NO PERSON HAVING A “COMPLAINT” SHOULD GO FOR AN “EXECUTIVE” HEALTH CHECK UP
O P Kapoor
Ex. Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai,
Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
By now, I have seen dozens of patients who have had an executive health check up but the diagnosis was missed. My reasoning is as follow :
1. An executive health check up is meant for any person who has absolutely no complaints but would wish to know if he has any silent disease (diabetes, hypertension, cancer, osteoporosis, gall stones, cirrhosis of the liver etc).
2. Once a person develops a complaint, the method of a special investigation differs and the cause may not be detected by a full executive health check up.
To quote a few examples
a) I happened to see a patient who had lost 15 kg weight within a period of 6 months with no other complaints and who went for health check up. As usual the test of ESR was not done in health check up; rest of all his investigations were negative. I found his ESR to be 110 mms so I asked for HIV test (which was also not in a routine health check up) and out came the diagnosis.
b) In a similar case, I found markedly elevated T3, T4 levels to explain the weight loss and these tests were not carried out in a routine health check up.
c) I also would like to quote a case of a patient having left chest pain (who was left handed) who used to do heavy manual work, cycling and carrying 100 kg of load on the bicycle; whose left pectoral tenderness disappeared with physiotherapy and avoidance of the above factors when his repeated health check ups were absolutely normal!
The reason is that in a health check up doctor would never go for the details of left chest pains (like left handedness, cycling, etc.) and only depend on X-rays and STT to diagnose heart and lung conditions to diagnose the cause of chest pain.