Your physical. Your year.

What an executive physical is — and where the model came from

The executive physical was developed in the 1970s as a way for time-constrained senior executives to get a comprehensive annual workup in a compressed format. The original premise was practical: an executive's time was the rate-limiting factor, so deliver an entire year's worth of preventive care in a single day or two on a medical center campus.

The standard components have been stable for decades. A typical comprehensive executive evaluation includes a thorough medical history and physical exam, advanced cardiovascular and metabolic laboratory testing, body composition assessment, functional fitness evaluation, cardiac risk imaging, cancer screening, cognitive baseline testing, sleep evaluation, and a written summary of findings with recommendations.

Who delivers it varies. Mayo Clinic, Cleveland Clinic, and Johns Hopkins built the institutional model. Princeton Longevity Center, EHE Health, and Sollis Health offer it through dedicated executive-health centers and concierge memberships. Independent concierge practices in major metros offer variations as part of premium membership tiers. A generation of longevity-branded platforms have offered variations on the same workup at different depths and price points.

The structural limitation of the one-day model

The legacy executive physical was designed around a specific constraint: the executive's calendar. Compressing care into a single day solved that constraint elegantly when patients were flying in from out of state. In 2026, with widely available telehealth, local concierge medicine, and remote monitoring, that constraint has eased.

The remaining structural limitation of the one-day model is what happens after.

A typical one-day evaluation produces a comprehensive findings binder: dozens of lab results, imaging reports, recommendations, follow-up referrals. In the legacy model, the patient takes that binder home and shares it with their local primary care physician. Who has 15 minutes per visit. Who didn't order the tests. Who doesn't know the clinical context. Who isn't following the executive-health center's protocol. And who isn't accountable for implementing it.

The clinical value of an executive evaluation compounds with what comes after. If the cardiometabolic findings translate into a sustained intervention — actual statin titration, actual exercise prescription, actual nutritional change, actual hormone optimization where indicated — the value is real and durable. If the findings live in a binder that gets glanced at once and filed, the evaluation produced a thorough snapshot of a moment in time.

Many patients we've spoken with who have previously completed an executive physical at a major center report a version of the same experience: thorough workup, clear written recommendations, no follow-through structure to actually implement them.

The year-long evaluation, month by month

• Month 1 — Foundation visit (90 min). Comprehensive medical history, goals, current medications, baseline vitals and exam. Tier-1 labs ordered: CBC, comprehensive metabolic panel, advanced lipid with apolipoprotein B and lipoprotein(a), hemoglobin A1c, hs-CRP, TSH, vitamin D, B12, ferritin.
• Month 2 — Advisor onboarding (60 min). Body composition referral (DEXA scan at a local imaging partner), baseline biometrics, supplement reconciliation. Lab logistics established for the year.
• Month 3 — Physician follow-up (45 min). Full lab review, cardiovascular risk discussion, prescribing decision if indicated. Coronary artery calcium score ordered if clinically appropriate.
• Month 4 — Cardiac imaging. Coronary artery calcium score at a local imaging center. Optional advanced coronary plaque characterization for patients who elect it. Resting ECG.
• Month 5 — Functional fitness baseline. VO2 max test through a local exercise lab. Grip strength, gait speed, sit-to-stand, and balance battery — the movement panel that correlates with biological age.
• Month 6 — Mid-year physician visit (45 min). Integrate cardiac imaging, fitness data, and labs into a unified risk picture. Medication adjustment if indicated. Second-half-of-year priorities set.
• Month 7 — Cognitive and sleep baseline. Validated cognitive assessment, sleep questionnaires, home sleep study referral if indicated.
• Month 8 — Advanced labs round two. Hormone panel (testosterone, estradiol, DHEA-S, cortisol where indicated), 14-day continuous glucose monitor trial.
• Month 9 — Physician visit (30 min). Hormone and metabolic data review, lifestyle prescription refinement.
• Month 10 — Imaging gap-fill. Optional whole-body MRI for patients who elect it, age-appropriate cancer screening reconciliation, multi-cancer early detection blood test for patients who choose it.
• Month 11 — Blueprint assembly. Your longevity advisor compiles the year into a written Longevity Blueprint — labs trend, imaging summary, fitness baseline, cognitive baseline, three-year forward plan.
• Month 12 — Annual review visit (90 min). Walk through the Blueprint with Dr. Sahni. Set year-two priorities. Repeat Tier-1 labs to establish trend.

Patient pace can extend the timeline. Clinical findings can compress it. The structure is a default rhythm, not a fixed schedule.

How it's priced

The year-long executive evaluation is included with Concierge Internal Medicine membership at $349 per month ($4,188 per year). Founding member discounts are available.

What's included in the monthly fee:

• The full year-long executive evaluation described above
• All Tier-1 lab work at wholesale rates throughout the year
• Direct physician communication between visits
• Longevity advisor coordination and between-visit check-ins
• The annual written Longevity Blueprint
• Care coordination with specialists when indicated

What's billed separately at vendor cost (patient option):

• Cardiac risk imaging (CAC score, advanced coronary plaque characterization) at local imaging centers
• VO2 max testing at local exercise labs
• Home sleep study (if indicated and elected)
• Multi-cancer early detection blood test (if elected)
• Whole-body MRI (if elected)
• Specialist consultations outside primary care scope

Private MD receives no commission, kickback, or referral fee from any vendor. Patient pays vendor directly at vendor cost. Total third-party costs over the year typically range from $200 to $2,500 depending on which optional components the patient elects.

Compared with the $10,000-$25,000 range for one-day evaluations at major executive health centers, or the $14,000-$25,000 annual range at premium concierge memberships, Concierge Longevity at Private MD is structured to deliver comparable clinical content at the price of a small-panel local practice. The savings come from the structure — no academic medical center overhead, no rotating specialist team, no large institutional brand premium — not from cutting clinical content.

What we offer, plainly

A year-long executive evaluation delivered by a board-certified internist with former Mayo Clinic and University of Minnesota faculty appointments, distributed across the year you actually live. The comprehensive workup — labs, imaging, body composition, functional fitness, cognitive baseline, sleep evaluation, hormone optimization, written Blueprint — embedded in an ongoing physician relationship with monthly check-ins, quarterly advisor sessions, and structured physician follow-up.

Included with Concierge Internal Medicine membership at $349/month (founding member discounts available). Optional advanced imaging and screening billed separately by third-party vendors at patient option.

For patients who want every imaging modality, every screening test, and every component bundled with vendor coordination, we also offer 360° Deepscan — the flagship comprehensive tier, by application only.

If you're considering an executive evaluation and want to talk through whether this is the right fit, the next step is a free 15-minute Discovery Call.

About the author

Nishant Sahni, MD is board-certified in Internal Medicine and the founder of Private MD, a small-panel direct primary care and concierge longevity practice serving Granite Bay, Folsom, El Dorado Hills, and the greater Sacramento area. Former faculty at Mayo Clinic and the University of Minnesota in Internal Medicine.

Pricing for comparison programs is based on publicly available information accessed 2026-05-15 and varies by location, tier, and included services. Programs differ in scope, facility access, and care model. This article is for educational purposes and is not a substitute for individualized medical advice.