The annual checkup we can't have - Tucson Local Media: Voices

The annual checkup we can't have

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Posted: Tuesday, June 2, 2009 11:00 pm

Consider yourself fortunate if you have access to good health care; if you get an annual physical examination that's even better. But odds are the once-a-year physical you and I receive isn't an executive, deluxe or boutique version costing $5,000-$10,000, depending upon the medical facility offering it.

Several questions come to mind: 1) Who can afford these exams, 2) are they worth the price, 3) does insurance cover them, 4) where are they offered, 5) what do they include?

Surprisingly, executive exams have been around for decades, but until recently were never disclosed due to the high-profile nature of those partaking of them. Corporations cautiously included them in compensation packages for their top executives. Typically, CEOs and assorted "rich and famous" folks serve as the primary clientele, but anyone with the cash can sign up for a primo exam.

There's a split decision regarding the value of these physicals. Some doctors don't believe an executive exam is the best idea, with many questioning the inclusive full body scans. Also, the tests for rare diseases or conditions haven't been proven totally reliable. This means someone could be diagnosed with a rare condition they actually don't have because these unordinary tests sometimes fail to provide accurate diagnostic measures that prove useful to doctors. Testing positive for any rare condition usually guarantees additional testing.

Conversely, some insist that the executive physical is exceptionally comprehensive and reliable and provides patients with a unique opportunity to have an illness diagnosed that could routinely be undiagnosed. All agree that early diagnosis and treatment of a condition can result in cure or management of conditions that, when overlooked, may be untreatable or irreversible by the time obvious symptoms manifest themselves.

For basic tests, many insurance plans pick up most or all of the cost, but most executive exams include an array of atypical tests and procedures that aren't covered by insurance and required payment out-of-pocket.

Executive examinations are performed in all of the most prestigious hospitals, such as Johns Hopkins and Mayo, along with countless others across the country. Even the trendiest spas are stepping up and establishing "medical exam" areas for use by teams of specialized medical professionals.

An executive physical examination is an intensive evaluation of one's potential for disease and illness with compressed turnaround time for test results. These physicals routinely include a full body scan, blood testing for numerous rare conditions, and ample, unhurried time with a physician discussing medical history and covering any issues that a patient might otherwise overlook in a standard physical. Even minor symptoms are viewed as relevant and receive scrutiny. Actual exam duration time varies from site to site, lasting from four to eight hours to as long as two days. The longer the stay, the more you'll pay.

Impressively, many hospitals, clinics and spas don't have patients, only patrons or clients. And you won't find the title doctor used in some of them; they're called professional health care providers. In addition to the actual exam, patrons are given the royal treatment beginning at check-in. There's no worn tile waiting room with outdated magazines and hordes of people with nasty coughs and screaming infants. Instead, the clients are immediately and personally escorted to plush rooms with designer furniture and decorations, flat screen TVs, computers and Internet service, and oftentimes a concierge is on hand to discuss extensive food and entertainment offerings for those infrequent waiting times and for helping the time pass more comfortably for an accompanying spouse or friend.

Clearly, pampering is a big factor in executive exams and it should be.

What you won't hear from anyone working at these prestigious sites is the mention of a patron or client receiving better health care than people who visit standard primary care doctors. Regardless of where you go, the "lawyer factor" remains an issue.

If you get the urge, various exotic destinations are offering executive exams and combining them with luxury vacations. Many of these facilities are staffed with American doctors and specialty medical personnel who relocated offshore because of unendurable operating expenses for their practices. Exams at these sites normally cost a fraction of those offered stateside, but all expenses are paid for in cash; no insurance accepted.

As superior as these posh exams sound, I'm partial to my primary care doctor. She gained my trust through competence and proven interest in my well-being. From my perspective, I'm already getting an executive exam.

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