What’s in an executive exam?

Any good physical examination is highly individual, whether it’s with the family doctor who’s known you since childhood or with a team at a hospital-based executive physical program.

Patients going for an executive physical can expect a packet of information to precede their visit. They’ll fill out head-to-toe medical information and answer questions about lifestyle and family medical history so that a team of physicians can design a physical for their unique needs.

When they arrive, they’ll be briefed on what tests to expect, and why they’re deemed necessary. In general, the first time they go through the exam will be the most extensive.

It will include an electrocardiogram, the gold standard for detecting cardiac arrhythmias, and perhaps a stress treadmill test. A chest X-ray, which looks for heart, lung or airway problems, could be part of the exam. Bone-density scanning will provide a baseline of bone health, a point from which to accurately measure the rate of future bone loss and possible osteoporosis. Women, depending on age, will get a mammogram to screen for breast cancer; and men, also depending on age, will get a digital rectal exam and PSA test to screen for prostate cancer.

Blood tests to screen for heart disease risk factors and thyroid problems, as well as fecal occult blood tests and urinalysis will be part of the laboratory testing. A pulmonary function test to check for lung capacity, as well as vision tests and hearing tests are usually part of the package.

A full-body exam by a dermatologist is important, especially in sunny Southern California.

Depending on the patient’s family history and per colon cancer screening age guidelines, a colonoscopy may be part of the package. But these are usually every five years, not annually. At the end of the exam, they’ll get the full picture from a physician who has studied their histories and their test results, and consulted with other specialists if necessary. Some programs, such as Scripps Center for Executive Health, provide consultations with a nutritionist to help patients design a better eating plan, and an exercise physiologist to help design a personalized exercise plan.

Within a few days, patients receive a binder with all their medical information and test results.

Some programs, such as the one at Good Samaritan Hospital in Los Angeles, also provide the information on a CD, as well as a memory stick – small enough to file with a passport, in case the patient gets sick in Beijing or Paris.

susan.brink@latimes.com