Relying on Executive Physicals

Serious illness often strikes without warning, leading to weeks of incapacitation or even death. For companies, the loss of a key executive can have damaging results as well. Insisting on executive physicals can help minimize the risks.

Wednesday, May 2, 2007
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Companies depend on their key executives. They make the most important decisions; they bring in the big contracts and accounts. So, what will happen to a company when its executives are suddenly no longer there?

It's not something people like to think about but serious illness strikes without warning. For one of every three people with coronary artery disease, the first symptom is sudden death. For those lucky enough to avoid sudden death, the first warning sign may be a heart attack or bypass surgery that results in weeks of lost time from work.

Whether the diagnosis is cancer, diabetes, strokes or heart attacks, the costs to a company in lost productivity, hiring and training can easily dwarf the costs of medical care.

To minimize this risk, companies have relied on executive physicals for key executives.

In the past, executive physicals relied on conventional risk factors, such as cholesterol levels and stress tests, to try to find disease before it struck. But these exams were generally ineffective. Cholesterol levels turn out to be no more predictive of cardiac risk than flipping a coin. By the time a stress test is abnormal the treatment options are surgery or stents and the opportunity to prevent advanced disease has already been missed.

In recent years, new and emerging technologies have radically changed the landscape of executive physicals. High-end centers now offer effective tools that can detect the earliest stages of disease 10 to 20 years before symptoms begin. The emphasis has shifted from early-disease detection to effective-disease prevention. An executive exam is no longer just a longer version of the same exam offered by primary care physicians in a prettier setting and a fluffy bathrobe.

High-speed 64-slice CT scanners can directly see the inside of arteries to detect even minute amounts of plaque that can lead to heart attacks or strokes. At that stage, treatment is easier and far more effective.

CT lung scans can pick up early-stage tumors just a few millimeters in size, before they have spread.

New technologies can find a wide range of cancers, aneurysms, kidney stones and other potential threats years in advance of conventional exams. Advances in genetic and laboratory testing can help to predict an individual's risk of disease as well as create individually tailored treatment plans to prevent or delay the onset of illness.

An executive physical also is an opportunity to focus on the lifestyle issues that not only prevent disease but also enhance the enjoyment of life. Top centers provide exercise physiologists and registered dietitians to offer guidance on optimizing nutrition and fitness.

When finding the time for exercise and good eating habits in a hectic schedule is a challenge for most executives, it is helpful to discover that there are simple, healthy strategies that can fit into almost any lifestyle and require very little time or effort for big rewards.

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The payback from a healthier lifestyle is not limited to just lower health-care costs. Numerous studies have shown that improving fitness and nutrition and lowering stress levels leads to improved productivity and better employee retention. And there is the intangible benefit of the peace of mind that comes from a clean bill of health.

Running a successful business includes anticipating potential risks and taking proactive steps to minimize those risks.

Often, people end up taking better care of their business and careers than themselves.

With the latest advances in preventive medicine, the time has come for responsible key executives to recognize the potential risks to their companies due to unexpected and preventable illness. While an executive exam is often perceived as a nice "perk", in fact, it can be a highly cost-effective strategy for preventing the loss of a key team member and improving performance and morale.

David A. Fein, M.D.. is founder and medical director of the Princeton Longevity Center. He completed his undergraduate studies at Franklin & Marshall College in Lancaster, Pa., and received his medical degree from New York University School of Medicine. He was elected to the Alpha Omega Alpha Medical Honor Society and completed his residency training at Bellevue Hospital-NYU Medical Center. He is Board Certified in Internal Medicine. Dr. Fein has traveled extensively to research the latest medical advances to incorporate them into the Princeton Longevity Center. He is a founding member of the Society for Cardiovascular CT and lectures extensively on topics in preventive medicine. He can be reached at

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