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Executive Health

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PROGRAM DESCRIPTION

Johns Hopkins Executive Health is a preventive medicine program designed for the convenience of people with busy schedules.  The program provides a comprehensive medical assessment and preventive strategy.  Evaluations are coordinated and scheduled in a single day, with a possible second day if additional studies are required.

Basic Services
Additional Services
For Women
Johns Hopkins Travel Medicine
Pricing


PERSONALIZING YOUR EH PROGRAM


Your day-long visit to the Johns Hopkins Executive Health program will be tailored to meet your individual health needs, based on personal preferences and your Patient Information questionnaire. 
 
A typical Executive Health visit may consist of the following services:

  • Comprehensive Medical History and Physical Examination 
  • Laboratory Screening Tests 
  • Hemoccult Test 
  • Urinalysis 
  • Electrocardiogram (EKG) 
  • Chest X-ray 
  • Audiogram 
  • Pulmonary Function Testing 
  • Eye Evaluation at the Wilmer Eye Institute 
  • Nutrition Counseling 
  • Personal Representative for the day, continental breakfast, hosted lunch, and parking

Detailed Medical History and Physical Examination
A good medical history is the cornerstone for effective assessment and diagnosis.  It reviews any past problems and looks for susceptibilities based on your personal and family background, as well as your health habits.  This is the opportunity for you to raise any medical concerns you may have.  Your personal Executive Health physician will perform an extensive physical examination. 

Comprehensive Laboratory Screening Tests
These detect indications of anemia, diabetes, thyroid disease, liver and kidney disease, and include a lipid panel to assess cardiac and stroke risk factors.  Testing for men also includes Prostate Specific Antigen (PSA) screening.  The PSA is appropriate in any male whose digital rectal examination raises any concern about malignancy.  We begin testing men at age 40 if there is a family history or other risk factors and at age 45 in all other men.  We generally do not obtain PSAs in men over the age of 70.

Hemoccult 
Performed to detect gastrointestinal bleeding from tumors, polyps, ulcers or other causes. 

Resting Electrocardiogram (EKG)
Detects changes in the heart’s electrical activity.  Patterns seen in the tracing indicate where tissue may have been damaged, if coronary arteries may be blocked, or if irregular beats occur frequently.

Chest X-ray 
Assesses heart size (thickened walls may reflect decreased pumping ability) and pulmonary disease, including lung masses.  A chest x-ray should be obtained at the first visit.  Subsequent studies may be needed if the individual  has a history of respiratory symptoms, smoking, or known lung disease.

Pulmonary Function Tests (PFT)
Assess for emphysema, bronchitis, asthma, or other pulmonary problems.  PFTs should be obtained at the first visit.  Follow-up studies on subsequent visits may be obtained if the individual has a history of respiratory symptoms, smoking, or known lung disease.

Audiogram 
Performed by an audiologist who also makes recommendations to help preserve hearing or who may suggest sound amplification.  Hearing loss of some degree affects 22 million Americans; high frequency loss, which impairs speech comprehension, is the most common form.  An Audiogram should be obtained at the first visit.  Subsequent studies will be determined based on the individual’s need.

Eye Examination 
Performed at the Wilmer Eye Institute and includes the external eye structures, pupils, eye muscle function, internal pressure, visual fields, and visual acuity.  An Eye Examination is appropriate on a biannual basis unless visual, ocular symptoms or known eye disease warrants reevaluation or a second opinion.  Annual examinations for those over 50 years old and without ocular symptoms are recommended for individuals with diabetes, individuals with a family history of glaucoma, and for African Americans (due to greater risk of glaucoma).

Nutrition Counseling
This is available for individuals who wish to seek advice and information from a registered dietitian.  Specific nutritional issues related to health maintenance and disease prevention will be discussed based on the individual’s current laboratory indices and nutrition assessment. 

Final conference
Includes a review of test results, recommendations for any further testing or follow up, and counseling about personal health habits. This may be the most important part of the day.  A personalized, written summary will also be sent a few weeks later; a copy can be sent to your primary care physician if you desire.  We encourage you to contact your Executive Health physician if you have any questions about his/her findings or recommendations.

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Additional elective services that are available if clinically indicated might include:

  • Exercise Stress Electrocardiogram Test
  • Metabolic Stress Test 
  • Exercise Counseling 
  • Dermatology skin cancer screening 
  • Colonoscopy  (must typically be scheduled on an additional day of service)

Exercise Stress Test
This treadmill test provides information about how your heart responds to physical activity.  A baseline test is recommended beginning at age 40 for individuals with risk factors for premature arteriosclerosis (diabetes, cigarette smoking, significant hypercholesterolemia, and family history of heart attacks at a young age) and for others beginning at age 50.  Whether or not it should be repeated requires individualized review with your Executive Health physician.

Comprehensive Metabolic Stress Test 
In addition to the above exercise stress test, this treadmill test provides a comprehensive assessment of your cardiorespiratory fitness.  This test is appropriate for the individual who want to know the level of their fitness. 

Exercise Counseling
This is available for individuals who wish to seek advice and guidelines from a certified exercise specialist on their present exercise regimen and ways to enhance it, as well as those interested in starting an exercise program.  These guidelines will include the appropriate type, intensity, duration, frequency, and rate of progression relative to the initial level of fitness.  These guidelines will be based on the results of a metabolic exercise stress test if available and your exercise goals and interests.

Dermatology Examination for Skin Cancer Screening 
Advised on an annual basis by a member of our Dermatology faculty.  A check for cancer, moles, rashes and other lesions is performed.  This is particularly appropriate for those living in sunny climates or who have suffered sun damage (such as severe or frequent sunburn) at any point in their life.  Close to 1 million cases of basal cell or squamous cell carcinoma are diagnosed yearly.  Melanoma, the most serious form of skin cancer due to its propensity to penetrate and spread, is increasing in frequency by 4% per year.

Colonoscopy
This is recommended (in place of sigmoidoscopy) by the American Cancer Society to screen for colorectal cancer in all Americans 50 years of age or older every 10 years.  Greater frequency of colonoscopy is appropriate for individuals with a family or personal history of colorectal cancer or polyps.  This procedure requires thorough cleansing of the bowel, intravenous sedation, usually an overnight stay and a chaperone to accompany the individual home after the procedure.  In comparison to sigmoidoscopy screening, colonoscopy has the advance of greater detection of colorectal cancer and polyps.

Screening Whole Body Computerized Tomography 
Computerized tomography (CT) is an indispensable tool in the evaluation of many medical questions and disorders.  Aggressive marketing by for-profit facilities promoting the putative advantages of screening asymptomatic people with whole body computerized tomography (WBCT) has prompted many patients participating in the Executive Health Program to ask whether this is a test that they should have as part of their Hopkins evaluation. 

Although its proponents portray it as a study we should all want to have, it is important for patients to know that there is no current evidence that screening WBCT in the asymptomatic person is effective.  (This is true even in the person with a significant smoking history.)  Furthermore, it is equally important for the public to know that there is an undisputed downside, including Significant radiation exposure. 

The frequent demonstration of abnormalities that require further additional expensive and possibly risky studies; often lengthy follow-up or monitoring for inconclusive initial results; and the generation of significant patient anxiety.  Significant false negatives, i.e. the failure to demonstrate important abnormalities which leave the patient with a false sense of security. 

The American College of Radiology, the American Heart Association, the American Cancer Society, and the American Association of Physicists all recommend against screening CT scans.  Until the results of further research and data collection become available, these studies are not recommended as part of routine testing in those patients who participate in our Executive Health Program.  Your physician will be happy to discuss this further with you if you have any questions or desire more information.

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For Women

  • Gynecology examination (with Pap smear) 
  • Breast Imaging 
  • Bone Density Study

Gynecology Examination 
Including a PAP smear to screen for cervical cancer

Mammogram
This is advised as follows:

a. Women in their 40s should be screened at least biannually with mammography

b. Women aged 50 and older should be screened annually.

Our Breast Imaging Center offers breast examination and ultrasound if clinically indicated.

Bone Density Scan 
To detect osteoporosis.  This study should be obtained by women who are peri-menopausal and have not been previously tested.   Mild bone loss begins in the late 20's, but with the onset of menopause women begin losing bone mass at the rate of 1-5% per year, putting them at risk for one of 1.5 million wrist, hip and spinal fractures caused yearly by osteoporosis.  The necessity of annual follow-up is determined by individual’s situation. 

Ultra-sensitive CT scanning and PET Scanning is not recommended for routine screening at this time.

Johns Hopkins Travel Medicine 
If your travel includes international destinations, we can arrange a consultation to discuss risks, update travel immunizations, and provide appropriate prescriptions.

Your daylong visit to the Executive Health is designed to meet your individual needs and address health issues raised in the Patient Information Questionnaire which will be sent to you after we receive your Inquiry Form.  Please select Corporate as the region.

Pricing

The Executive Health visit is personalized for each individual patient. As such, the exact total cost for services cannot be determined in advance. Additional testing or procedures may be requested by the patient upon scheduling or recommended by the physician on the day of service.

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