
A Five-Hour, $5k “Super Physical” Exam - RickJWagner
https://www.insidehook.com/article/welcome-to-the-era-of-the-five-hour-5000-super-physical-exam
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petercooper
I've had a similarly priced full day medical in the UK (with Preventicum)
although it included (almost) full body MRI (less annoying than I thought it
would be!), ultrasounds of abdominal organs, lung capacity tests, and various
such things.

I am very glad I did. While people are often warned away from such things due
to the risk of finding things that could cause concern but which are not
strictly dangerous, it has hugely put my mind at rest given some health
problems I was having. It is also amazing to have full body medical grade MRI
scans I can navigate on my computer(!)

I can't think of a huge deal to say about the experience, but I am happy to
answer questions if anyone has any.

~~~
CapriciousCptl
Doctor here. You didn't have a false positive-- of course you _feel_ better
off. But, you're not _physically_ better off because nothing came back as
positive or treatable. Some will start in your shoes, but be unlucky and have
a false positive. They would be mentally and _physically_ worse off as
potentially inconclusive tests followed by potentially unnecessary procedures
resulted in, say, removing one of your kidneys. Yes, that will only happen
very rarely and yes I've seen it happen.

There can be kind of a two prong "test" to determine if screening is harmful.
Physically, is it a good idea? Answer is probably no. We're not in a scarcity
situation really where the "prestige" demographic isn't getting recommended to
get appropriate tests based on their risk factors (on the other hand, some of
our poorest aren't getting them but that's not an issue solved here). The
other side is mentally. Again, I'd argue that people with a clean unnecessary
screening got out lucky. They'd be mentally much worse off had something come
back positive.

Bizarrely, there's new data suggesting that even fixing known problems, like
coronary artery blockages doesn't improve mortality in a lot of situations
you'd think it would. That suggests that we're doing too much screening in
that case (I mean, if the treatment is worse than the disease... why screen?),
not too little. As another example there is a well-known vascular surgery
group going to churches under the pretense of "screening" for leg
atherosclerosis, then performing high-margin, high-turnover, and unnecessary
procedures on the very high "induced" false-positives.

I also find it utterly bizarre that screening would include lung capacity
testing. In an otherwise healthy adult who can say, climb a flight of stairs
or something of the sort without getting shortness-of-breath, that test is
completely meaningless and expensive from a "disease" perspective. On the
other hand, it does give you a number to compare to your peer group, kind of
like resting heart rate. On the other hand, resting heart rate is free, can be
done yourself, and literally takes 15 seconds to measure.

In the end, I'm not really against having these sort of "prestige" medical
services available. Particularly because more choice is generally good-- and
it's your body, you should do what you want with it (within reasonable
bounds). But, everyone should educate themselves because on balance, I doubt
people end up up _feeling_ or _being_ better off considering the ones who will
have false positives.

~~~
learnstats2
It seems to me that doctors are the only people with the opinion that testing
doesn't help people. Is this taught?

Either I test positive, and this gives me a treatment program or more
knowledge about the situation - and how I can manage it physically and
emotionally.

Even given a chance of testing false positive, it allows me to do more
appropriate research and weigh up the risks and benefits - something I don't
have without that test.

or I test negative, and I gain reassurance that I don't need to worry about
this risk.

The worst case (in my view) is a false negative - but that's the same position
as I was in without a test.

~~~
michaelbuckbee
Here's a concrete example from my own life. I've had a very minor and benign
heart condition my whole life. Switching doctors after I moved across the
country they're like: "We should do an echocardiogram to just check that it
hasn't changed."

They do the ECG and find a really crazy high blood pressure in my heart so
they think I have pulmonary hypertension. This kicks off:

\- A sleep study

\- Lung capacity study

\- Restricted travel (they didn't want me to fly - which was a problem with my
consulting work)

\- A full-on cardiac catheter procedure - which is outpatient, but still a
procedure where they put you under twilight sedation and insert large metal
sheath into your groin (femoral artery)

Easily a dozen doctors visits, thousands of dollars in additional tests, and
multiple weeks of time altogether. Also, non-trivial risks of infection and
complication from the procedure.

On top of that, it's a mental thing. Every twinge of a muscle in my chest
would cause a spike of concern, I'd sit around worrying about my heart
inflating and bursting, etc.

All to (thankfully) find out that definitively 100% that the ECG was a false
positive and I'm perfectly fine. One kicker to this though is that I was
initially rejected for health insurance at a new job (pre ACA) as I'd had this
procedure. It took patiently explaining over and over again to insurance
people the above before they would accept me.

~~~
y-c-o-m-b
I'd like to see some data on the rate of false-positives for this type of
scenario. I can only assume your situation was an edge case and that were it
indeed a serious problem, you would be singing a different tune. Clearly there
is some benefit to using ECG as a diagnostic tool to save lives, so your
scenario doesn't necessarily negate the ones that are truly cardiovascular
problems. Not that you don't have a valid argument (you do and thanks for
sharing btw), but it's a matter of weighing the total outcome across the board
I think.

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stareatgoats
These types of magazines[0] seldom write something without getting paid by the
topic. I don't have proof in this case, but it sure reads like an ad.

[0] From their 'About' page: “the go-to news and luxury lifestyle
recommendation platform for the affluent, on-the-go gent.”

~~~
James_Henry
I would guess that the author received the screening for free on condition
that they wrote about their experience. It definitely reads like an ad, but
ads can often be useful to learn about interesting services and what they
include.

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mavsman
They didn't mention it at the start or end of the article but I do wonder if
this post was paid for by the clinic that provides the exam.

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alkonaut
I didn't see anything mentioned in the article that you wouldn't get checked
in a regular $250 yearly checkup... what was it that they did that made it
cost $5k?

~~~
James_Henry
The blood draw looks more comprehensive than you'd usually get in the US (the
author mentions mercury for instance).

Also, radiology is something that is usually done only if they find something
wrong during a standard checkup or if the patient is complaining about
something, and that is going to bump up the price to above the usual $250 or
whatever.

I've never heard of cognitive tests, comprehensive eye exams, DXA scans, or
comprehensive hearing tests being part of a normal checkup. All of these
things can be done but the costs would add up and they'd often be done by
different doctors on different days and usually using different emr's that
don't talk to each other.

Also, the author points out that "the most valuable aspects of the exam,
though, is time with an experienced physician who simply has nowhere else to
be". This is something that you will not get in a $250 yearly checkup from my
experience.

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sschueller
I wonder how effective it would be to make an exam like this when you are at
your healthiest as a baseline.

Then when you are not doing that well your values can be compared to your
baseline and not the average person.

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rblatz
This sounds like the more accessible version of the Mayo Executive Health
Program.

[https://www.mayoclinic.org/departments-centers/mayo-
clinic-e...](https://www.mayoclinic.org/departments-centers/mayo-clinic-
executive-health-program/home/orc-20252811)

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PhantomGremlin
I saw mention of "radiology services" but I didn't see any specific mention of
a CT scan.

I needed a CT scan recently. It wasn't for reasons of blood flow or anything
like that. But the radiologist must have been bored (or perhaps concerned
about liability) because he threw in this comment: _No abdominal aortic
aneurysm with mild circumferential atherosclerotic calcifications_

Wow.

I didn't know that CT scans were useful in diagnosing atherosclerosis. There
were all sorts of other similar tidbits in the report.

If I were rich enough, I'd want a full body CT done, perhaps every year. It
shouldn't be done too often because it's ionizing radiation.

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benguild
You can do the same thing in Japan for less than $1000.

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Mountain_Skies
Wonder how this compares to the $2000 "Executive Exam" you can get in several
medical tourism countries.

~~~
rune1
Could you name any companies that offer that service?

I think it should probably be just as good. Doctors are terribly expensive in
the western world.

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ttymck
So it's a technical interview for your body?

