Executive decision

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Dr Sarah Peeters, PHG's clinical director.

Nevertheless, to many, executive health programmes represent another opportunity for the wealth gap to widen the health gap.

"There is that perception out there and there is a reality of that, too," says Mayo Clinic's Hensrud. He admits that he has thought a lot about the matter over the years, but is satisfied that the ethics are all in order.

"These people aren't more important as individuals - they are executives and we are offering a specific service to that group of people," he points out. "And Mayo is not as expensive as people think - it is expensive because we do a lot in a short period of time, but the amount is effectively the same as any other way of going through Mayo clinic apart from a nominal administration fee."

Any financial gain from the programme at Mayo is ploughed back into improving care for those that can't afford top-end treatment, Hensrud adds, citing the Medicare system as an example.

In sickness and in wealth

Most executives pride themselves on their ability to stay on top of complicated situations. If they were to flatly ignore a weakness in their company's business because they felt they didn't have time, then come the next AGM they probably wouldn't have a job.

Yet many executives still have a strategic blind-spot when it comes to health, according to Dr Kevin Waters at Duke.

"I see a lot of executives and everyone of them has a five-year business plan that they could tell you about - you ask them what their personal finance plan is, or what their retirement plan is, and they will know it in detail," he remarks.

"But if you ask them what their healthcare plan is, you discover that they mostly do not proactively take care of themselves."

Dr Miles Varn is chief medical officer at the US-based Pinnacle Care, which positions itself as a private health advisory firm for high net-worth individuals and wealthy families. Pinnacle Care is not a direct healthcare provider, rather members pay to have their health looked after by an account representative, as if their medical record were a financial portfolio.

"It is very similar to the services you receive for wealth management, because every single individual has different needs and status and goals," explains Varn. Although Pinnacle Care has relationships with all the top providers, they are not commercially bound to favour any one institution.

"What can happen to families that have wealth is that they become aligned with a particular medical institution, whether it is a Johns Hopkins or a Mayo Clinic," says Varn.

"Each of those institutions is incredible for certain things, but they're not the best for all the medical problems that someone might have and our job is to get the best person for each problem."

Pinnacle Care's model is one that Varn feels would be particularly suited to the Middle Eastern market, where assessing the quality of the emerging providers is a daunting task.

"There is obvious wealth in the area and an increasing interest in top quality health resources on a local level but also on an international level," he says. Regardless of location, Varn has discovered that wealthy individuals are normally struck by how much sense outsourcing their healthcare actually makes.

"People outsource just about every other aspect of their life," argues Varn, "but they feel this is the one area they can't control - which is wrong."

A day in the life

Executive health programmes are not simply about having the best physicians, states Dr Kevin Waters. It is about having the best available resources. "I was in private practice for 14 years and for me to do all what we do here would take three or four days," he confesses.

"And because these people are so busy, most of it wouldn't get done." By taking a dedicated day out of a hectic schedule, executives might find they have nothing further to worry about than holding back on the foie gras.

But they might just save themselves and their company a boardroom trauma. Whether or not the death of McDonald's Charlie Bell can be linked to his diet is a moot point - what's not, however, is the fact that survival rates for early stage detection colon cancer are about five times higher that of late stage diagnoses.

"A few months ago we had a patient who had a colonoscopy and he was diagnosed with cancer - that day he saw one of the best colorectal surgeons in the country," states Waters.

"Two days later he had surgery. Three days later he was out of the hospital and he's still doing well." Three years after his premature death, it's difficult not to wonder if Charlie Bell might have been so lucky.

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