Executive health programs

The idea of detecting disease early enough so that it can be cured before it can harm us has been around for a long time. So-called early detection and early treatment strategy is the founding stone of various executive health programs. Johns Hopkins call it as Executive & Preventive Program and Mayo Clinic calls it as Executive Health Program. In those programs, a client, rather than a patient, undergo extensive tests. Examples of tests can be performed in executive health programs are:

  • Height, weight
  • Blood pressure
  • Blood tests such as complete blood count, liver panel, lipid panel, kidney panel
  • Urinalysis
  • Heart evaluation, usually auscultation and EKG
  • Body fat analysis
  • Vision test
  • Hearing test (audiogram)
  • Chest X-ray, or Low Dose Chest CT
  • Ultrasonography for abdomen or neck (thyroid)
  • Tumor marker blood test
  • Mammography for women
  • Pelvic exam for women
  • Colon cancer screening such as colonoscopy or stool occult blood test
  • Sometimes MRI, PET-CT

A lot of these executive health programs claim that consultations and screenings are tailored to client’s specific needs and concerns. This means if you are concerned about brain cancer your doctor can order brain MRI for you to address your concern. But right question is not if your doctor can address your concern. It is rather if those extensive tests allow your doctor to find a disease early enough so that it can be cured before it can harm you. The answer is that there is no evidence supporting health benefits through so-called shotgun method executive screenings. Instead, check out the recommendation of US Preventive Service Task Force. The USPTF recommends only some of the tests performed in executive health programs done in very specific situations. Check out below or refer the recommendations at the website of USPSTF.

 

USPSTF A and B Recommendations

Topic Description Grade
Abdominal aortic aneurysm screening: men The USPSTF recommends one-time screening for abdominal aortic aneurysm by ultrasonography in men ages 65 to 75 years who have ever smoked. B
Alcohol misuse: screening and counseling The USPSTF recommends that clinicians screen adults age 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. B
Anemia screening: pregnant women The USPSTF recommends routine screening for iron deficiency anemia in asymptomatic pregnant women. B
Aspirin to prevent cardiovascular disease: men The USPSTF recommends the use of aspirin for men ages 45 to 79 years when the potential benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage. A
Aspirin to prevent cardiovascular disease: women The USPSTF recommends the use of aspirin for women ages 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage. A
Bacteriuria screening: pregnant women The USPSTF recommends screening for asymptomatic bacteriuria with urine culture in pregnant women at 12 to 16 weeks’ gestation or at the first prenatal visit, if later. A
Blood pressure screening in adults The USPSTF recommends screening for high blood pressure in adults age 18 years and older. A
BRCA risk assessment
and genetic counseling/testing
The USPSTF recommends that primary care providers screen women who have family members with breast, ovarian, tubal, or peritoneal cancer with one of several screening tools designed to identify a family history that may be associated with an increased risk for potentially harmful mutations in breast cancer susceptibility genes (BRCA1 or BRCA2). Women with positive screening results should receive genetic counseling and, if indicated after counseling, BRCA testing. B
Breast cancer preventive medications The USPSTF recommends that clinicians engage in shared, informed decisionmaking with women who are at increased risk for breast cancer about medications to reduce their risk. For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians should offer to prescribe risk-reducing medications, such as tamoxifen or raloxifene. B
Breast cancer screening The USPSTF recommends screening mammography for women, with or without clinical breast examination, every 1 to 2 years for women age 40 years and older. B
Breastfeeding counseling The USPSTF recommends interventions during pregnancy and after birth to promote and support breastfeeding. B
Cervical cancer screening The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap smear) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. A
Chlamydia screening: women The USPSTF recommends screening for chlamydia in sexually active women age 24 years or younger and in older women who are at increased risk for infection. B
Cholesterol abnormalities screening: men 35 and older The USPSTF strongly recommends screening men age 35 years and older for lipid disorders. A
Cholesterol abnormalities screening: men younger than 35 The USPSTF recommends screening men ages 20 to 35 years for lipid disorders if they are at increased risk for coronary heart disease. B
Cholesterol abnormalities screening: women 45 and older The USPSTF strongly recommends screening women age 45 years and older for lipid disorders if they are at increased risk for coronary heart disease. A
Cholesterol abnormalities screening: women younger than 45 The USPSTF recommends screening women ages 20 to 45 years for lipid disorders if they are at increased risk for coronary heart disease. B
Colorectal cancer screening The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary. A
Dental caries prevention: infants and children up to age 5 years The USPSTF recommends the application of fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption in primary care practices. The USPSTF recommends primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is fluoride deficient. B
Depression screening: adolescents The USPSTF recommends screening adolescents (ages 12-18 years) for major depressive disorder when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up. B
Depression screening: adults The USPSTF recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up. B
Diabetes screening The USPSTF recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg. B
Falls prevention in older adults: exercise or physical therapy The USPSTF recommends exercise or physical therapy to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls. B
Falls prevention in older adults: vitamin D The USPSTF recommends vitamin D supplementation to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls. B
Folic acid supplementation The USPSTF recommends that all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid. A
Gestational diabetes mellitus screening The USPSTF recommends screening for gestational diabetes mellitus in asymptomatic pregnant women after 24 weeks of gestation. B
Gonorrhea prophylactic medication: newborns The USPSTF recommends prophylactic ocular topical medication for all newborns for the prevention of gonococcal ophthalmia neonatorum. A
Gonorrhea screening: women The USPSTF recommends screening for gonorrhea in sexually active women age 24 years or younger and in older women who are at increased risk for infection. B
Healthy diet and physical activity counseling to prevent cardiovascular disease: adults with cardiovascular risk factors The USPSTF recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. B
Hearing loss screening: newborns The USPSTF recommends screening for hearing loss in all newborn infants. B
Hemoglobinopathies screening: newborns The USPSTF recommends screening for sickle cell disease in newborns. A
Hepatitis B screening: nonpregnant adolescents and adults The USPSTF recommends screening for hepatitis B virus infection in persons at high risk for infection. B
Hepatitis B screening: pregnant women The USPSTF strongly recommends screening for hepatitis B virus infection in pregnant women at their first prenatal visit. A
Hepatitis C virus infection screening: adults The USPSTF recommends screening for hepatitis C virus (HCV) infection in persons at high risk for infection. The USPSTF also recommends offering one-time screening for HCV infection to adults born between 1945 and 1965. B
HIV screening: nonpregnant adolescents and adults The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults ages 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened. A
HIV screening: pregnant women The USPSTF recommends that clinicians screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown. A
Hypothyrodism screening: newborns The USPSTF recommends screening for congenital hypothyroidism in newborns. A
Intimate partner violence screening: women of childbearing age The USPSTF recommends that clinicians screen women of childbearing age for intimate partner violence, such as domestic violence, and provide or refer women who screen positive to intervention services. This recommendation applies to women who do not have signs or symptoms of abuse. B
Iron supplementation in children The USPSTF recommends routine iron supplementation for asymptomatic children ages 6 to 12 months who are at increased risk for iron deficiency anemia. B
Lung cancer screening The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults ages 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. B
Obesity screening and counseling: adults The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions. B
Obesity screening and counseling: children The USPSTF recommends that clinicians screen children age 6 years and older for obesity and offer them or refer them to comprehensive, intensive behavioral interventions to promote improvement in weight status. B
Osteoporosis screening: women The USPSTF recommends screening for osteoporosis in women age 65 years and older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. B
Phenylketonuria screening: newborns The USPSTF recommends screening for phenylketonuria in newborns. B
Preeclampsia prevention: aspirin The USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia. B
Rh incompatibility screening: first pregnancy visit The USPSTF strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care. A
Rh incompatibility screening: 24–28 weeks’ gestation The USPSTF recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24 to 28 weeks’ gestation, unless the biological father is known to be Rh (D)-negative. B
Sexually transmitted infections counseling The USPSTF recommends intensive behavioral counseling for all sexually active adolescents and for adults who are at increased risk for sexually transmitted infections. B
Skin cancer behavioral counseling The USPSTF recommends counseling children, adolescents, and young adults ages 10 to 24 years who have fair skin about minimizing their exposure to ultraviolet radiation to reduce risk for skin cancer. B
Tobacco use counseling and interventions: nonpregnant adults The USPSTF recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and U.S. Food and Drug Administration (FDA)–approved pharmacotherapy for cessation to adults who use tobacco. A
Tobacco use counseling: pregnant women The USPSTF recommends that clinicians ask all pregnant women about tobacco use, advise them to stop using tobacco, and provide behavioral interventions for cessation to pregnant women who use tobacco. A
Tobacco use interventions: children and adolescents The USPSTF recommends that clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use in school-aged children and adolescents. B
Syphilis screening: nonpregnant persons The USPSTF strongly recommends that clinicians screen persons at increased risk for syphilis infection. A
Syphilis screening: pregnant women The USPSTF recommends that clinicians screen all pregnant women for syphilis infection. A
Visual acuity screening in children The USPSTF recommends vision screening for all children at least once between the ages of 3 and 5 years, to detect the presence of amblyopia or its risk factors. B

 

 

 

 

 

 

 

 

 

 

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