Dr. Raymond Zakhari
Executive Physical ExamsAn Executive Physical Exam is a useful assessment of your health. This comprehensive exam can give you the information you need to make important health decisions from a place of power. An Executive Physical Exam is especially helpful for men, because they have higher rates of morbidity and mortality. Men are usually unaware of underlying health conditions. Men usually ignore their health until they have a problem. Waiting until you have a problem to get an Executive Physical will usually cost more time and money.
The year was 2020 and the world went into a lockdown. The death rate increased and persisted. An epidemic swept the world and the most vulnerable were the people with underlying medical conditions. The word comorbidities entered the vernacular. We all became experts on health risk. Some healthy young athletic people succumbed to Covid-19. Doctor’s office stopped seeing patients in person. The only care available was a telehealth appointment with whomever happened to be available.
I have said in the past, and I will repeat again: The best time to go to a doctor or health care provider is when you are well. The best time to get an Executive Physical is when you are well, or not so ill that you cannot take part in the planning. Most executive physicals in New York City deliver a template of care. The services they offer generally include a total body CT scan. The CT scan is sometimes called the diagnoses machine. The reason is it will often find many things. The problem is most of the findings will not be insignificant. Insignificant means we found it and do not know what to do about it. That leads to “let us scan you again in six months.” Each CT scan gives you the radiation equal to 500 X-rays.
Often Executive Physicals in NYC use endless referrals to a stream of doctors. These Executive Physical programs strive to get you to see all the specialists in one day. Amidst the covid pandemic the one-day Executive Physical has become rare. Most Executive Physical programs are scheduling appointments 3-4 months in advance. Usually, the process will take several days. An Executive Physical at an academic institution will usually start with a financial review and a 10-page medical history form. Then regardless of what you write on the form you will be see an internist, dermatologist, ophthalmologist. Men over 50 see urology. Women see a gynecologist. If you are over 45 years old, you will also see a gastroenterologist to schedule a colonoscopy. You may or may not get an EKG depending on what you checked off on your medical history form. Academic medical institutions will charge you an administrative fee, but they will also bill your insurance. In general, the person making your Executive Physical itinerary will try to get you in with physicians who take your insurance. As a result of using your insurance you and your doctor are bound to abide by the limitations of the contract. This type of Executive Physical offers two benefits. It helps contain the cost, and you meet many subspecialists while you are in good health. Before an emergency arises. In short if you have an eye issue or skin issue, you will have already established a relationship with an ophthalmologist or dermatologist. The problem is what happens when they are not available, and you have an emergency. You go to the emergency room. Emergencies are for the emergency room. They will corroborate that you are having an emergency and call the specialist on call covering that day.
Another way to have an Executive Physical Exam in New York City is find an experienced and well-connected primary care provider. This primary care provider should be the one to conduct your Executive Physical Exam. A nurse practitioner provides many of the routine health checks you will need such as: your total body skin exam to screen for skin cancer, screen for prostate cancer, and testicular cancer screening. The Nurse Practitioner will order and interpret baseline test. These tests allow comparison for when something does go wrong. Having this type of relationship with a primary care provider who knows you when you are generally well means they can connect you with the right specialist when the need arises. Your primary care provider can help knock down some of the usual barriers to getting into care. Often, we can get the right physician on the phone, explain your situation and convey the urgency of the need.
In my private practice I provide the Executive Health Experience to men over age 30 years old. The Executive Physical exam includes an often-overlooked part of care. Mental health care is an essential component to your well-being. The Executive Physical Exam includes a Psychiatric Evaluation. The psychiatric evaluation includes your spiritual and sexual function. Problems in these two areas often arise long before physical symptoms arise. Most physicians take a don’t ask don’t tell approach to sexual and spiritual health. Most physicians are uncomfortable discussing these areas, even in an Executive Physical Exam. For more details about what a physical exam may include I refer you to a previous entry “The Whole Package.”