Doctor Says Executive Physicals Are Bad Medicine
Oct 01, 2008
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News
The Health Blog sure aren’t executives, and we don’t expect to join the ranks of top businessmen anytime soon. Maybe that’s why we’re so curious about those expensive executive physicals that go on behind medicine’s velvet rope.
From what we’ve heard, you get the amenities of a spa and the fanciest work-up imaginable, often including a CT scan looking for signs of heart trouble. The battery of tests promises early detection and prevention of problems. But are the exams worth the thousands of dollars they cost? Brian Rank (pictured), medical director of HealthPartners Medical Group and Clinic, says no way.
In the current issue of the New England Journal of Medicine, Rank writes executive physicals are “one of modern medicine’s most expensive and least proven approaches to care.” The way he sees it, VIP exams fail on three counts:
- Efficacy: More testing isn’t necessarily better, with
research piling up that shows inappropriate testing can cause more harm
than good. Take CT scans looking for heart calcifications, a staple of
the top-shelf physicals. The scores may be interesting but are “rarely
meaningful as a predictor of disease,” Rank writes.
Cost: The pricey exams reinforce the misperception that “costlier is better.” In fact, Rank writes, the exams “are almost a parody of the high-cost, low-return procedures” that companies want to eliminate for other employees.
Equity: And that brings us to fairness, one of Rank’s biggest beefs. The mystique of executive physicals makes it appear that folks with lots of money or the backing of a company “are more worthy of effective, respectful and personalized treatment than others.”
We gave Rank a call to find out what drove him to give VIP exams such a
beatdown. He told us that on trips to Florida he kept seeing ads in the
Orlando airport for executive physicals at the Mayo Clinic in Jacksonville.
“It bugged me,” he told the Health Blog. If the exams were “just
repackaging and selling evidenced-based preventive services, that would
be one thing,” he said. But the battery of tests can lead to harm–from
radiation exposure from CT scans to false alarms that lead to worry and
more testing.
Rank just about flipped when another member of the board at HealthPartners said he was considering getting one of the physicals. “Are you nuts?” he asked him. “Why would you expose your company to excess costs and yourself to tests that could hurt you?”
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