What to Expect During an Executive Health Exam in San Francisco

Most executive physicals follow the same formula: show up at a hospital one morning, cycle through a battery of standardized tests, shake hands with a physician you’ve never met, and receive a PDF report weeks later. It’s efficient. It’s also rushed, impersonal, and structurally limited in what it can find.

We designed our executive health exam around a different premise: if you’re going to invest in a comprehensive health evaluation, the physician should know who you are before ordering a single test.

Here’s what the process actually looks like.

Phase 1: The Physician Intake (Video Telemedicine, 60 Minutes)

Your evaluation starts several weeks before any testing. We begin with a 60-minute video visit with one of our physicians — not a nurse practitioner, not a health coach, not a questionnaire. Your physician.

This conversation covers your full medical history, family history, occupational exposures, stress profile, sleep patterns, exercise habits, nutritional patterns, and health goals. It’s more thorough than most people have experienced in a physician visit, because we’re not trying to fit it into a 15-minute slot.

The intake shapes everything that follows. If you have a family history of early cardiac disease, we’ll add advanced vascular imaging. If your work involves significant travel, we’ll screen accordingly. If you’re already tracking biomarkers yourself, we’ll review your data and build on it rather than duplicating it. The evaluation is tailored to you — but it can only be tailored if someone takes the time to listen first.

Phase 2: Targeted Diagnostics (Labs & Imaging)

Based on what we learn in the intake, we order a customized panel of labs and imaging. The baseline includes 30+ biomarkers — but “baseline” is a starting point, not a ceiling.

The standard panel includes an NMR lipoprofile with particle analysis (not just total cholesterol), Lp(a), ApoB, fasting insulin, advanced inflammatory markers, thyroid function, comprehensive metabolic panel, vitamin D, ferritin, and several others that standard physicals don’t run. We also include genetic screening for hereditary cancer and cardiovascular risk — tests that reveal genetic risk factors present from birth that may never have been checked.

Imaging typically includes a CT coronary calcium score, carotid intima-media thickness (CIMT) ultrasound, EKG, exercise stress test, spirometry, body composition analysis, optometry, and audiology. We include Galleri multi-cancer early detection, which screens for over 50 cancer types from a single blood draw, and a home sleep study — because undiagnosed sleep apnea is remarkably common in high-performing executives who assume their fatigue is just from working hard.

For patients in San Francisco, we coordinate all in-person testing within the downtown medical corridor — often compressing it into a single visit day. For those flying in, we handle the logistics of scheduling everything efficiently so you’re not waiting between appointments.

Phase 3: The Comprehensive Physical Exam

By the time you sit down for the physical exam at our 450 Sutter Street office, your physician has already reviewed your full history, your lab results, and your imaging. This changes the entire character of the encounter.

Instead of meeting you for the first time and trying to cover everything in one rushed visit, your physician already knows your story. The exam picks up where the data left off — focused on the findings that matter, unhurried, and informed by everything we’ve already learned. Questions that came up during the intake get addressed. Unexpected lab findings get discussed in real time. The physical itself is comprehensive, but the conversation around it is what most patients tell us they’ve never experienced before.

Phase 4: Your Health Strategy Report & Wrap-Up (60 Minutes)

You receive a comprehensive written report and slide deck covering every finding, organized by clinical significance — not alphabetically, not by organ system, but in order of what matters most for your health.

Then we sit down for a 60-minute wrap-up conversation. This isn’t a results dump. We walk through what we found, what it means, what requires action now, what requires monitoring, and what’s reassuringly normal. We discuss trade-offs, answer questions, and build a prioritized plan.

If the evaluation identifies something that warrants specialist follow-up, we include specific referral recommendations — chosen by clinical fit, not institutional affiliation. Because we’re independent of all hospital systems, we refer to whichever specialist is genuinely best for your situation, whether that’s at UCSF, Stanford, Sutter, or in private practice.

What Happens After

You have two options. Many patients take their report home to their existing primary care physician, who now has a detailed, actionable document to guide follow-up care. Others choose to continue with us as members of our concierge medical practice, where we become their ongoing physician team and help implement the findings directly.

Neither option requires a commitment up front. The evaluation is designed to stand on its own. If it leads to an ongoing relationship, that’s because you experienced something you didn’t want to lose — not because we required it.

A Note on Privacy

Because we operate entirely outside insurance networks, your evaluation and records remain within our private system. No claims are filed, no clearinghouse data is generated, and your health information isn’t shared across an institutional health system. For executives, public figures, and professionals in regulated industries, this architecture is often what makes it possible to seek comprehensive care at all.

Our executive health evaluation starts at $12,500. Appointments are typically scheduled 4–6 weeks in advance. If you’d like to learn more, contact us or call (415) 963-4431.