To Your health

Health care for the Harried
Executive health programs are growing along with the recognition that a company’s strength lies in its people.

It’s not surprising how easily descriptions of executive health programs gloss over words like “colonoscopy” or “coronary CT scan” in favor of others that you would associate more with vacations, like “continental breakfast” and “massage.” But really, executive health programs are all about the colonoscopy and other (luckily less invasive) procedures. And at least according to those running the programs, this is a good thing.
Executive health program descriptions sound the way they do because they’re aimed at busy executives who work for companies with big wallets. The basic cost for a day of tests can range from $1,800 to $3,000—higher, even, if specialized services, from eye exams to Botox, are included. Although the details vary depending on the program, patients usually arrive early in the morning, meet with a physician, go through a long series of tests, and at the end of the day meet with a physician one more time to discuss results and recommendations.
They might sound like they were specifically designed for today’s hurried lives, but executive health programs are not new. Many were started at institutions all over the U.S. during the 1990s, a decade that also saw the rise of managed care and the decline of satisfaction with the amount of time doctors were able to spend with patients.
Dr. Bimal Ashar, medical director at Johns Hopkins Executive Health Program, explains that programs like his allowed patients to stop worrying about how much time they would get to speak with a doctor.
But Ashar does attribute the continued growth of these kinds of programs at least in part to the ever-increasing pace of life. Although the program at Johns Hopkins started out small in 1994, Ashar says it now works with a large number of companies, some of whose executives simply “ignore health altogether” because of their hectic schedules. And it is certainly not a phenomenon specific to Johns Hopkins. Dr. Benjamin Ansell, director of the Comprehensive Health Program at UCLA, says his program has had “double digit volume growth” every year since it started in 2000.
The more skeptical among us might think that companies that pay for these programs are merely looking out for themselves. After all, taking care of key individuals makes good bottom-line sense. Numerous studies have shown that early diagnosis and detection of risk factors, often delivered through regular check-ups, help prevent disease. And, as Ansell explains, providing a physical for 100 directors not only keeps them healthy and productive, it is also less expensive than replacing a single CEO.
However, Ansell also believes that companies have embraced executive health programs also as a way to cater to talent.
“Companies recognize the competitive work environment,” Ansell says. “If you want good people, you have to offer value-added incentives.”
Executive health programs are one such incentive, used to attract top candidates to a job. Sure, in the end it’s still about the bottom line, but advocates of executive health programs believe it is also about a growing recognition that the health of a company resides in its people, as well as in its financial statements.
Supporters of the executive “super-physical” praise its thoroughness, but critics question its superiority as compared to regular, less comprehensive physical exams administered through primary care physicians. Dr. Ashar at Johns Hopkins admits he has not seen tangible data to prove that executive health programs extend patients’ lives. But he and others have plenty of anecdotal evidence.
“We see many patients who have ignored their health, who don’t see their doctors, who ignore signs of stress,” Ashar says. “Many of our patients have a difficult time making time for anything other than work.” These kinds of patients are more likely to talk to a physician in the context of an executive health program, and they’re certainly more likely to go through a day-long series of exams than they are to make a dozen separate appointments and spend hours waiting at doctors’ offices.
Dr. Kevin Waters, director of the Duke Executive Health Program, says executive health programs pack days of medical attention into approximately six hours. The purpose is to address a very specific time crunch or, as Waters says, “to give executives what they need.”

Health A la carte
If you’re in the market for executive health programs, you will be faced with some choices. Here are a few things to consider:
• Basic tests, such as eye exams, are optional in some programs. Some programs include nutrition, stress and exercise counseling, in addition to standard medical exams. Ask about standard and elective services.
• Most programs allow patients to work between appointments and offer a variety of services (telephone, fax, Internet, photocopying). At the same time, most programs try to minimize wait times between appointments. Find out just how much work you might be able to squeeze in.
• Although most programs have a majority of “sponsored” patients, meaning patients whose companies pick up the bill, patients who pay for their own services are a sizeable minority. Even if your company pays for the physical, it might not cover the cost of additional testing (in the event it becomes necessary). Check with your insurance company about coverage for additional procedures.
• Ask if the program can provide you with detailed bills to submit to your insurance company for reimbursement.
• Find out if your physician will be available to answer questions throughout the year.