Are comprehensive medical evaluations becoming the new “must have?”
The topic of “executive physicals” is one that seems to be coming up more often in my conversations with clients and colleagues in the industry. It’s certainly not a new thing, since they’ve been around for a long time, but it seems like the idea is getting more attention and creating some buzz, especially in the post-Covid era.
Proponents of executive physicals, and the somewhat broader concept of executive health programs, often cite a number of specific benefits but, for me, I think the core concept is fairly straightforward. I see the executive physical as a cornerstone of an overall personal wellness program that can have lasting positive effects for the individual and the organization.
Basically, an executive physical is an in-depth medical assessment, a checkup on steroids as one person called it, that seeks to place possible health concerns in one of three categories:
- areas where you’re doing just fine and have nothing to worry about for now;
- areas where you may be at some risk that you should be addressing before they become serious problems;
- and, just possibly, areas where you have a serious issue, perhaps in the early stages, that you may not have been aware of, but that can now be dealt with before they become harder to treat.
I know that most family physicians recommend a periodic health exam, and these are covered by provincial health insurance. As I’ve mentioned in this blog before, I think it’s important for patients to take full advantage of this option, and to make the most of it by not holding back on asking questions about anything they may be concerned about.
Executive physicals, which are not covered by provincial medical plans, take considerably longer than a routine doctor’s visit and can take anywhere from an hour to a day – or more. They can cover a lot of ground but, depending on the level of assessment and amount of time devoted to it, can include the following areas of investigation.
- A review of personal and family medical history, lifestyle, current situation and risk factors
- Physical examination, including skin, lymph nodes, heart sounds and neurological tests
- Weight assessment and dietary habits review
- Vision and hearing tests
- Cardiovascular and heart health review, including ECG and stress testing
- Blood pressure assessment over several tests
- Blood work to identify cholesterol levels and other markers
- Lung function testing (spirometry)
- Possible cardiac imaging (usually only if other risk factors are identified)
- Cancer screening, including PSA screening for prostate issues for men, and examination and PAP tests for women
- Blood and urine testing for a range of issues such as blood count, hormone levels, glucose levels, thyroid function, liver and kidney enzymes
- Colonoscopies
- Mammograms
- Vaccination review
- Stress and mental wellness review
- Sleep pattern assessment
- Fitness review, including diet and lifestyle
This list, which I pulled together from some of the services being offered in Canada, is not by any means a complete list or the specific program that any given patient would receive. Every patient’s assessment would depend on his or her history and risk factors, as well as the results of the assessment itself. In other words, the result of some tests might rule out the need for other tests, or they might indicate that further testing is required.
The testing, physical assessment and review are, of course, only half of the equation. The second half is the plan of action going forward. These could include the following.
- Action plan for dealing with any identified issues. If the results of the assessment reveal, for example, early stages of hypertension or pre-diabetes, an early intervention plan can be made to prevent those issues from developing or becoming more serious.
- A plan and possibly a schedule to follow up on areas of identified risk with future monitoring and reassessment. In other words, if the assessment identifies a higher-than-average risk of, for example, breast cancer, a plan can be made for regular future follow-up.
- Specific nutritional goals and referral to counseling and other resources related to healthy eating.
- Recommendations regarding optimal weight and including weight loss and maintenance targets as well as an action plan to achieve them. These could include diet and exercise as well as possible prescription medications.
- Fitness goals and strategies tailored to the individual and his or her circumstances.
- Stress management counseling and possible referral to specialized services that can help to develop a plan consisting of specific techniques tailored to the individual’s lifestyle and situation.
- Sleep optimization, including management of insomnia and possible sleep apnea, as well as basic techniques for developing healthy sleep patterns.
For employers potentially sponsoring an executive health program including executive physicals, there are a number of significant potential benefits.
- Recruitment and retention. Executive physicals help to attract and retain the best talent when they are offered as part of the executive remuneration package.
- Focus on corporate wellness goals and culture. Organizations that focus on wellness in the workplace offer a range of services and wellness options to employees.
- Potential reduction in down-time and sick leave. Early intervention, as well as overall wellness programs will help to reduce problems in the future.
- Increased job satisfaction and employee loyalty.
I think that the major take-away for individuals who go through a comprehensive executive physical is that the results help to focus and identify proactive measures that will have an impact and make a difference in the long run.
Of course, one outcome of an executive physical that doesn’t get a lot of attention in the discussion is also one of the most common: when the doctor, at the end of the process, says something like, “Well, you could eat a little better and exercise a little more but, all in all, you’re fit as a fiddle.”
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I really appreciate comments, ideas, suggestions or just observations about the blog or any other topics in benefits management. I always look forward to hearing from readers. If there’s anything you want to share, please email me at bill@penmorebenefits.com.
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