Executive health and Concierge Care at Home

by ih-mmd ih-mmd

What is concierge medical care? What is boutique care? What is direct primary care or personalized care?  These are all euphemisms for paying directly for your care and not going through an insurance provider. This allows for the patient and no other party to have control of the healthcare encounter. These concierge care practices are usually the ones providing executive health physicals.  This practice takes the service to a higher level by providing the care directly in your home.

If your personal physician is not providing you with the time and attention to detail you need and deserve perhaps it is time to switch or get a second opinion. 

Making time for individualized preventative care can be difficult. Perhaps an executive health physical may be the perfect solution to your time constrained life in New York City and abroad. Now with the resurgence of medical house calls this level of attention is readily accessible. 

What is an executive health physical and do you have to be an executive to get one?

First, you do not have to be an executive to have an executive health physical exam.  It helps if you have the salary of an executive as these comprehensive exams are usually not covered by insurance.  An executive health physical is simply a comprehensive physical exam and health assessment that helps you and your primary care provider stratify risk for the disease over time, but unique to this service is that the care is delivered to your home in the form of a medical house call.

An executive health physical begins with a one-on-one meeting in your home with your primary care provider in which a detailed comprehensive health history is reviewed.  Special attention will be given to your family history and lifestyle to uncover modifiable risk factors.  As part of your comprehensive health history, your primary care provider will review your current diet, exercise, sleep, and even your sexual practices. After your comprehensive health history is reviewed a hands-on head-to-toe examination will be done in the privacy of your own home. For men, this will include a urogenital prostate exam.

Following your comprehensive history and physical exam, your primary care provider may consider ordering various blood tests for screening and diagnosis.  Additionally, non-radiation imaging studies and sensory tests (Vision, and Hearing) may be prescribed to provide a more detailed look at your physiology.  The tests ordered should be judiciously considered so as to not increase the likelihood of false positive findings.  False positive test results compound stress and increase the risk of harm.  For this reason, total body scanning is generally not a prudent idea for screening purposes. There is a very high risk of incidental findings without clinical significance in general body scanning. 

In addition to the comprehensive history and physical exam at home you should also receive a comprehensive psychiatric evaluation in the form of a medical house call (not for the purpose of necessarily identifying a mental illness), but for identifying coping mechanisms and risk factors for maladaptive coping in the future.  A comprehensive psychiatric evaluation can provide you the anticipatory guidance necessary to relieve your stress at the different ages and stages throughout your lifespan.  Mental illnesses such as depression and anxiety schizophrenia and bipolar would have likely been discovered prior to your executive health physical. Less known but more common conditions such as dysthymia, adjustment disorders, dysfunctional grief, addiction, PTSD, insecurities, and phobias will also be screened.  The comprehensive medical history, complete physical exam and the psychiatric evaluation are the three components that comprise an executive health exam. 

After this comprehensive evaluation is completed you will now have established a foundation for a participatory care relationship with someone that knows you very well. Now you have a relationship with medically trained consiglieri (who comes to your home) whom you can call on in your times of need.  A modifiable personal wellness plan can be implemented with your coach at your side.

What happens if you need a specialist?

Should you need consultation from a sub-specialist a facilitated referral will be arranged, some specialists also make house calls.  Specialists are selected from renowned institutions in the New York City area.              

How great would it be if you had the guy that could conveniently and confidentially take care of you and your family in the form of a medical house call?  


Dr. Raymond Zakhari is a triple board certified (Adult- Adolescent, Family Practice, Psychiatric Mental Health) Nurse Practitioner (NP). He provides Concierge Medical House Call services in Manhattan and outer boroughs.

General #MedicalHouseCalls #PsychiatricHouseCalls (Therapy & Medication Management) #SkilledNursing House Calls Dr. Raymond Zakhari, NP does not take any insurance as he is out of network; provides concierge-style medical and psychiatric House call services. (If you have out of network benefits you may be reimbursed, check your plan for details).