Keeping the Madmen Healthy


Executive Classrooms

Could it get any better at the top? Corporate executives seemingly have many perks; private jets, golf club memberships, and events held at exotic locations. Companies and their boards justify these perks, due to the stresses and strains of the job and the need to keep their top executives healthy; otherwise these companies risks declining fortunes. Adding to this increasing notion of ‘it’s good to be the boss’ comes the concept of the executive physical.

More hospitals now cater to corporate executives, establishing executive health programs that—for a very steep price—leave no stone unturned in evaluating the fitness of the executive. These “full-body examinations” includes extensive history taking, blood work, heart and lung evaluations, prostate checks, colonoscopies, hearing and vision exams, to name a few. Time is money to these key executives, so the executive may see a litany of specialists in a compressed time frame of a couple of days, enabling the executive a quick return to the business of running their company.

This is clearly not ObamaCare. In fact, most executive health programs accept only cash—or corporate check—which companies willingly write (and write–off) as a cost of doing business. No insurance pre–approval, no concern about ordering tests outside of evidence—based guidelines, freedom to chase down the most minute medical anomaly until assured it’s absolutely, positively meaningless. Test, test, then test some more. The happy executive goes home assured of continued health for another year, refers his corporate friends and family to the ever efficient program, and everyone in this circle of life couldn’t be happier.

Dave, a recent out–of–work day laborer never had, or even heard of a routine physical examination. He receives his care—usually emergently— through emergency departments or urgent care centers. He had insurance once, but the steep co–pays kept him away from the doctor’s office. He had some blood in his stools on occasion, attributing it to the heavy lifting he did everyday. No physician ever asked about his family history. If they had, they might have learned about the colon cancer that took his father and older uncles. And a screening colonoscopy? A trip to Mars must have seemed more affordable.

Two extremes of the corporate food chain: the ‘I got to have it’ and the ‘have not.’ As health care organizations become more accountable, they need to look closely that they spread resources equitably, efficiently and effectively to all who walk through the door. No special programs for the rich; just what they do everyday for anyone regardless of societal place, or ability to pay. No perks, just providing for people—that’s the American health care dream.

About Steve P. Sanders

A general internist writing and sharing ideas and art.

One Response to “Keeping the Madmen Healthy”

  1. Good one to send to your Congressman!

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