DATE: Monday, September 15, 1997            TAG: 9709140003

SECTION: DAILY BREAK             PAGE: E1   EDITION: FINAL 
SOURCE: BY PAT DOOLEY, STAFF WRITER 

                                            LENGTH:  130 lines

THE ROLLS ROYCE OF CHECKUPS FOR THOSE WHO CAN AFFORD THE $2,500-$2,750 FEE, THE EXECUTIVE EVALUATION CENTER IN NORFOLK MAY BE JUST HE TICKET TOWARD BETTER HEALTH AND PEACE OF MIND.

FIFTY-YEAR-OLD ERIC FOX hadn't had a physical in a decade.

An investment adviser in Norfolk, Fox typically worked a 10-hour day, often seated and talking on the telephone, while helping clients manage millions of dollars in investments.

To combat stress, he'd puff on cigarettes and feast on chili dogs, greasy cheeseburgers and barbecue sandwiches - ``all those things that are bad for you,'' he says. He also toted around an extra 20 pounds.

Then, a co-worker died of a heart attack - at age 50.

Fox, who'd long considered himself immortal, began to reconsider his lifestyle and his health.

That included a physical exam. But instead of the standard check-up he'd been familiar with - a quick scan of his heart rate and blood pressure and some basic blood work - Fox tried something new.

He paid more than $2,00 for a day's worth of screenings at a Norfolk health clinic targeted to busy executives.

Called the Executive Evaluation Center, it was opened in January by Sentara Health Systems, in plush offices on the ninth floor of the Wainwright Building on West Bute Street.

It's a kind of one-stop shop for state-of-the-art medical testing, designed to find health problems that traditional physicals may not - before they become obvious, costly or life-threatening, said Dr. William M. Bethea Jr., center director. He came up with the idea about two years ago; Sentara provided the financial backing, location and staff.

Similar services are popping up around the country - a response to managed care and a growing effort to hold down health-care costs, some experts say. Of about a dozen centers across the United States, most have been launched in the last couple of years.

At the Norfolk center, services include a basic physical, chest X-ray, blood work, treadmill studies, ultrasound screening of the carotid arteries and abdomen, exercise and nutrition counseling, and a personal assessment at the end of the day.

Clients are treated to breakfast and lunch, and assigned to individual rooms equipped with desks and telephones for those who want to conduct business.

The day, which begins about 7:30 a.m. and winds down some eight hours later, costs $2,500 for men and $2,750 for women. Bethea says the tests, if done individually, likely would be spread over several weeks and cost more than $4,000.

Generally, the tests are not covered by insurance because patients are not experiencing problems, Bethea says. In today's managed-care environment, he says, ``necessary'' is defined as ``when something goes wrong.''

Many clients pay for the tests out of pocket. Some companies have paid for their executives to attend.

The center has served more than 100 clients in its first nine months. Most have been men, in stressful professions. Many practice high-risk behaviors, such as smoking and eating fatty diets, but tend not to visit a doctor regularly.

What they get, Bethea says, is a service that's more comprehensive than any other in the country - combining the newest tests available with patient education and guidance.

Treadmill studies to detect heart problems, for example, are done in conjunction with cardiac ultrasound - a test not even available when Bethea put together his proposal.

Clients also get what Bethea calls a ``mini-medical degree'' - a layman's explanation of the tests that will be performed, and what they mean.

Open only on Tuesdays and Thursdays, the center limits service to six patients a day to ensure expediency and privacy. Each day is devoted to men or women. Reservations are required.

Meals are served in a small conference room, where a laminated binder boasts dozens of letters from satisfied former participants. Some have changed their lifestyles for the better, or were thankful to learn of health conditions they were unaware of. One woman, after learning she had 60 gallstones, was scheduled for surgery two weeks later.

``With most people, you don't find anything,'' Bethea says. ``That, in itself, is a relief.''

Mary Hawthorne, 64, co-owns a Richmond construction company with her husband, Hugh, 66. They heard about the program by word of mouth and, though neither had experienced significant health problems, liked the ultra-preventive concept. They went through on separate days.

``I had had physicals, but nothing like this,'' Mary Hawthorne says. ``They were thorough. They checked for things that doctors don't do in their office anymore.''

As with most clients, the overall news was good for the Hawthornes. They walked away with some suggestions for getting more exercise and improving their diets.

They also walked away with ``peace of mind,'' Mary Hawthorne says. ``That means a lot.''

While such services can go a long way toward providing a sense of comfort, there is some debate about the need for top-to-bottom, preventive testing, says Dr. Percy Wootton, a Richmond cardiologist and president of the American Medical Association. It may be most helpful to people at risk for certain diseases or in high-stress environments, he says.

But more people, he says, need to follow the first steps of good care: Choose and use a primary-care physician and develop healthful lifestyle habits, such as exercising, eating right and not smoking.

At the Mayo Clinic in Rochester, Minn., where one of the first executive programs was begun 25 years ago, Dr. Donald H. Hensrud agrees.

Because few outcome studies have been done, it is not known how valuable some preventive tests may be, says Hensrud, the Mayo program's director.

A test may indicate a potential health threat that never develops, he says. Or a patient may worry needlessly after being ``labeled'' with a possible problem.

Some centers even screen for genetic defects, he says. The Mayo program, which grew out of the clinic's department of preventive medicine, does not.

There, for about $1,400 to $1,600, the average patient receives a basic health screening, as well as tests to meet their individual needs. Tests may include blood work, mammography and colon-cancer screening, for example, and usually are done over one or two days.

The program has become more popular in the last couple of years, Hensrud says. ``It's catching on with everybody.''

Though not meant to replace primary care, Henrsrud says, such comprehensive assessments can help set someone on the road to better health.

Fox, the Norfolk investment adviser, has dropped 20 pounds, adopted a more healthful diet and cut back on cigarettes since his visit to the local center earlier this year.

He's also been swimming in his backyard pool and plans to buy a stationary bike.

He says he feels better too.

``I came away feeling I had really had a complete physical - for the first time in my life.'' ILLUSTRATION: Color photo by Bill Tiernan/The Virginian-Pilot

Dr. William M. Bethea Jr., Director of the Executive Evaluation

Center...

Color photo

Linda Taylor demonstrates use of a treadmill...

Send Suggestions or Comments to webmaster@scholar.lib.vt.edu