Arranging an executive health assessment during a visit to London

What the assessment is

An executive physical is a structured review of your health in one day, led by one physician from the first conversation to the final plan. It includes advanced bloodwork, an electrocardiogram (ECG) to record the heart’s rhythm, and a measure of body composition, alongside a full history and examination.

The value is in the conversation at the end. You leave knowing which results matter for you and what to do about them, written down so you and your doctor at home can act on it.

Who it suits and who it does not

It suits a person who is well, wants a clear picture of their health, and finds it easier to give one day in London than to piece the same tests together at home. It also suits someone who has not had a thorough review in some years and wants a baseline to compare against.

It is not the right first step for new or worsening symptoms, which need a doctor promptly rather than a planned day. If you are unwell on arrival, a same day GP appointment is the better start. If you have chest pain, sudden breathlessness, severe bleeding or signs of a stroke in the UK, call 999, and elsewhere call the local emergency number.

Benefits and limitations

An assessment gives you information and a plan, and it does not on its own make you healthier. A Cochrane review of 17 trials, with outcome data from 251,891 people, found that general health checks offered to whole populations had little or no effect on total mortality [1]. Its value for an individual lies in the decisions it helps you make with your doctor.

Testing has risks as well as benefits. The same review notes that screening leads to more tests and treatments, which can harm as well as help [1]. A normal result can also give false reassurance, and a finding may need follow-up after you have flown home. A blood draw can leave a small bruise. The physician will explain what each result means before you leave.

How you prepare

You will be told before the day whether to fast. Some blood tests, such as fasting glucose and insulin, need an empty stomach, while a full cholesterol profile does not have to be fasting [2]. Drink water as usual unless told otherwise.

Keep taking your regular medicines unless the doctor has said to stop one. If you travel with prescribed medicines, carry a letter showing they were prescribed for you, and keep any controlled drug in your hand luggage [3]. Check before you travel that your permission to enter the UK covers your trip. An ETA covers business trips and tourism of up to 6 months [4].

• Previous blood results and ECGs, with their dates
• Letters from specialists you have seen
• A list of your medicines and supplements, with doses
• Any allergies and past operations
• Comfortable clothes and shoes
• The questions you most want answered

Time zones and jet lag

Jet lag can bring poor sleep, daytime sleepiness, slower thinking and a general sense of being unwell [5]. The body clock adjusts by about 1.5 hours a day after travelling west and about 1 hour a day after travelling east, so a flight across many time zones takes several days to recover from [5].

Plan the assessment for a day after you have settled rather than the morning after landing, so the doctor sees you as you usually are. Daylight at your destination time helps the clock shift, and after flying east, bright light early in the morning and less light in the evening help most [5]. A short nap of 20 to 30 minutes can keep you alert without spoiling the night’s sleep [5].

In a Cochrane review, nine of ten trials found that melatonin taken near the local bedtime reduced jet lag after flights crossing five or more time zones, with doses between 0.5 and 5 mg working similarly [6]. The same review noted possible harm for people with epilepsy or taking warfarin, so ask a doctor before you try it [6].

What to expect on the day

The day begins in the morning with your history and the blood tests, taken early so the laboratory has time to report. The ECG and body composition follow, then a full examination and time to talk through anything you have been putting off.

Later in the day the physician reviews every result with you, explains what each one means for you, and sets out a written plan. When a finding needs a specialist, the doctor says so and explains the next step, which can often be arranged before you fly.

Results and follow-up from home

Your results and plan go into one record you can open from any country, and the doctor writes a letter your own doctor at home can read [7]. A follow-up by video lets you go through repeat tests or new questions from home, with the doctor who saw you in London.

• Which of my results matter most, and why?
• What should I change first, and how will we know it is working?
• Which tests should be repeated, and when?
• What should my doctor at home do with this plan?

How The Wellness can help

Our London clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia, and every doctor is GMC registered. Regulated services are delivered through registered partner clinics and accredited laboratories. For a wider picture, the Longevity Foundation programme adds a full body MRI, DEXA and VO2max testing to a metabolic and hormone panel, with a physician roadmap. A full body MRI can find incidental findings that lead to further tests, and the physician talks this through with you first.

If you would rather be seen nearer home, appointments are arranged with partners in 12 city pages beyond London.