Once a year, William Rowley spends a day at the Cleveland Clinic getting a soup-to-nuts physical exam that includes multiple blood tests, vision and hearing checks, and if he chooses, meetings with nutritionists and exercise physiologists to review his lifestyle choices. Two years ago, his physician at the Cleveland Clinic Executive Health Program, Richard Lang, discovered Rowley had signs of prostate cancer. The disease was detected so early that surgery was the only treatment needed.
"They're proactive. They identify issues before they become major problems," says Rowley, 63, president of Mercury Plastics in Middlefield, Ohio, and founder of Healthnetwork, a nonprofit in Chagrin Falls, Ohio, that facilitates medical care for executives. The Cleveland Clinic was one of the pioneers of executive health, having launched its first program in the 1940s. The program has since evolved to include a battery of offerings that go way beyond a normal annual physical. Patients with a family history of serious diseases, for example, can get genetic tests designed to predict their risk. Stressed-out execs suffering from insomnia can talk to psychologists and get referrals to sleep clinics. And many can get advanced imaging tests to detect clogged arteries and other risk factors for disease.
The pricetag: $1,000 to $4,000, depending on the services patients choose. Often employers will kick in all or part of the cost. "Companies ask for this as a way of protecting their assets," says Lang, who is the Cleveland Clinic's department chair of preventive medicine. "They look at this as a life insurance policy for people that they can't afford to lose because they're not taking care of their health."
Some experts worry that people are not aware of the potential risks of submitting to many advanced imaging tests, such as radiation exposure and the possibility of finding something that looks abnormal but turns out to be no big worry. "Often things will be picked up that are either not relevant or can lead to other tests or treatments that may not be indicated," says Steven Weinberger, executive vice president and chief executive of the American College of Physicians in Philadelphia. Lang responds that his approach is to only recommend imaging tests consistent with each patient's individual health risks, and to fully disclose the risks of those procedures. "This is always something that should be discussed with patients when they're going on a screening protocol," he says.
The executive health program has grown so popular that the Cleveland Clinic began offering it at its Weston, Fla., campus in 2003 and its Toronto facility in 2006. Other hospitals with similar programs include Robert Wood Johnson in New Brunswick, N.J., Johns Hopkins in Baltimore, and the three Mayo Clinics. Hackensack University Medical Center in New Jersey will include a corporate wellness program in its new fitness center, which is slated to open by the end of this year. The center will become a one-stop shop for wellness, with everything from smoking cessation programs to cooking classes for people with diabetes, heart disease and other chronic conditions.
As health reform takes root, look for more hospitals to expand their wellness offerings as they seek to "build relationships for the future," Cirillo predicts. When prevention is a key aim, he says, institutions "have to think about owning more of the continuum of care."