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Gilded care for executives

Monsour Executive Wellness Center
From left: Colleen Chappell; Dr. Roger Monsour, wellness center founder; and Dr. H. James Brownlee, medical director. Chappell's executive physical turned up breast cancer in its earliest stage. She underwent chemotherapy and radiation treatment and is cancer-free now.
[Photo: Mark Wemple]

Colleen Chappell never seemed to be able to find the time to get to the doctor for a comprehensive medical checkup. Last year, however, as her business partner battled terminal cervical cancer, Chappell decided she couldn't wait any longer. "I realized that my resolution for myself and my company needed to be protecting our most valuable asset, and that's the health of the leadership."

Trends

Younger Patients: Executive physicals aren't just for the over-50 set anymore. "Now we're starting to see people in their late 30s or early 40s come in, oftentimes prompted by a friend or loved one who had a bad health outcome and they want to try and prevent that from happening," says Dr. Stephen Avallone, who heads Cleveland Clinic Florida's executive health program in Weston.

International Appeal: Centers in Florida offering executive physicals report a significant number of international customers. Baptist Health South Florida in Miami reports that 40% of its executive health patients come from abroad, with its top feeder countries being (in order) the Bahamas, St. Kitts, the Cayman Islands, Jamaica and Honduras.

Pay Shift: As many companies restructured or downsized over the past several years, they also jettisoned some gold-plated medical benefits for CEOs. Executives, however, are choosing to pay out of pocket for the evaluations.

Chappell, who heads an advertising and public relations company in Tampa, signed up for a one-day executive physical at the University of South Florida Health's Monsour Executive Wellness Center. The checkup took about nine hours, cost $5,000 and included blood work, a vision screening, treadmill stress test, abdominal ultrasound and more. By the end of the day, Chappell learned that her risk of having a heart attack during the next 10 years was "slim to none." But an MRI of her breast had detected something abnormal. A biopsy revealed cancer at its earliest stage, stage one.

Dr. Stephen Avallone, who leads the Cleveland Clinic Florida's Huizenga Executive Health program in Weston, says: "Fifty percent of the time we're finding something of some significance that needs to be addressed so it doesn't become a problem, and 10% to 20% of the time we're finding something of more significance that needs to be addressed promptly."

Critics of such in-depth screening, however, point out that increased testing is likely to yield more false positives, leading to expensive and unnecessary treatment. Moreover, patients might even be harmed from repeat radiation exposure from CT scans and other imaging tests often used in executive physicals. In a piece he wrote in 2008 for the New England Journal of Medicine, Minneapolis oncologist Brian Rank says that executive physicals are "one of modern medicine's most expensive and least proven approaches to care."

Chappell counters that "the cost of the exam is nominal compared to what it costs to be sick. If I had not had this physical, the costs for me to have waited would have been five times more healthcare costs, because (the breast cancer) would have been stage three. The cost also would be 10 times more time out of the office."

Even those without life-or-death experiences still see value in the comprehensive executive exams.

John Hitt
University of Central Florida President John Hitt makes an annual visit to Rippe Health in Celebration. "He had a heart attack and another health-related scare in 2006. Especially since then, he has been very health conscious, as you can imagine," says UCF spokesman Grant Heston. [Photo: Gregg Matthews]
Joel Cantor, a St. Petersburg developer and real estate private equity fund manager, says getting an executive physical gave him "peace of mind" when he started ramping up his personal fitness regimen. "I started running triathlons and had considered running longer distance events and more serious training, and I just wanted to make sure I was in good condition to do it."

On the recommendation of his friend, Steve Raymund, chairman and former CEO of Tech Data, Cantor went to see Dr. Steven Masley, a St. Petersburg physician who has been performing executive physicals since the late 1990s. Masley conducted a battery of tests and spent hours with Cantor going over his findings. The result? Cantor wasn't in quite the "amazing shape" he thought he was. "He said that day it would probably be good if I lost 10 pounds. I was probably better than average, but I could have a lot of improvement."

Since then, Cantor has stepped up his exercising and is pleased with the results. "I've improved my cardio endurance. I look better. I feel better. And I feel confident I'm not going to drop dead when I take a 10-mile run."

As for Chappell, who has since completed chemotherapy and radiation and is cancer-free, she tells every executive she meets about her experience and paid for the physicals for all three principals in her agency. "I was wanting to do this a couple years prior and I faced the same issues other executives face: ‘How am I going to make time? Can I afford to be out of the office?' The truth is, you can't afford not to be proactive with your health," says Chappell. "It was the best nine hours I've spent in my career."

Joel Cantor
Joel Cantor says an executive physical gave him the peace of mind to step up his exercising. [Photo: Cherie Diez/Tampa Bay Times]