- A clinic is offering a deluxe $10,000 physical that includes extra testing, nutritional advice, and even an optional massage.
- But some experts question whether or not additional testing is helpful for your health.
- This type of concierge medicine is on the rise in the United States amid rising medical costs.
You can buy a lot of things with $10,000 — a dream vacation, an amazing home theater system, a rare designer handbag.
But you can also use that money on something many Americans already get for free through their health insurance: an annual physical.
This isn’t your conventional checkup — it’s a daylong endeavor that includes extensive screenings, same-day lab work, and even a massage at Elitra Health’s “five-star” facility in Manhattan.
While the base level of the physical clocks in at $4,900, it can easily hit five figures if a patient gets additional testing, like a full-body CT scan.
The million-dollar question, though, is whether or not expensive exams like this one actually lead to better health outcomes.
Catering to top executives, elite athletes, and celebrities, Elitra’s comprehensive exam offers “the most complete analysis of your health and well-being.”
“It’s probably the best overall examination you can get if you’re looking for a complete checkup,” said Dr. Avram Nemetz, medical director of Elitra Health.
About 60 percent of the practice’s business comes through corporations, like Estee Lauder and Colgate-Palmolive, who offer the exam as a benefit to its senior executives. The rest is direct to individuals, primarily those in the “top 1 percent in income,” said Ari Cukier, chief operating officer of Elitra Health.
So what’s included in the Elitra exam? While the exact testing may vary from person to person, depending on their preferences and health profile, patients can expect to start the day with blood work, followed by a light meal.
Then, they may go through full-body imaging in the radiology suite, a head-to-toe physical exam, electrocardiogram (EKG), cardiac stress test, vision and hearing tests, nutrition counseling, a fitness assessment, and fat analysis, among other services (like a full DNA sequencing analysis and brain MRI).
Patients wind down with a therapeutic massage and an in-depth discussion with a doctor about the results of the tests and lab work.
“What we do in one day and at one location, all with same-day results, would take three or four more appointments if you went through the standard insurance world,” said Cukier.
“People are busy and because we offer such an efficient and streamlined model of care, people actually go through with the testing that they want done and that, for many, is necessary.”
Patients leave the exam with a detailed report of the results and health recommendations.
“It has reached a point with the technology that’s available and our experience doing these exams that we can tie it all together for people in a way that they leave enlightened about exactly where they are physically and what they need to pay attention to,” said Nemetz.
There’s no doubt that medical tests, including elective exams that aren’t part of a standard physical, have provided some patients with lifesaving information.
Case studies released by Elitra Health share the stories of its exams uncovering the presence of acute leukemia in an otherwise healthy 29-year-old first-time father, severe kidney failure in a 50-year-old hedge fund manager, and tuberculosis in a 37-year-old marketing executive.
While doctors may see benefits on an individual level, some experts aren’t convinced that extensive testing improves health outcomes on the population at large.
“It’s a strange thing to think about, but medical tests and procedures have both benefits and harms,” said Dr. Alex Krist, vice chair of the U.S. Preventive Services Task Force (USPSTF), an independent, volunteer-based panel that offers evidence-based recommendations for medical screenings and other preventive services.
He warns that repeated exposure to radiation from things like CAT scans can lead to cancers. While the benefits of using a CAT scan may outweigh the risks of radiation when checking for lung cancer in a long-term smoker, that might not be true for a patient who has never smoked and thus has a much lower risk of lung cancer.
“Many executive physicals include preventative services that aren’t routinely recommended and they might not help patients or doctors,” said Krist.
“I have seen some executive physicals where they routinely do a stress test or EKG. We [the USPSTF] give that exam a grade D recommendation for doing in low to average risk individuals because there’s potential harm or no net benefit,” he added.
Undergoing superfluous screenings can also lead to false positives, uncover potentially suspicious yet probably benign things in the body, and result in more invasive procedures, Krist explained.
The anxiety of health scares and the potential pain and complications from surgery may ultimately leave the patient worse off than if they never underwent the additional testing.
“There’s a false presumption that medical tests tell us the answers definitively, but it doesn’t work that way,” he said. “A CT scan still involves a doctor looking at the image and interpreting what it means. There’s variability in that.”
Guidelines from the USPSTF are recommendations, not mandates. And some doctors may feel that more extensive testing gives them a more complete picture of a patient’s health.
This Elitra exam and others like it fall into a category of healthcare known as “concierge medicine.” It promises patients little to no wait times for appointments, round-the-clock access to their doctors, and sometimes advanced medical testing for a monthly or annual membership fee, rarely covered by insurance.
“The membership fee allows us to keep our patient panel very small and spend dramatically more time with our patients,” said Dr. Natasha Lewry Beauvais, who provides membership-based concierge medicine (including executive physicals) at Northern Virginia Family Practice.
Her executive exams never include things like full-body CT scans and whole-genome sequencing, as she believes these don’t provide enough benefit to the patient, even though other doctors may take a different approach.
Instead, she leverages the advantages of concierge medicine (particularly more time during appointments) to get to know patients on a deep level.
“When a doctor has enough time to be thorough, we can do a better job and pick up more things,” said Beauvais.
Concierge medicine may help physicians have a better relationship with their patients, but it also is only available to those who can afford the extra fees on top of premiums.