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posted: 6/3/2013 5:24 AM

Specialty physicals lure execs to scans some doctors doubt

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By Tyler Graham
Bloomberg

Standard physicals are, well, pretty standard. During a visit geared more toward detecting disease than preventing it, your doctor makes you cough and checks your numbers. If there's an abnormality -- your blood pressure has spiked or your liver enzymes are elevated -- it's your schedule that suffers as you're shuttled between specialists.

There's an alternative, loosely known as the executive health checkup. Participants in these programs spend $2,500 and up to receive daylong, state-of-the-art examinations administered by top U.S. hospitals, such as the Ronald Reagan UCLA Medical Center in Los Angeles, and specialty clinics, like the Princeton Longevity Center in New Jersey, that have emerged as global pioneers of the service. The aim: a more complete picture of your health, with clearer, actionable take-aways.

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Investment banker Mark Sweeney enrolled in the Princeton program after his primary-care physician told him he needed a statin to help control his elevated cholesterol.

"Considering the possible side effects of the drug and the limited usefulness of a standard cholesterol test, I didn't feel comfortable with that course of action," says New York-based Sweeney, 43, who maintains his 5-foot-9, 165-pound frame through healthy eating and regular running.

At the Princeton facility, an hour's drive from Manhattan, exam day begins with blood work at 9 a.m. During this phase, clients such as Sweeney learn that the cholesterol picture has become more complicated in recent years, as research has shown that some forms of the so-called bad LDL cholesterol may be benign.

"The standard cholesterol test is about as useful as flipping a coin," says David Fein, the program's director.

Clients then receive a whole-body CT scan that Fein scours for tumors, aneurysms and plaque buildup. A series of other tests examine lung function and declines in bone density, hearing and vision. Patients will also see an exercise physiologist, who looks for imbalances and weaknesses in the body, as well as a nutritionist, who makes dietary recommendations.

The dozens of hospitals now offering such programs take a similar approach, with the all-in-a-day aspect specifically designed for the busy executive.

"Many of my clients are on the road half the year," says Mark Moon, medical director of the Mayo Clinic's Executive Health Program, in Jacksonville, Fla. "This is often the only time they see a physician."

One concern surrounding CT scans is radiation exposure. However, according to the Environmental Protection Agency, the radiation from newer machines is the same as you would be exposed to by living in Denver for two years rather than at sea level.

Michael Ray, 58, credits the tests he received at the UCLA Comprehensive Health Program with helping him lose 50 pounds.

"It's hard to ignore the facts when you're looking at a complete picture of your health," the Woodland Hills, Calif.-based chief executive officer of Orchid Insurance Brokers says.

Another concern is the risk of false positives, which can lead to unnecessary treatment.

"The more tests you do, the more likely one is to turn up positive," says Stephen Lefrak, a professor of medicine and expert in medical ethics at the Washington University School of Medicine in St. Louis. "Only a handful of screening tests beyond those for cervical, colon and rectal cancer are of proven efficacy in terms of prevention."

One thing directors of these programs prefer not to test for is Alzheimer's disease.

"We can tell you that your risk of developing the disease might be 30 percent," Fein says, "but the value of that information is pretty limited."

When the day concludes, around 4 p.m., clients depart with their scans and test results bound into a thick dossier. At Princeton, if a recommendation such as losing 25 pounds seems too daunting, a subsequent program for $500 a year includes videoconferencing and an iPhone app to monitor diet and exercise.

Sweeney didn't require such a follow-up, as Fein deemed his overall health picture good, including the cholesterol levels that had brought him to the Longevity Center in the first place.

Fein did inform Sweeney that he had poor upper-body muscle mass for his age, putting him at risk of osteoporosis later in life. Weaknesses in his back were also compressing his vertebrae, and although Sweeney didn't yet feel pain, the condition could eventually become debilitating.

"The results provide a valuable base line," says Sweeney, who's now pursuing a rigorous strength-training regimen and will return again in five years.

"Executives are goal oriented, and that's how we are," says Benjamin Ansell, director of the Comprehensive Health Program at UCLA. "If we explain the science to them, they usually take that data and make good decisions."

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