People with money to burn, and unscrupulous doctors who take advantage of them. The ultimate in concierge care:
But executives with money to burn should be careful. Physicians who hear the sound of coins clinking have incentive to recommend procedures that cost a lot but may have dubious benefit. Whole body scans may sound cool, but they aren’t very specific. Many wealthy people who latched on to the body scan craze found themselves undergoing invasive follow-up procedures, including catheterizations and biopsies, that involved extra risks but uncovered no serious problems. According to the medical experts we talked to, anyone having a battery of tests needs to know the reason for each test, the downsides and potential benefits, even if that takes extra time and involves getting a second opinion.Costly diagnostic exams are also sometimes more trouble than they’re worth. Shawn Jenkins learned that the hard way, when he started experiencing vertigo in the mid-1990s. Jenkins, now 39 and CEO of software firm Benefitfocus, went to a specialist. Before he even saw the doctor, he was put through $25,000 worth of tests, including an MRI. Then the physician came in, looked in his ear and wrote him a prescription for an antihistamine.
Just throw evidence-based medicine out the window. (via Clinical Cases)
Related posts:
- Executive physicals, just say no
- Executive physicals, and what the Mayo Clinic doesn’t want you to know
- It’s executive physicals or quit
- Gerald Ford: A waste of end-of-life care?
- Health care reform analysis from a former insurance and hospital executive
- Is this the type of physical Kaiser provides?
- What the medical home means for PCP salary
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{ 15 comments }
“Before he even saw the doctor, he was put through $25,000 worth of tests, including an MRI.”
Gee, sounds like a routine visit to the ER for vertigo for anyone else…. Now what you don’t say is how much he spends at the car dealer when his car has a case of the shakes…
A fool and his money are soon parted.
A waste of time…correct.
A waste money…correct.
A waste of resources…correct
Bad medicine even…correct
But, when given the option, patient always seem to make foolish choices of more invasive studies. There was a recent article about how false positive result relate to patients. They will more often choose the riskier procedure because they don’t understand odds. They just want “to make sure.” Human nature and predatorial behavior.
Remember that executive physicals are usually a perk for senior executives. The physicals are meant to assure that the executive doesn’t have some fatal flaw that will result in his/her departure and the sudden liquidation of the company stock, since we all know how irreplacable these individuals are. That is why they receive such stellar compensation. Insurance companies do not usually cover the costs of such expenditures. These are discretionary dollars and part of a compensation package.
It is highly judgmental to say the physicals are a waste of time, money, or resources. We all know that patient that had the CT for one condition that serendipitously revealed the unrelated asymptomatic cancer before it was too late. Call it a fishing expedition of you like, it is just another way to spend a dollar,and at least in this country, you are free to do so.
By the way, evidence-based medicine has little to do with the care of the individual patient. When I have a concern about loss of life or limb, I want it checked out, even it it is at my expense. I don’t want to be denied based on statistical probabilities proffered by Ivory Tower eggheads. If you believe all that, then you must believe RBRVS is just and equitable! You must also believe in evidence-based jury verdicts…dream on.
Do you suppose there exists somewhere in a vault a copy of Ken Lay’s “Executive PHysical?
I love it. $25 k for a vertigo work-up and a prescription for Antivert! Just like for the average Joe in a walk-in clinic- minus $24,850, that is.
And you wonder why the country is going broke from escalating health care expenditure.
This has nothing to do with “going broke”. Quite the contrary. Such discretionary dollars help offset the unreimbursed dollars lost to bad debt and capricious insurance contracts.
And you wonder why the country is going broke from escalating health care expenditure.
It’s going broke because you’ve created physicians like me, who tomorrow morning will be deciding whether patients need that defensive menaingless CT scan and chest pain admission, all the while my mind actually on my next court deposition, for even more meaningless, outcome based, greed-induced bullshit.
We all know that patient that had the CT for one condition that serendipitously revealed the unrelated asymptomatic cancer before it was too late.
Except for for every person whose life might be saved, more may be harmed.
Tests have false positives that lead to more invasive tests and these tests may have serious risks.
Also, not every asymptomatic cancer is going to spread, and not every cancer can be cured if detected early. You don’t know if in a particular case early detection would make a difference or if it would cause you to suffer side effects of treatment unnecessarily; or if it would just prolong the time you know you have cancer with the same end result. This is why evidence matters.
And one other thing. If a CEO pays for these things with his own money – it’s his choice and his right. If he takes company money – there better be evidence that it is cost-effective. Otherwise, why should shareholders (or employees) pay for a CEO’s executive physical?
When I have a concern about loss of life or limb, I want it checked out, even it it is at my expense.
Obviously if you have a reason to be concerned you want to investigate it. This is about symptomless people.
“Also, not every asymptomatic cancer is going to spread, and not every cancer can be cured if detected early. “
You obviously don’t watch enough TV. Anybody who is home at Noontime and watches Soap operas has seen the Sodomite Commercials: “My doctor missed my cancer. I had to undergo chemo and radiation. Jim Sokolove will make him pay. “
None of us want to be that doctor. Sorry if the truth hurts.
Actually, I do watch TV. Just skip commercials – except for those with cute kitties and puppies.
I thought this thread was about executive physicals and not lawsuits… It’s not like you are going to be sued if a CEO misses an executive physical, is it?
Depends on whether shareholders lose money; could be a class action.
Amazing the amount of pessimism I read from doctors. You’d think we were dentists. Cheer up. Tomorrow is a new day.
Dentists are pessimistic? I was thinking maybe I should have been a dentist…..
Back to the original comment…
$3000 fishing expeditions can be a waste of time and money. But, what about a comprehensive, scientifically based medical exam with a thorough physician exam – paid for up front, without insurance involvement? All because the customer chose the service. Maybe sounds like medicine the way it used to be…
Just like any other service, the buyer should do their research and seek the “best” physical exam for their dollar. However, if people were responsible for themselves and did their research then we’d be in a less pessimistic state.
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