The executive profile

AN executive profile in health is a comprehensive medical evaluation that includes a detailed, head-to-toe examination and a battery of investigations. Dr Jomo James, internist, told All Woman that the suitability is often based on a person’s age, sex, family history, lifestyle, and other risk factors.

“The term executive is a misnomer in that due to the high cost of the medical evaluation, it was often thought that an executive profile only targets working professionals. Nothing could be farther from the truth. The executive only means the highly detailed, world-class, evidence-based service with prudent attention paid to a one-on-one medical evaluation.”

Dr James said another inaccurate interpretation of an executive profile is that it only involves blood tests or investigations. Rather, he said, a detailed executive, to be complete, must include a physical examination and a medical history.

The internist explained that the executive profile serves three main purposes:

1. As a screening tool in discovering potential health problems (mainly the “big” four — diabetes, hypertension, high cholesterol, which are themselves gateway to bigger health issues, and common cancers). It is also serves as a baseline to compare subsequent tests.

2. As a vehicle to target, reduce and eliminate medical risk factors, including risk behaviours.

3. As an opportunity by health professionals for health education, promotion and counselling.

Dr James said, as with everything in medicine, an executive profile begins with a medical history whereby the doctor takes information on your past medical issues, lifestyle and family health problems that might be passed on.

He further explained that a detailed examination from head-to-toe is then performed with particular attention to blood pressure measurement, pelvic exam/Pap smear in women, and a prostate exam in men.

“The laboratory tests, which is what is most associated with an executive, is where most costs of an executive, are associated with. The tests offered differ from lab to lab; however, executives profile share a lot of common areas in both sexes but differ in some.”

The common bare minimums are:

1. Complete blood count (CBC) which measures the number of each of the three types of cells in your blood (white blood cells, red blood cells and platelets) to see if low, normal or high.

2. Complete metabolic panel (CMP) checking for kidney function, liver function and chemical imbalances.

3. Thyroid hormone test.

4. Fasting lipid profile to check for high cholesterol levels.

5. Fasting blood sugar to identify at risk individuals for diabetes or diabetics.

6. HbA1c, another test for diabetes, which gives the average sugar levels over a three-month period as opposed to the fasting sugar which is just a snapshot.

7. HIV 1/2.

8. VDRL test for syphilis exposure.

9. Urinalysis to check for abnormal content of urine which maybe a precursor to kidney disease.

10. Faecal occult blood — a stool test to detect blood in the stool which could be an indicator of colon cancer; usually done if over 50.

11.Chest X-ray for heart size and chest evaluation.

12. Electrocardiogram to check for the rhythm of the heart.

Dr James also pointed out that the differences for women include pelvic exam, Pap smear, breast exam, and for males, a prostate exam, prostate specific antigen — which is a blood test to determine risk or likelihood of prostate cancer — and testosterone levels.

He stated that the cost of executive blood work up alone can run in the thousands of dollars, particularly if not covered by health insurance.

He said getting an executive depends on several factors, one being the older you are, the more likely you will need it.

“Most health professionals will agree that the executive profile is needed certainly by age 35 for both sexes, and preferably at age 25 in women due to the high risk of anaemia and the success of early cervical cancer screening in this age group,” he said.

How often you need it also depends on your age and if any abnormalities were detected before. He explained that yearly executives are the usual, and not more than two years apart.

If you’re unable to afford the executive profile, Dr James said since the primary goal of an executive is to screen for the most common chronic illnesses — diabetes, hypertension, high cholesterol — there are really four important tests that need to be done. These are:

1. Complete blood count (CBC)

2. Complete metabolic panel (CMP)

3. Fasting blood sugar and cholesterol

4. Urinalysis.

In addition, Dr James said these tests do not necessarily need to be done all at once but can be done from time to time as the need arises.