someone's genome to what we've seen in their gut microbiome, to what we've seen in their blood, to all these different research papers, again, that is already within the domain of something AI can do. So there are ways already which AI is helping at the level of data aggregation, data analysis, and then matching what we know about the person to what we know about medicine in a way that just humans cannot humanly do because there's just too much information out there.

Thanks for tuning in. If you're enjoying the podcast so far, please feel free to hit the subscribe button below. It makes a huge difference. Now let's get back to the episode. Do you think a general practitioner then will become redundant within 10 years?

No, I think that there are a lot of reactive and urgent care based scenarios where a GP is useful. Yeah. I also think that our primary care practitioners are going to be increasingly commoditized as prescribers. I don't think any technological system in the next 10 years is going to have prescribing capability. We will still see though the commoditization of the prescriber. And this is what Hims has done. I don't think Hims has done this well. They're not personalized, they're not providing high-quality care, but they have commoditized the prescriber. I think that a primary care practitioner will also be helpful at the level of trust and helpful as a touchpoint for members wanting a slightly more handheld user journey. A simple example is today, a lot of people could get a mortgage without chatting with anyone. You can get a mortgage online without chatting with anyone. But people will still use mortgage brokers because it's a very personal purchase. They want to feel like they're not making a mistake, et cetera. And I think because of this human psychological factor, primary care practitioners will still exist. That said, I think that far few people are going to go to their doctor as the first step in healthcare. They're going to go to ChatGPT or Superpower or some other algorithm instead. And we're already kind of seeing that, right? There's a billion Google searches every day related to health around the world. There's only 50 million doctor's consults every day around the world, right? The front, there's this idea that the front door of healthcare is your primary care doctor. That's not true. The front door of our healthcare is Google or some sort of technological system. And then if we even look at our members today, One of the things which absolutely shocked us is that only 40% of our members have a regular primary care doctor. So 60% of our members don't have a regular primary care doctor. And we hear people say, but aren't your members really young? No, our members are typically between the age of 30 and 50, right? And even them don't have a regular primary care doctor. And I think this is a leading indicator of where the industry is going in that regard.

Fascinating, like what I'm hearing is there is this kind of precursor to this personal moment with, with a general practitioner or a physician that you have this trust and this care with. But there is just a lot of improvement that can be made to be a bit more proactive with how we approach health and also to be more accurate with what we're searching for. So we, we at the moment are searching on ChatGPT and Google, but that's just going to be far more refined. So we can then probably make better— we can make improved actions on, on whether to call up a physician or not, right?

Yes, correct. Already, like if someone uses ChatGPT today and they prompt it right, they say you're a functional medicine doctor, here's all of my data, and you actually interact with that system. It's pretty good. Yeah, it's far, far better than YouTube or WebMD or Healthline. And once it has that data, it now has that data in memory, and every question you ask, it can be informed by that data. It understands you, your psychology, your budget, what you're willing to experiment with and explore, and it just constantly learns over time and gets better at knowing exactly what works for that specific person.

So 140,000 beta users or members, right, on the, on the membership list. You've got an active beta right now. What is keeping you up at night? Like, what are the things that you feel, what are the little fires that you're putting out?

Uh, there are a lot of fires where we're choosing not to put out, which I think is important because we can't do everything.

Yeah.

And I think it's really easy to get bogged down in incremental 1% improvements and forget the importance of the 10x improvements. So we actively ask the question as a company, what fires are we not putting out? And, and celebrate that, right? As a sign that we're focusing on the few things which really, really matter. If I look at the few things which really, really matter right now, it's the core customer experience of the core membership. In particular, we want to make sure that the initial consult someone has is a 10 out of 10 experience. And that means giving our clinicians tools to deeply understand the person. It means actually just workshopping the nature of that experience.

That's a nurse, right? That goes and—

That's one of our longevity clinicians.

Gotcha.

And so the nurse collects the blood, but then the actual consult is a one-on-one consult with a functionally trained clinician. So we, getting that loop really good, is really important. Beyond that, we have big ambitions for growth. So even though we have 140,000 people on the waitlist, we're not building a company for 140,000 people or like even a million people. Like we want this to be Amazon Prime scale, right? 150 million Americans have an Amazon Prime membership. So we have to get very good at understanding, at understanding how to build an engine that allows us to keep bringing members in the door. I think the final thing that keeps me up is working out exactly how we want to position. A risk is being everything for everyone, because then we're nothing for no one. So we're going to have to increasingly take an opinionated stance of where do we want to start, and how does that starting point earn us the right to then move to the next point, and then move to the next point. And I don't think we have a logical enough sequence of steps related to positioning and product. And that's something whether we're going to have to continue workshopping in motion over the next 6 months.

There's a saying in SF, I think a few VCs say it, which is you might be thinking big, but think even bigger. And it feels like you guys are just going— you're going for the grand slam. You are creating a system and operations that is going to serve 150 million people. That's your vision. And you're starting on day dot, right? In terms of the early adopters, are you seeing yourselves like— so I just want to understand this because you've got your early adopters that probably have a certain makeup, but you're actually creating a system for the mainstream as well. So how do you kind of meld serving the customer delight of this early adopter, but also catering for what is going to be the whole of, whole of the US, right, with different health needs and health outcomes, etc.?

In the long term, all that matters is we're providing the best outcomes for free. So in the long term, what matters is that we have a clinical model set up to deliver really great outcomes and that we have structured things systematically and technologically in a way that brings the cost down to zero. And that over time will earn us the right to be the primary way people engage with health. Lowest cost, uh, well, I guess like highest quality, functionally equivalent cost, and far more convenient earns us the right to go mainstream in the long term. The question in the short term is where do we start? And the risk we run is trying to be mainstream right from the start. And instead we need to have an understanding of why starting with a specific group of people, um, creates these set of, um, circumstances that allows us to then move to the next set of people and the next set of people and end up mainstream. And I think the irony is the way to end up mainstream isn't often to start mainstream because it's very hard to actually change culture and create a movement by starting with the laggards, right? By starting with the people who are really hard to acquire, find, persuade. By starting with the people who don't actually influence culture. Instead, there are a lot of tastemakers. In culture, be them celebrities, creators, fitness influencers, who determine what the future should look like. And I think the interesting thing about starting with the tastemakers is we start to not just rewrite technology or healthcare, but actually culture and the way people actually engage with this concept that today we call health.

I'm hearing a few of your early adopters you're shouting out. Do you have any celebrities people that we might have heard of as part of your waitlist?

We do, but I don't know if I can share. So we have quite a lot of wildly famous people on the waitlist.

Okay.

And we're closing out a few celebrity partnerships at the moment.

So we're talking about a huge incumbent. I think the US healthcare system is, what, $4 trillion a year?

$5 trillion last year.

$5 trillion. Okay. You got a lot of people within that industry that are probably protective of their own self-interests. How do you change a system that has benefited a few? How do you foresee that there is going to be an inflection point in 3 to 5 years? Are there certain movements or technologies that you think will fasten this process?

People will vote with their dollars. And the final person who receives healthcare is the consumer. And even if the consumer hasn't classically paid for healthcare, they're the ones who receive healthcare. And our belief is that if you can start by obsessing about what the customer wants or the member wants or the patient wants, you can start to get the other pieces to fall into place. That said, the risk we run is building an outsider. Company. And we don't want that, right? Like, there is a lot of good the healthcare system has done at the level of sick care, and there are a lot of ways that we want to work and collaborate with the system, because what we do is fundamentally different to what the healthcare system does. The healthcare system says, you're sick, let's get you just to the edge of well. We say, you're not deathly sick yet, Let's make sure you never get sick. Let's identify any transition from wellness to disease really early. Let's try to actually make you like optimally healthy. Yeah, right. Like, it's not good enough to just not be sick. Our belief is health should be a tool to help someone be optimally healthy, and that is a fundamental, fundamentally different belief to how the healthcare system operates. And that's fine. I think the healthcare system will still exist to get someone from -5 to -1, and we will exist to get someone from like -1 to positive 10.

Super interesting. Okay, let's become a member. I've done the tests, I've seen the Longevity Clinician. Let's say I'm slightly overweight, I'm based in San Diego, and what happens next? Walk me through the journey. What sort of advice am I going to get? Am I going to be put on a bunch of medication? Am I going to be told to eat a bunch of pineapples? Like, what's going to happen?

There is 3 steps. Step number 1 is we'll test someone's whole body. So 100+ lab tests. That's around 5 times more than your, your normal primary care doctor will tell you. And we'll visualize that all in a beautiful dashboard for someone. We'll pull in their data over time and show them how they track. We'll allow them to read more info about the biomarker. And we've defined optimal ranges. We've worked with a team of PhDs out of Oxford who have defined the difference between optimal and normal based on research. Right, there are a lot of people out there who say, oh, this is optimal, this is normal, but they don't have the research to back it up. We have explicitly shown why being in optimal is better for vitality, longevity, disease prevention. We'll aggregate all of that data about the person into what we call like the superpower score, which has like 100 different inputs It's a score out of 100 to really create the one number that gives someone a sense of how they're tracking over time. And then you want your Superpower Score to go up, to get closer to 100. We will also show someone their biological age and the breakdown of that score. And at this stage, we will also allow someone to access additional testing if they want it or need it. Gut microbiome testing, microplastics, mold, heavy metals, CAC scans, DEXA scans. And finally, we'll pull in all of someone's medical records by integrating with the rest of the system. So step number 1 is let's get as much data on someone as possible and help them understand it. Step number 2 is we'll put someone on a call with one of our functionally trained clinicians to step through everything, right? To actually connect the dots, to hear what someone wants, to create what we call a custom protocol that says, here are all of your issues, here are all of your goals, and here's what we can do about it. So that's a very collaborative process. And someone will get a big report at the end of that process. Step number 3 is we make it as easy as possible for someone to take action. So we'll ship everything to someone's door, whether it's, whether it's a pharmaceutical, whether it's a supplement, whether it's booking future consults reimbursed with insurance, whether it's getting follow-up diagnostic testing. We'll do all of that for someone, ship to their door, so they don't have to like hunt around the healthcare system and, and go to 10 different places to get their that get their care. So basically, we'll test someone's whole body, we'll tell them what to do about it, and then we'll actually make it as easy as possible for them to actually take action.

Is the idea that eventually you're gonna go from step 1 to step 3 without even thinking? You seamlessly get a test, and all of a sudden the supplements are on your door, you've got 3 gym sessions, strength training and jumping through different types of hoops or whatever, in the diary. Is that the idea?

In the limit, yes. I think that's where healthcare gets to. I think healthcare ends up being run by agents or an algorithm such that it's on autopilot for people. Yeah, there are a lot of, um, psychological and technological and legal barriers to preventing that happening, but I do think around 10 to 15 years from now, that's where we'll be.

That's pretty fascinating. I, I still want to talk a bit about the you've got these early adopters. There are people that are actively looking to improve their health and their health outcomes, probably a bit more aware than your average person, right? But a lot of people, they will be sitting on the couch and their idea of comfort is putting on the TV and eating some, you know, fast food or whatever that will give them the dopamine hit or the craving or cut the craving. Like, at what point do you think we're going to get to that level where, you know, 150 million people They shop at Amazon because there's convenience in getting same-day delivery and all that. At what point do you think— I don't want to even say a name or a person, but let's go back to David in San Diego. David's going to say, you know what, this is what I need.

I don't think that the future of healthcare looks like radical behavior change. We've been trying radical behavior change for 50 to 100 years and it's never worked. I think the future of healthcare looks like changes at a systems level. Let's actually regulate preservatives and pesticides out of the system. And then it looks like innovation at the biotechnology level. And the first time for 50 years in the US, the BC has gone up and to the right. Last year for the first time it started going backwards because of a pharmacological innovation. Innovation or invention, which is GLP-1s. Now there's other problems with GLP-1s, but I think what they are is a harbinger of where the world is going, which is a world we have increasingly potent biotech interventions which can drive really powerful outcomes. And we kind of intuitively know this is true. If I said to someone 1,000 years from now, let's take the extreme. If I said to someone 1,000 years from now, are people, just like really disciplined and not touching any unhealthy food? Or are people just taking the magic pill? 1,000 years from now, people are taking the magic pill. We kind of know that's true in 1,000 years. Well, what happens if that doesn't happen in 1,000 years? What happens if that happens in 20 years or 10 years? And I think that's more what the future of healthcare looks like than all of a sudden human psychology changes and people have perfect self-discipline.

That's like a radical change. Let's look a bit, bit into the future. So GLP-1s, as you say, the harbinger, this is just the start, right? What do you— what can we expect in the next 3 to 5 years? Any cool innovations that you're excited about that you're hearing about in SF and in the tech space?

I think there's like a surprisingly high probability that just about everyone is going to be on a GLP-1 like drug. And I think that what's required is the cost to come down, which is happening, the delivery mechanism to become more frictionless. I swallow a pill rather than stab yourself with a needle and the risk profile to be proven out. I.e., the downside risks are low, the side effect profile is negligible, and the upside risk is high. And I think all of those things in the context of peptides such as GLP-1 receptor agonists are going to play out in the next 5 to 10 years.

Are you bullish about psychedelics being— again, with, with RFK, he talked about peptides, talked about hyperbaric chambers and psychedelics, but are you bullish on them becoming more mainstream and legal to administer within the next 3 to 5 years?

Yes, in controlled facilitated settings with a therapeutic rather than recreational use case.

What about, um, hyperbaric chambers? Do you see the benefit in them?

I haven't gone deep enough, but I know a lot of people who swear by them. There is some research on them as well. I think that research on these things tends to be early, and the absence of evidence is not the lack of evidence. Um, uh, before there's evidence, there's always no evidence. That's just like the nature of things, right? It's the nature of science. So from the outcomes I've heard anecdotally and from the dataset that exists in the brains of the 10x doctors who are using them often, if I was making a bet, I would bet on hyperbaric oxygen chambers increasing in prevalence. And I would bet on research being done that continues to prove their efficacy.

Max, do you ever think, you know, I could be on a beach in Sydney, just having a great life, not here in SF working, you know, your ass off building this thing out? Do you ever think, you know what, I'd be happier just doing something a bit more simple?

I think happiness is independent of any of that. Like, I think happiness is just what we choose. Yeah. Um, I think that happiness is downstream of authenticity, and I think that, um, authenticity is not doing the mainstream thing, which is thought of as happiness maximizing. But instead it's doing the thing which works for a specific person. In my case, I don't think about what I'm doing as like working my ass off. I think of what I'm doing as having fun and enjoying myself and doing what is like authentic and true and energizing. There's this saying in Italian, dolce far niente, which means the sweetness of doing nothing. For me, I couldn't imagine anything worse.

I love that. It's like sweet. Is that sweet fuck all? Yeah, yeah, something like that. Good, that's really interesting. And you said that you were able to tap into your happiness through reading Untethered Soul by Michael Singer, which is one of my favorite books. So what, what did that book teach you, um, and how are you implementing that kind of simplicity and surrendering into the work you're doing at Superpower?

The way I used to go through life is trying to force things into place. It's like, well, if I force things, if I overthink things, if I agonize over things stuff will work out. And I think an equally true version of the world is actually one where you let things fall into place, right? Where you focus on, rather than forcing yourself to be happy, just letting yourself be happy or choosing to be happy. Rather than forcing the world to do a certain thing, instead assuming the world is going to do that thing, living as if it's already true, and then waiting for it to happen. So I think that the being view of the world or the surrender view of the world or the belief view of the world, which is captured in Untethered Soul, is a potentially more accurate view of how things work than the I need to micromanage and force everything into place view of the world, which is I think where I was trapped several years ago.

I'm gonna push you a bit back on the happiness is a choice, statement, just because again, I'm sure some of our listeners are going to be very healthy and be eating the right things and sleeping well and exercising. But hey, I'm going to speak personally. When I haven't had a good night's sleep, when I'm eating shit food, as happens more and more in the States than, than elsewhere, um, and when I haven't exercised for a few days, it becomes incredibly hard for me to be happy. Have you been able to Just optimize a way of just like making your brain—

I'll rephrase it. Happiness is a choice given the foundations are set up correctly. Okay. So I do think the foundations are essential. If your gut health is a mess, if your metabolic health is a mess, if your sleep is a mess, if your light viewing behaviors are a mess, I think it's basically impossible to be happy.

So what would be your blueprint for being healthy? Just maybe let's point out 3.

I think that it starts by— a lot of people will say, well, I have this biomarker problem, therefore let me optimize that biomarker. But I think the way to target every system systemically is to start by optimizing the foundations. Yeah. All right. So make sure your metabolic health is good. Are you good at burning carbs? Now, are you good at burning fat? And, uh, are you sensitive to insulin? Let's make sure that system's good. Let's make sure inflammation is low, right? Let's make sure cellular efficiency and mitochondrial health is high. Let's make sure your mineral balance is correct. A lot of people's mineral balance is out of whack because the soil and water is depleted of minerals, particularly in the US. Let's make sure your micronutrients are balanced, right? Again, similar story to the mineral balance problem. Let's make sure your hormones are functioning correctly. Let's make sure your gut health is good. If your gut is an absolute mess, well, that's going to have impacts on mental health, on focus, on sleep, on skin aging, on happiness. So I think that rather than someone trying to, uh, hack their way to a specific outcome, the more systematic or systemic way of thinking about things is to get all the foundations right And once all those foundations are right, typically every outcome starts to happen in concert. Right? You start to look younger, feel younger, be more energetic, be happier, sleep better. All in concert.

Very interesting. So what would be your magic pill for 2025?

My magic— like, tactically speaking?

So I'm gonna give you an opportunity to put maybe 3 things in this magic pill. That's one of your super, super Superpower members can take?

Um, gosh, just 3 things. Okay, that is really hard. Um, my sense is this is a hack, but this is a cheat, but I, I would literally say a multivitamin goes a long way for a lot of people. And I think the reason why is that good high-quality multivitamins are stacked with the right kinds of minerals and micronutrients that people are missing out on. If I look at the things that tend to be stacked in a high-quality multivitamin is vitamin D. It's very hard to get too much vitamin D and just about everyone I've seen is deficient in vitamin D. So having 2,000 to 3,000 IUs in a multivitamin goes a long way. The right multivitamins will stack that with vitamin K, right? Which is important for the absorption of vitamin D. The second thing I'd say is magnesium. A similar story to vitamin D, a very low risk, Reasonably high reward. A lot of people are deficient. If you take too much, it's not harmful, obviously within reason. And I think the other thing that is stacked in a multivitamin tends to be the right balance of B vitamins. B2, B6, B9, so methylated folate, B12, and that go a long way. A lot of people have a gene mutation called MTHFR, which means that they're not methylating correctly. And one way to support the methylation system is through these B vitamins. So I would say that you can go a long way with the right multivitamin, particularly looking out for the quantity of magnesium, which you might have to supplement separately, and the quantity of vitamin D. I'm at the level of supplements. My sense is that supplements though aren't like first line intervention. Right, they're like a tool you use, um, afterwards.

I was going to give you two more things to add into that pill. It can be— it doesn't have to be an ingestible, it can be doing star jumps or anything else you want to add together.

I would add, if we're looking at this from like a very rational point of view for the average person, I would actually add a microdose GLP-1, um, which is a hot take. But the reason why is I think The side effect profile and risk profile is far lower with a microdose. I think the systemic impacts are really broad acting. It improves, um, metabolic health, uh, it can improve cardiovascular health, it can improve, um, mental health and addiction. And obviously it, um, downregulates ghrelin, which reduces hunger, which results in weight loss. And the second you start losing weight, a lot of other things start to fall into line.

Sorry, can you just go into the why? Like, why do all these things happen? Is it just simply that the GLP-1 is making you eat less?

No, so there are other— I don't understand all of the mechanisms, but the— it's not— even if you control for the caloric intake, there are other mechanistic things which are happening by binding to the GLP-1 receptor as an agonist. And I don't understand the full cellular biological mechanism.

Max, so next steps for Superpower. What can we expect this year in 2025?

We are about to start letting many more people off the waitlist. We're going to be making some really exciting announcements around the intersection of healthcare, biology, and AI. And we're going to continue to become a, like, a resonant lifestyle brand. No one's walking around wearing a One Medical t-shirt or Forward Health t-shirt. There's no real aspirational brand in healthcare. We want to change that and be the Nike of healthcare and build a real, like, community and aspirational culture around this idea of if you take care of your health, you take care of your life.

What does an aspirational culture look like for a— you'd call yourselves a health brand, a longevity brand.

Um, it looks like one where people believe that healthcare can allow them to be better, right? You can allow them to be happier, to feel younger, to look younger, to be more energetic, to be more, more present, um, to not be riddled with disease. It looks like a, a brand that stands for not just curing sickness, but that stands for actually enhancing human capability and maximizing human potential.

I feel what I'm hearing is you're at the intersection of not just healthcare and really disrupting what healthcare looks like, especially in the US, but also this is mental health, this is like self-development, this is bringing a lot of themes together. It's the combination of all, right? Mm-hmm.

Yep. I think that we're going to see right now healthcare and wellness kind of yell at each other, right? They're like, tutu. Like, you'd expect them to be best buddies, but they, they healthcare's like, wellness, that's not a thing. And wellness is like, nah, just do wellness and you don't need healthcare. I think we're gonna see a blending of the two. And I think that's a big part of what we want to stand for. The things that have classically been thought of as self-improvement and wellness are actually parts of healthcare, right? And healthcare is a big part of how we can actually be maximally well and energetic.

I really wanna think about this magic pill that you've talked about. About this happening in 10 years' time. Like, how do we get there? Because again, it's— what I do for my wellness is I meditate every day and I do breathwork and I will be in nature and ground myself and work out 5 times a week and I'll eat healthy. But that's a lot of effort and a lot of people don't have as much time as I probably give to my wellness or have other interests. Like, what does that journey look like? Especially when you're looking at the camp that currently is yelling, the camp within the wellness space that's kind of yelling at healthcare?

I don't think there's a magic pill anytime soon. And I think that a belief in a magic pill can get in the way of a belief in the importance of taking healthy behaviors. And I think The magic pill narrative is dangerous because it can say to people, you don't have to have healthy behaviors. And I think where we are in the world at the moment is at a place where healthy behaviors are essential. Yeah. So the magic pill might be something which is true 20 years from now. I still think today the primary ways people can maximize their health are through sleeping, Exercising, eating well, having human connection, et cetera.

For any of our listeners that want to potentially partner with Superpower in the future and maybe build a company that serves Superpower through an API or, or whatever it might look like, do you have any recommendations of what people might want to think about building into 2025, but also '26, '27?

I think that we are going to continue to need a lot of deep tech innovation in diagnostics and therapeutics. And the reality is the way we create the future of healthcare is going to be by innovating at the most complex level, which is by developing novel ways of detecting disease and novel ways of treating and preventing disease.

Awesome. Just a final question, um, culture. You've got a great culture at Superpower, but one of the key things is that you're probably working incredibly hard, you're probably sleeping very little. How do you build a strong, healthy culture that has wellness at its heart whilst also operating in the startup somewhat toxic culture of being an SF.

We believe that if you take care of your health, you actually improve performance. And this is a narrative we want to champion amongst founders, which is that improving health improves performance, or better health is better business. And practically, we embody that as a company. We have one of our cultural principles called Superpower Your Health, and we have a channel in Slack called Superpower Your Health where people set, uh, talk about different health interventions and things they're learning. We have an Oura Ring circle where we're all sharing, uh, our health and Oura Ring. We're going to soon create a dashboard in the office where people can compare their CGM results and their wearable results. We genuinely believe that if you take care of your health, everything else starts to fall into place, including your performance at work.

Max, thank you so much for your time. It's been an absolute pleasure learning more about Superpower and your journey as well.

Thank you, Julian. Awesome to be here.

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