Thoughts on those 'executive' physicals?

[Sniggle]

I have considered getting one of those executive, whole body physicals, provided by places such as the Princeton Longevity Center, when I turn 60 in a few years.

Have any of you done this? What did you think of the process and the feedback? Would you do it again?

Thanks

 

[pb4uski]

Our firm offered them the last few years that I worked and since it was free to me I did take advantage of them... much more through than a typical annual physical and IMO worth the time.

We had one practice leader who seemed by all outward appearances to be in good shape, wasn't overweight and was a regular runner. He started on the treadmill for his EKG and they stopped him after a few minutes and ordered him to go to the nearest hospital... they put in a stent right away.

 

[OldShooter]

Years ago I used to get those in connection with a job. They are kind of fun and make you feel like a big important person, but in the end you are working with a doctor who knows nothing about you, has no history, and will have limited communication with your PCP if you even have one.

It's apples & oranges to be sure, but we are now in a concierge practice, know our PCP very well, and get very thorough physicals tailored to our history. This 3-doc office operates within a health care megacorp and also does the "executive physicals" that the megacorp sells. The good news for the executive physical customers in this office is that the concierge docs have been hand-picked for their jobs -- not just the usual crap-shoot when picking a doc.

All that said, if your executive physical is free why not do it? If you have to pay, I would start by consulting your PCP or by finding a good one to consult with.

 

[nobodyspecial]

I had one done a few years ago. My PCP at the time advised me Not to do it - but, I did it anyway. The results were interesting, and showed a couple of abnormalities, but nothing horribly out of range. I had the results sent to my PCP, and we discussed them at my next appointment. She went over the results with me, and explained that she didn't think the items out of range were issues, but we now had to have specialists look at the abnormalities. After I saw the specialists, my PCP and I went over their findings (or, lack thereof) during my next appointment. Afterwards, she promptly fired me as a patient. I guess she didn't appreciate a patient who ignored her advice..

 

[brett]

I skipped mine for about 10 consecutive years. Company HR sent me a memo each year saying it was mandatory. Then the clinic would call. Never did go. No follow up by my firms HR so I never bothered with it.

Then I retired.

 

[Midpack]

It was required for most of career, and I welcomed them - free so why not? I wish I had such thorough physicals now, when I probably need it more than my younger years. Now I get something in between Medicare basic and the executive physical…

 

[LarryMelman]

I skipped mine for about 10 consecutive years. Company HR sent me a memo each year saying it was mandatory. Then the clinic would call. Never did go. No follow up by my firms HR so I never bothered with it.

You say that as if you're proud of it. I don't get EVER turning down free stuff.

 

[MuirWannabe]

Was a great perk when I was employed. Took advantage every year of it. Kinda miss it now, but not enough to unretire

 

[travelover]

..... I guess she didn't appreciate a patient who ignored her advice..

Well, I guess she thought you were nobody special.

 

[nobodyspecial]

Love it!!!

 

[brett]

You say that as if you're proud of it. I don't get EVER turning down free stuff.

Not really. We have universal health care where we live.. It is part of our taxes. N/C when we go for a physical or have the requisite lab work done. Or when we are hospitalized.

 

[MrsHaloFIRE]

I considered one at Mayo. I try not to cheap out on food and healthcare. Never got that way in your road trip wanderings (was looking at their AZ campus i think).

 

[braumeister]

My last doc recommended one of those super-duper executive physicals where you spend nearly two full days at the place and it starts out with a full body CT scan and then runs you through pretty much every test imaginable.

What concerned me was the very high radiation dose from the scan, and then the alarming number of false positives. I read of one guy who had some suspicious spots found on his lung and by the time they were through they had removed most of the lung and found nothing to be concerned about.

I think these services are marketed mostly to companies so they can give their executives a perk. Definitely not needed for most of us.

 

[ExPatKiwi]

Sometimes better not to know. The number of men who’ve had prostrate surgery for a false PSA test is reported quite high too.

 

[6miths]

My last doc recommended one of those super-duper executive physicals where you spend nearly two full days at the place and it starts out with a full body CT scan and then runs you through pretty much every test imaginable.

What concerned me was the very high radiation dose from the scan, and then the alarming number of false positives. I read of one guy who had some suspicious spots found on his lung and by the time they were through they had removed most of the lung and found nothing to be concerned about.

I think these services are marketed mostly to companies so they can give their executives a perk. Definitely not needed for most of us.

+1

Hard pass. Have a good friend who had a similar experience. I don't think that there is any professional or national health entity that recommend these. Non-directed testing is more likely to be harmful than beneficial - multiple trials have shown this. People underestimate the risk of false-positive tests - especially in a profit driven system. IMHO, the premise that the company has purely altruistic motives is also suspect. Color me cynical.

 

[pb4uski]

Was a great perk when I was employed. Took advantage every year of it. Kinda miss it now, but not enough to unretire

+1

 

[pb4uski]

Well, I guess she thought you were nobody special.

And she was right!

 

[RetiredHappy]

We decided to go with our "old" doctor who went the concierge doctor route earlier this year. For those who are unfamiliar with concierge doctor, you pay an annual membership fee to the practice and the doctor in turn, has limited number of patients and who will provide immediate response (texting, emailing, calling) and same day appointments. Anyway, the first thing he did was to schedule a "Mayo" type check-up with us and those were his words. I have yet to look up what is a Mayo check-up. But we got our hearts checked with EKG, lung capacity tests etc. The lung capacity test ended with a lung specialist referral for me and ended up with a series of test which cost me a couple of thousand dollars... in the end, my lungs were normal. Whatever!

 

[cbo111]

My previous life in aircraft flight test for a defense contractor, they included the offer of executive physicals. We were already required to submit to an FAA annual class 2 physical to maintain our license to fly. Another detailed examination might find some odd ailment that would ground me from flying and earning a paycheck. I declined the free executive physicals. For me and a number of peers in my work, it was always a tricky balance deciding when to seek medical attention that would help me but might end up affecting my flying status. Now that I am retired it is still difficult to be forthcoming when getting routine medical care, opting instead for the "it should go away on its own" treatment style. Fortunately DW usually pushes me in the correct direction to get treatment when needed.

 

[Bamaman]

My wife used to run a laboratory at a very supercharged physicians' practice. My PCP took some seminars and purchased a top line EKG machine and a treadmill. He made the EKG on a treadmill part of his yearly physicals, and he headed off heart issues before they became really serious problems.

I was one of those that hac an abnormal EKG when he kicked the treadmill into high gear. I've since been under close watch by a cardiologist--without any problems.

Those that are on Medicare can only get a mini-physical paid for. But that's not enough to call a real physical which includes a full blood chemistry analysis and chest x-rays.

We had two close friends die last year of lung cancer, and they were stage IV before they even knew they had cancer. It's #1 in cancer deaths. Both were gone in 6 months. And neither were getting full yearly physicals.

So you can see the importance of getting yearly physicals when approaching ER--even if you've got to pay a little to get one.

 

[Extra Medium]

+1

Hard pass. Have a good friend who had a similar experience. I don't think that there is any professional or national health entity that recommend these. Non-directed testing is more likely to be harmful than beneficial - multiple trials have shown this. People underestimate the risk of false-positive tests - especially in a profit driven system. IMHO, the premise that the company has purely altruistic motives is also suspect. Color me cynical.

I’m very skeptical too. Screening is good for many diseases, but it’s not necessarily better to have more (or more intense) screening, and false-positive findings can do harm.

One of the aphorisms in the surgical community is that there are two types of medical care: standard and sub-standard. Beware of anything that sounds like you’re getting around the velvet rope for immortality. Things that sound too good to be true usually are.

 

[6miths]

My wife used to run a laboratory at a very supercharged physicians' practice. My PCP took some seminars and purchased a top line EKG machine and a treadmill. He made the EKG on a treadmill part of his yearly physicals, and he headed off heart issues before they became really serious problems.

I was one of those that hac an abnormal EKG when he kicked the treadmill into high gear. I've since been under close watch by a cardiologist--without any problems.

Those that are on Medicare can only get a mini-physical paid for. But that's not enough to call a real physical which includes a full blood chemistry analysis and chest x-rays.

We had two close friends die last year of lung cancer, and they were stage IV before they even knew they had cancer. It's #1 in cancer deaths. Both were gone in 6 months. And neither were getting full yearly physicals.

So you can see the importance of getting yearly physicals when approaching ER--even if you've got to pay a little to get one.

I won't comment (much) on the evidence for screening for heart conditions with 'a top of the line EKG machine and a treadmill' but you can guess what it is. This acquisition was not driven by evidence that it would be beneficial to patients and it is quite easy to see some downsides.

But the second example of lung cancer and annual physicals is part of the misunderstanding of what an 'annual physical' is and is not. An annual physical exam will not result in benefit with respect to survival from lung cancer nor will doing annual chest X -rays - the evidence is clear. In people who have a significant smoking history there is evidence that doing a CT-scan of the chest periodically will reduce mortality from lung cancer so this is a recommended manoeuvre in this at risk group. So for those at risk, the recommendation is not an annual physical but rather low dose chest CT periodically. The recommendation varies depending on the organization from yearly starting at age 50 to 3 years in a row starting at 55 (as was done in the trial that lead to the recommendation). Most lung cancers are caused by smoking (as are many other cancers, most chronic obstructive lung disease and a good deal of atherosclerosis leading to heart attacks) - so just not smoking entirely prevents most lung cancers. Even in those screened appropriately the majority of those with lung cancer diagnosed early still eventually wind up dying of lung cancer - they are not cured. There are also both false positives and false negatives to the best screening option available and the radiation from CT undoubtedly causes cancer in some. Moral of story is don't smoke. If you do smoke - stop. Simple right?