A physician goes through a patient's medical history at a desk during an executive physical

Terminology in medicine is a funny thing, and as a physician I have my own preferences.

The physical exam, often known as just a “physical,” is a non-urgent visit with your physician to check in on your overall health. It’s a proactive way to find out what’s going on in your body and establish baselines for the future.

“Executive” physicals appear to have originated as a perk (or a requirement) for executives at Fortune 500 companies — thus the name. While these exams are no longer limited to boardroom members, the idea behind them remains the same: medical evaluations without time constraints or insurance company interference.

These days, physicians who offer a more comprehensive physical than the traditional yearly exam often use the term “executive physical” to reflect that higher quality.

I dislike using the term “executive physical,” though, because it implies this level of attention and care is a luxury, reserved only for the select few with corner offices. I believe everyone — regardless of their job title — deserves such a comprehensive physical exam.

So that’s what I call it in my practice: a comprehensive physical exam.

What Is an Executive (or Comprehensive) Physical?

All of my physical exams are comprehensive (or “executive”) exams, because as a concierge physician, that’s how I practice medicine. Since I’ve left the hamster wheel of traditional medical practice, I can spend as much time as I need with each patient and consider their health in as much detail as they deserve.

In my practice, a comprehensive exam has three parts: history, physical exam, and testing. In terms of time breakdown, it looks like this:

As you can see, I place great emphasis on the history aspect of the comprehensive exam. The “history” is a conversation you and I have about where you are, where you’ve been, and what’s gone on with your health.

I devote most of the exam time to history because your history holds the clues that tell me where I need to look to best support your health. If I get a good, thorough history, I know what tests to order, and I can give you more valuable information about your health.

I’ll also discover your personal health goals, as well as any upcoming changes. Some people want to be very proactive about their health, while others are more hands-off. We look at the psychosocial aspects of your health: How are your stress levels? How do you fill your leisure hours? Do your daily habits contribute to or detract from your health goals?

If it’s our first comprehensive exam together, we’ll have more ground to cover. And if you’ve been my patient for years, we’ll continue to drill down into the topics that most affect you.

Who Should Get an “Executive” Physical?

Everyone should get a comprehensive, or executive, physical.

That said, not everyone needs a physical with the same frequency or the same tests. It depends on the individual.

From birth to adolescence, people need regular and frequent exams because of the extraordinary rate of growth and change during this time. Babies and children, for example, need to visit their pediatrician often for well visits.

As we age and the rate of change and development plateaus, our need for frequent physicals decreases. A young, healthy adult may get a comprehensive physical every three years. But when you hit your 40s and 50s, changes of a different kind occur, and you need to go yearly.

The types of tests you get will be determined largely by your state of health, your age, and your history. Not everyone needs a cardiac stress test, for example.

Infographic: What Is an Executive Physical (And Do I Need One)?

Functional Medicine: Comprehensive “Executive” Physical vs. Traditional Physical

In a traditional physical, a physician will typically review your routine lab tests, make sure you’re up to date on vaccines, and look for significant red flags. If you’re fortunate, they’ll also have time for questions.

Comprehensive (and executive) physicals look quite different.

In our office, because we are a concierge practice practicing functional medicine, we’re able to take much more time for your exam and focus on trends over time, lifestyle factors, and preventive strategies.

For example, when we look over your lab work, we give you positive feedback on specific results to reinforce your positive behaviors and highlight the effects of your lifestyle habits.

Let’s say I notice the size of your red blood cells is a little larger than usual. This might represent too much alcohol intake.

So I bring it up, and you tell me you only have two drinks a day, which is within recommended guidelines. But the recommended guidelines are general. Those two daily drinks are affecting the size of your cells, meaning they’re taxing your bone marrow in some way. And that’s what matters.

Guidelines are meant to give us a standardized understanding of what’s statistically healthy for most people. They’re not tailored or individualized in any way.

But your lab results are.

So, when the comprehensive physical uncovers that a particular behavior — like a seemingly safe two drinks per day — is affecting your health, you can change that habit so it doesn’t harm your body.

In a comprehensive physical, I look at your normal and apply our findings to what I see. I compare your lab work over time, even from before we met, and I notice if your labs start trending in a negative direction. Even if your results are all within the “normal” statistical range, a negative trend can mean your health is heading in the wrong direction.

In this way, we can identify disease very early, and often prevent it altogether through proactive, preventive action.

Everyone Deserves an “Executive” Physical

Whether you’re a CEO, a bank teller, or an Uber driver, you deserve the same “executive” level of care.

A comprehensive physical with a physician who is neither harried nor hurried gives you the kind of personalized information that can transform and prolong your health and life.