When it comes to perks, most business owners have a reserved parking space near the door, while employees dump their vehicles wherever they can find an open spot. So why do executive health checkups not get the same priority?
Most business owners and their employees have always gotten the same $250 annual health checkup, which typically consists of spending a few hours waiting for the doctor, then having your vital signs checked before you have a 10-minute chat about test results and your overall health.
Things may be changing, however, as more entrepreneurs opt for so-called "executive physicals." These all-day affairs cost at least 10 times as much as a regular physical and involve advanced exams such as cardiac stress tests, fitness evaluations, nutritional consultations, wellness counseling and more. Some are even downright luxurious, including massages and freshly prepared meals during your appointment.
At the end, patients can expect an hour-long sit-down with an internal medicine physician to discuss findings and craft recommendations. You'll leave with an individually tailored action plan for improving your health and managing long workdays, jet lag, stress and other hazards common to business leaders’ health.
The Doctor Is In
Executive physicals are offered by many hospitals across the country. Around 40 percent of those who get them aren't the usual corporate executives, according to Dr. Benjamin Ansell, director of the UCLA Comprehensive Health Program, which has conducted executive physicals for more than 5,000 patients since 2001. And more business leaders are participating. “Every year, except for 2009, has been an up year for us,” Ansell says.
Although executive physicals may involve what looks like pampering, these day-long appointments are more than mere perks, Ansell says. By keeping business owners from getting sick and improving their health, he explains, the comprehensive exams can improve a company’s performance and bottom line.
At a minimum, executive physicals can save a business leader time. They’re often offered as one-stop shopping for health tune-ups. For instance, patients don’t have to come in beforehand to provide blood for testing. Instead, samples are collected in the morning when they arrive and test results are available later that same day.
Most patients get a wide variety of tests done in a single day. Depending on your medical history, along with the usual height, weight and blood pressure readings, these can include a body composition analysis, electrocardiogram, cardiac stress test, lung capacity analysis, fitness evaluation, eye exam, hearing test and nutrition assessment in addition to lab tests for cholesterol and other health markers. Gender-specific exams such as pap smears and tests for prostate cancer markers are also available.
Above and Beyond
But an executive physical is more than just a series of tests. You'll also likely discuss fitness and exercise plans with an exercise physiologist and get detailed diet advice from a nutritionist. Your conference with a physician may cover such topics as sleep quality and stress management.
“These are the things that busy physicians don’t usually have time to cover in depth and that often impact people’s health,” says Dr. Lorrie Elliott, medical director at Northwestern Executive Health, which is affiliated with Chicago’s Northwestern Memorial Hospital.
But that depth comes at a cost of $2,500 to $10,000, depending on which tests are conducted. Elliott says their average executive physical costs around $5,000. And companies or patients, not insurance, pay most of that. But providers of executive physicals say they're cost-effective compared to regular physicals, in part because convenience makes it easier for busy business leaders to fit them in.
Outcomes are also tailored to those with busy schedules and too much to think about. Instead of vague recommendations—lose weight, get more sleep—which are easy to ignore, Elliott says Northwestern patients leave with a bulleted list of specific actions to take to improve their health. For instance, rather than being told to “eat more fiber,” a nutritionist might suggest you have granola and blueberries for breakfast instead of packaged cereal. An exercise physiologist could recommend adding more cardio to your regular gym routine.
Weighing the Benefits
So if executive physicals are so much better than the more cursory exams patients have been getting, why aren't more business leaders signing up? For one thing, there’s no solid evidence that paying $5,000 or more for an otherwise healthy person to spend a day away from work with a battery of health-care professionals actually improves a company’s bottom line.
And as Harvard Business Review points out, such comprehensive physicals haven't been shown to improve health outcomes across broad populations. For instance, critics say that some illnesses aren’t readily detectible before symptoms appear, while false positives can cause patients to worry and undergo more procedures to rule out illness. In addition, some tests, such as whole-body CT scans, may expose patients to unhealthy amounts of radiation while producing little useful information.
Sidestepping these objections is simple, however, if you get an executive physical from a well-regarded source, such as a doctor attached to a university hospital. At UCLA, Ansell says, they don't perform whole-body scans—even when patients request one—and only do chest x-rays for heart disease or other special circumstances.
“It’s not that we’re anti-scanning or anti-radiology,” Ansell says. “We want to be prudent and not be tempted by the premise that 'more testing is necessarily better,' especially if radiation is involved.”
Northwestern’s Elliott says the doctors there don’t automatically run a number of tests that others might, including genetic testing for risk factors. “A lot of these tests end up not telling you much,” she says. “We don’t feel those are medically warranted, generally.”
For practical reasons, executive physicals also often don’t include tests, such as colonoscopies, that require advance preparation or sedation. Although UCLA routinely does colonoscopies as part of executive physicals, it's usually on the day after the rest of the exam, Ansell says.
And if the patient requires additional testing, Ansell says the doctors at UCLA try to get the tests completed the same day. For instance, if a radiologist interpreting a mammogram indicates the need for an ultrasound or even a biopsy, the extra test will usually be done that day. The emphasis is on one-stop shopping to make the experience as convenient for business leaders as possible.
Most patients get executive physicals annually, but those younger than 40 or so often wait a few years between exams. And those who haven’t been in a while could find future exams have added features, such as genetic testing.
No matter which route you choose—conventional yearly health exams or comprehensive all-day executive physicals—taking care of your health should be a top priority for you. After all, your business—and your life—depends on it.
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