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Executive Physicals: An Unnecessary and Possibly Harmful Perk?

With the country's attention focused on health care, the following article provides some interesting things to think about:

From the Pioneer-Press

Researcher puts 'executive physicals' under the microscope

Researcher questions wisdom of the gilded checkups for CEOs

Dr. Brian Rank has created something of a melee in a medicine chest.

The medical director at Bloomington-based HealthPartners is challenging the value of a time-honored special perk for many CEOs: the executive physical.

Year after year, companies offer the CEO and other corporate chieftains a trip to some prestigious medical center — it's often the Mayo Clinic — for the very best physical examination that money can buy.

The visits often involve an intensive one- or two-day set of medical tests complete with a personalized interpretation of the results, and last year just more than half of Minnesota's 50 largest public companies offered them to their chief executives.

But in October, Rank published an article in the New England Journal of Medicine arguing that executive physicals don't necessarily help CEOs and could actually hurt them.

"At a time when many companies are downsizing and restructuring and need to be doing the right thing for everyone, I'm surprised that they would commit resources to something that is unnecessary, unhelpful, expensive and potentially harmful," he said.

Apogee Enterprises CEO Russell Huffer also got a physical last year, at a cost of $3,598, but the Bloomington-based maker of glass products has since decided to eliminate the perk after more than 20 years.

"The (board) committee was following current compensation trends to eliminate perks," said Mary Ann Jackson, a company spokeswoman. "Since Apogee has enhanced the preventive benefits under its employee health plan, it was decided a separate executive health physical program was not required."

That's the sort of thinking applauded by Rank, the medical director for Health Partners Medical Group. He said the harm caused by the executive physical goes beyond the money that companies spend on the exams.

"Many of the centers that provide (executive physicals) tout an environment of exclusivity, personal attention, and luxury of the type one might expect to see at a four-star hotel or high-end resort," Rank wrote in his journal article. "Those who undergo these physicals clearly appreciate the indulgent touches, such as complimentary bathrobes and slippers or the performance of the whole process in a so-called VIP area."

Such amenities perpetuate an idea that wealthy patients are somehow more worthy of better and respectful care, Rank said. That's counter to the move in medicine to try to eliminate health care disparities that are based on income, race, geography and other demographic factors, he argued.

As for the executive, it's unclear whether the intensive set of tests received during the physical really is helpful, Rank said. There is no evidence the lengthy examination provided during the executive physical actually delivers better patient results, he said.

On the contrary, too many exams can be a bad thing.

"Unnecessary testing may cause more harm than good, owing to false positive findings, unwarranted follow-up visits and costs, needless worry, and harmful side effects of the tests themselves," Rank wrote.

Of course our friends at Mayo disagree with Rank.

The Mayo Clinic has been providing executive physicals informally since the 1940s, and in a formal program since 1972. The executive program provides exams for about 7,000 per year, Hensrud said, up from about 2,000 executives in 1999.

Executives can obtain their physicals at Mayo medical centers in Rochester, Arizona or Florida. While some executive health programs might pamper CEOs, executives visiting the Mayo Clinic receive much of their care in the same setting as other patients, Hensrud said.

"We don't provide bathrobes or slippers," he said. "We're certainly not a spa here in Rochester."

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