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For the busy exec, a $2,000 physical

February 18, 2008|Susan Brink | Times Staff Writer

For busy people, time is money. And when you've got more money than time, the cost of an executive physical examination is kind of like the price of a yacht. If you have to ask, you can't afford it.

Tom Gilmore arrived at L.A.'s Good Samaritan Hospital on a bright Friday morning, sporting a dark blue Nike warmup suit the hospital had sent. Priscilla Castillo, VIP patient service manager, was waiting at valet parking to escort him to a waiting room, where coffee, tea, juices, fresh fruit and yogurt were continually replenished.

But he didn't have to wait long. Soon he was being escorted to an exam room, where the bathrobe he changed into was so plush and soft that he couldn't resist holding out an elbow for Castillo to touch, saying, "Wow, feel this. What do you think? Some sort of microfiber?" The slippers were just as snuggly, and they, along with the bathrobe and warmup suit, were his to keep. "For $2,000, it better be mine," he says.

That's the cost, not covered by insurance, of the most extensive physical examination he's ever had.

It's not your usual checkup. It's called an executive physical, and Gilmore, downtown real estate developer, was patient No. 1 at Good Samaritan Hospital's new program, which aims to market its preventive health services to busy downtown corporate types.

Such programs for years have quietly attracted those who can pay and want fast, excellent and comprehensive medical service. "They cast a halo over the public image of the hospital and might attract more admissions from well-insured patients," says Alan Sager, professor of health policy and management at Boston University School of Public Health.

Now, with a rich lode of high-income earners starting to occupy newly renovated lofts, marketers for the downtown hospital figured new residents need more than a place to walk their dogs and buy their groceries. They need a medical home, says Andy Leeka, chief executive of Good Samaritan Hospital. Similar programs are available in other area hospitals, including Scripps Center for Executive Health in La Jolla, Cedars-Sinai Executive Medical Services and UCLA’s Comprehensive Health Program.

Some so-called boutique medical practices offer equally comprehensive physicals. Such practices charge a flat annual fee, do not accept insurance and promise their patients quick appointments and plenty of time with the doctor. But the full complement of state-of-the-art testing and laboratory technology available at large hospitals isn't available under one roof at a boutique, or concierge, practice.

The emphasis with hospital-based executive exams is on a quick and painless in and out.

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Rolls Royce of physicals

The baseline costs range from $2,000 to about $2,700, possibly more depending on the tests deemed appropriate for the person's age, sex and medical history. The granddaddy of the hospital-based executive physical is the Mayo Clinic program in Rochester, Minn., chronicled in orifice-probing detail by James McManus in his book, "Physical: An American Checkup."

The exams represent the Rolls Royce of physicals. "We market specifically to affluent individuals who can pay the toll," says Dr. Scott Carstens, medical director of the Scripps program. "We have corporations that provide it as a perk to their employees. But we have other individuals who are tired of being constrained by insurance companies and providers. They want an absolutely no-holds-barred review of how they're doing physically."

The exams emphasize thoroughness, efficiency, top-of-the-line technology and on-site laboratories to hurry results along.

Gilmore, 55, had his blood drawn and his urine analyzed. He had an EKG to test for heart abnormalities; a chest X-ray for images of heart, lungs, airway and bones of the spine and chest; a carotid ultrasound to check for artery narrowing that could put him at risk for a stroke; a bone-density scan to check for early signs of osteoporosis; and a 64-slice CT scan to look for signs of calcium plaque on artery walls, early signs of heart disease.

By noon, Dr. William Howell was explaining the results and making recommendations.

"All of this is done in a VIP area," Leeka says. That means no coughing, hacking, contagious masses sharing the fruit plates and mineral water.

Theoretically, it's what any basic physical exam should be: all about you. "That one-stop-shopping kind of exam brings all the results together in one place," Sager says. "This is one way of integrating across the chaos that many of us see in our healthcare."

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All about the patient

By the time patients arrive, a team of physicians will have gone over their medical histories, filled out beforehand in 20-plus-page detail. The battery of tests will be based on broad medical guidelines, with a sharp eye on the individual's age, sex, family history, lifestyle and personal concerns.

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