When Worth covered executive health programs five years ago, our story was largely based on the experience of male patients. Today, some of the country’s top hospitals and medical entrepreneurs are addressing female executives’ specific screening and health needs, including birth control, perimenopause, menopause, bone density, breast and gynecological cancers.
“Women want to feel they’re being heard, that their needs are being met and that they’re in a program that’s not just designed for men and jury-rigged for women,” says the Cleveland Clinic’s Dr. Roxanne Sukol. “Women shouldn’t have to wear a men’s golf shirt to get excellent medical treatment from an executive health program.”
Here, some of the top resources in C-suite women’s healthcare:
The Cleveland Clinic Executive Health program measures patients’ vital statistics and uses sophisticated testing to assess their risk for disease, but it also focuses on self-care and emotional well-being. “In addition to their careers and home, my female patients tend to be concerned about how everything fits together in a way that makes everyone feel they’re included and part of the whole. They do that at home, at work, everywhere they go,” says preventative medicine specialist Dr. Roxanne Sukol. “Women tend to have different presentations for stress, depression, anxiety and cardiovascular risk factors. One of the overarching goals of our program is to help patients understand, identify and implement changes that reduce risk factors.” The Cleveland Clinic also has outposts in Toronto, Canada and Weston, Fla.
Contact: 216.444.5707, my.clevelandclinic.org/departments/wellness/executive-health
Dallas-based Cooper Clinic places a premium on evaluating heart health, so female patients can expect a treadmill stress test, which gives doctors information about cardiovascular risk, blood pressure, blood pressure response to exercise, fitness and other subtle risk markers like poor heart rate recovery, says Dr. Riva Rahl, preventive medicine physician at Cooper Clinic. Female patients also have bone density tests because “many women with osteoporosis or osteopenia have no idea their bones are not as strong as they have been or could be.” Rahl checks vitamin D levels for deficiency, which is very common, can cause fatigue, muscle and joint aches, and has “many health implications relating to risk for heart disease, cancer, autoimmune diseases and bone health.”
Contact: 866.906.2667, cooperaerobics.com/Cooper-Clinic.aspx
Yale-trained internist Dr. Lisa Larkin is on a mission to provide gender specific, C-suite level health services for 45- to 65-year-old women. “It was very clear to me that traditional executive health programs were not really addressing women’s health needs. The focus in medicine and research has always been that women are ‘small men.’ Very clearly, that’s not the case,” says Larkin, director of Women’s Corporate Health for Cincinnati’s TriHealth health system. Last year, Larkin launched Ms. Medicine, a Cincinnati-based women’s health concierge medical service. She expects to open another office in the Washington DC/Northern Virginia region by early 2020.
Like other traditional executive health programs, Larkin’s includes evaluations of a patient’s weight, blood pressure and cardiovascular health. In addition to providing a comprehensive physical, lab work, cardiac imaging and mammograms, Larkin gives patients a comprehensive questionnaire about aging, pelvic floor issues and hormonal changes. She then guides her patients through concerns about perimenopause, menopause and bone health. A breast cancer survivor, Larkin is passionate about assessing breast cancer risks in her patients, evaluating their risks with a series of complex algorithms. She also addresses sexual health and the issues prompted by aging pelvic floors. “In traditional executive health programs, no one’s touching it with a 10-foot pole,” she says, adding that traditional medicine still lags in training internists to care for middle-aged women. “If more women are educated and empowered to say: ‘I need gender-specific primary care,’ we’ll see more training and better care.”
Contact: 513.760.5511, msmedicine.com
Consistency is key to care at MDVIP, a private service that matches executives with one of 1,000 physicians nationwide and boasts that it provides patients same-day appointments, even while traveling. “Our patients will go through a host of different screenings and sit down with their doctor for one to two hours, several times a year. The doctor helps them enact the best health plan, all year long,” says Dr. Andrea Klemes, MDVIP’s chief medical officer. For female patients, Klemes focuses on screening Vitamin D levels, which influence bone health; educating patients about cardiovascular disease, cholesterol and inflammation; and pre-screening for diabetes, as well as examining gastrointestinal issues and food sensitivities. Another important step for many women: creating diet and exercise plans to counteract the dropping basal metabolic rate prompted by menopause. MDVIP doctors use a women’s health lab panel to pinpoint things like hormone levels and thyroid disease, which is more common in women. A former Procter & Gamble executive specializing in personal healthcare, women’s health, digestive wellness and bone health, Klemes and her colleagues are increasingly interested in inflammatory diseases like rheumatoid arthritis, as well as research on inflammation and the microbiome.
Contact: 844-393-6070, mdvip.com
Northwestern Executive Health
“Women have many more screening issues to discuss than our male patients, and they’re increasingly complex. Should you get a mammogram between 40 and 50? How often? What’s the right frequency for pap smears and pelvic exams? Do you have low bone density and when do we start to treat it?” says Dr. Lorrie Elliott, medical director of Northwestern Executive Health in Chicago. Patients begin with an extensive questionnaire and a 30-minute phone call with a physician six weeks prior to their day-long visit, which includes lab tests, discussions of medical issues, meetings with an exercise physiologist and dietician, a review of lab results and a plan for sleep, diet and stress management.
A crucial part of the approach, Elliott says, is distilling complex and sometimes conflicting medical guidelines for procedures like mammograms, genetic testing and bone density scans, all while keeping a healthy skepticism about the newest screening gadgets. “The conversations we’re having around screening and new technologies are becoming increasingly complex. Because healthcare is competitive and technology is racing ahead, every hospital wants the new shiny thing, but often it’s marketed to the public without a lot of data behind it.”
Maintaining daily wellness becomes increasingly challenging for executives who are frequently jet lagged and sleep deprived, crossing multiple times zones for meetings and rising early and staying up late for cross-continent calls. Family obligations, Elliott says, compound her patients’ exhaustion. “While many male executives have stay-at-home wives that take care of the household, the vast majority of female executives don’t have stay-at-home husbands. They’re managing their company, their household, their kids. Even with household help, the vast majority of my female executives can tell me how much milk is left in the fridge.”
Contact: 312.926.1300, northwesternexecutivehealth.com
Johns Hopkins Executive & Preventive Health Program
The newly renovated Johns Hopkins Executive & Preventive Health Program center takes the same holistic approach for both male and female patients, says Dr. Sarah Clever, an internist who’s been seeing executives for the past 16 years. “One of the things I’m most focused on is helping patients recognize that their behaviors make vastly more difference than a test or screening I can provide for them. Getting regular vigorous exercise and maintaining a healthy weight will do more for a woman than having regular mammograms,” Clever says. “Data supports mammography for early diagnosis, but I always try and turn the conversation to, ‘What can we do to keep you healthier?’” For example, Clever advises executives who constantly travel to integrate a seven-minute workout into their days, rather than give up on exercise because they don’t have time for the gym. All patients at the center meet with an internist, have blood drawn, see a dermatologist, ophthalmologist, nutritionist and exercise counselor, as well as having diagnostic and lab tests. Still, Clever notes, the central value of the program is working with executives to identify stress factors and to implement necessary lifestyle changes. “More tests may feel more thorough, but we’re not necessarily getting better information.”
Contact: 410.955.9819, hopkinsmedicine.org/executive_health
Joan H. Tisch Center For Women’s Health, NYU
Dr. Caren Behar, director of clinical operations at NYU’s Joan H. Tisch Center for Women’s Health, prides herself on taking extensive patient histories. “You get so much more in two hours than in 20 minutes. Getting personal, family and social histories puts patients in context. Someone who’s a CEO has different stressors than an artist or a doctor,” says Behar, a practicing physician for the last 35 years. After an in-depth conversation, Behar oversees an extensive testing program for her executive women patients, beginning with a mammogram, which she deems essential. “I tell most of my patients, if you’re going to get one test, forget everything else and do a mammogram, even for women in their 40s.” The second most important test, she says, is a hemoglobin A1C, which measures average blood sugar over three months, and is an important pre-diabetes indicator, particularly after menopause.
One of the benefits of the executive-level testing, Behar notes, is that it includes once-standard preventative screening tools like chest x-rays and electrocardiograms, which health insurance now typically doesn’t cover unless a patient has a qualifying complaint. Another benefit, Behar adds, is being able to refer high-risk patients to NYU’s cancer screening center. “Every week I send patients for genetic testing or evaluations. When people have mutations, we can do things preventatively.”
For all of the impressive technology, Behar’s real value may be in her accessible approach. “I give most patients my cell phone number. They text me all the time. I prefer it. I’d rather them have access to me, every day of the week.”
Contact: 646.754.3300, nyulangone.org/locations/joan-h-tisch-center-for-womens-health