Extreme Prevention

Elite Virginia medical practices go above and beyond.

Sherlock Holmes has nothing on Dr. Randy Baggesen.

The founder and medical director for Executive Health Group (EHG) in Richmond bucked traditional medicine protocols and pioneered a fundamentally different concierge practice. The zealous EHG team takes longevity medicine to the next level, delivering extreme preventative care. They stop at nothing, digging deep to get answers to medical mysteries.

“I want to take the very best care of you. I want to listen to the science. I want to listen to the deployment of technology,” Baggesen says. “When it comes to health care, the American medical system is a system of sick care, right? They don’t do prevention. That’s what we do here—early detection and prevention.”

It’s a refreshing take on conventional medicine. Generally, early detection consists of screening for cancer of the breast, colon, prostate, and skin in the traditional medical world. Baggesen thinks that’s not enough.

“Eighty percent of the cancers that kill people are not screened for at all,” he says. ​​

As such, EHG staff scans patients inside and out using cutting edge technologies to detect potential risks and establish benchmarks for the future. The goal isn’t to merely manage disease; it’s to detect and prevent it. 

“Traditional medicine tends to be more reactive than proactive,” says EHG’s Dr. Amy McConnell. “If we pick something up and we can prevent that heart attack or we can pick up that early cancer, isn’t that priceless?”

For over two decades, Baggesen has relentlessly hunted down root causes of medical red flags, redefining wellcare and championing preventative medicine.

His concierge medicine-on-steroids approach makes him an intriguing outlier in the marketplace of rank-and-file primary care and concierge medicine models.

What’s In A Physical?

One of the most basic elements of healthcare is an annual physical exam. Traditional primary care and concierge medicine provide these checkups, but they are not all created equal—some concierge practices take yearly physicals to new heights. At EHG, for instance, patients receive a comprehensive checkup with every bell and whistle available. For some screenings, EHG is the only private practice in the world to own the equipment. Every patient completes a full body MRI, Galleri multi-cancer early detection (MCED) screening, problem-focus genomics, coronary CT scanning, an EKG, and Vectra 360 skin scanning. 

“We want to turn our patients into health warriors,” Baggesen says. 

In addition, the physical includes advanced comprehensive cardiometabolic laboratories, body composition analysis, ultrasonography, gut health analysis, hormone analysis and replacement, men and women’s health screenings, as well as lifestyle help with exercise, nutrition, and longevity. It’s a far cry from the mainstream physical.

“The medical establishment looks at all of this, like, what are you doing? Where’s the data?” Baggesen says. “You have physicians here who have done a great deal of training on how to interpret these studies, how to use the information to raise the level of wellness in our patient population—and it’s bloody unique.”

Concierge Medicine’s Meat and Potatoes

In most traditional primary care practices, patients make appointments weeks, or even months, ahead. Access to a primary care provider can be iffy at best, with patients sometimes being passed off to a nurse practitioner or other medical professional. According to data from PartnerMD, a concierge medical practice headquartered in Richmond, primary care physicians have a roster of 2,000 to 3,000 patients and see 20 to 35 people daily. For immediate care during an illness, it’s a tall order to get face-to-face with your doctor in a day or two.

And, annual physicals generally only include standard tests and screenings.

Concierge medicine—charging patients an annual fee for upgraded care— gives the public another option. These physicians treat between 400 and 600 patients in their practice and six to ten people daily, according to PartnerMD. More time with patients is the draw.

A staple to the concierge medicine model is increased and simpler access to doctors and appointments. Pat Toth, 84, from Vienna, is a Care One Internal Medicine concierge customer in Reston. 

“It’s rare not to get a response to an email or text within an hour with 24/7 coverage, and I have a longstanding relationship with my doctor,” she says, adding, “Email and text numbers for medical staff are provided to patients; prescriptions are called in within minutes of discussion. Appointments can generally be made within 24 hours.”

Many, like Toth, say the luxury is well worth the $2,000+ price tag. Quick access is the defining characteristic of the concierge medical model.

Live Longer, Live Better

According to data from the Centers for Disease Control, the average life expectancy in 2023 in the U.S. was 76.4 years—the shortest it’s been in nearly two decades. Some consumers prioritize advanced screenings to get the most thorough picture of their health.

Blayre Gottwald, a 37-year-old mother of four, was fortunate to receive care from Randy Baggesen’s team at EHG the past four years. She and her husband faithfully pursued annual comprehensive checkups.

“How many people our age even get a physical?” she asks. “We believe knowledge is power. We were invested.”

During the Richmond resident’s annual physical exam last November, her Galleri bloodwork, which can detect a signal shared by over 50 types of cancer, showed signs of breast cancer. The blood test is not commonly administered, but it’s a staple of the EHG physical workup. Asymptomatic, she had an MRI one week later, which showed a mass in her right breast, diagnosed as an aggressive form of cancer. 

“It was terrifying,” she says. Gottwald is receiving treatment from a top surgical oncologist who specializes in breast cancer. She says her doctor was amazed when she heard the fast-growing cancer was detected through an annual checkup.

“The time from my physical to my treatment was incredibly fast—I give a lot of credit to Baggesen and his team,” she says. “It’s quite possible it saved my life.”

Early Detection

Early detection through a routine physical affected Peter Van Winkle, 58, a patient of Dr. Baggesen’s for eight years. When he turned 50, he took a profound interest in his health and familiarized himself with components included in annual physicals from Richmond-area PartnerMD and EHG. 

“I like what Randy was doing a lot more in terms of the more comprehensive physical,” says the Richmond CPA. “The thing I like about him is he’s much more focused on the preventative side.”

Good thing—during Van Winkle’s January 2021 physical, Dr. Baggesen found a suspicious mole during a skin cancer check and compared it with photos from previous exams, thanks to images taken with advanced machinery. He removed the mole and sent it in for a biopsy, only to discover it was melanoma—the deadliest form of skin cancer. Surgery was scheduled right away.

“Fortunately for me it had not traveled to my lymph nodes yet,” Van Winkle says. “I really dodged a bullet—if we hadn’t found it, there’s a good chance I wouldn’t be here now.”

What’s Out There

Choosing a concierge plan can be daunting, since each practice’s options, pricing, and screenings vary. 

INOVA VIP 360, with 15 concierge doctors in four Northern Virginia locations, offers an extensive, periodic medical review and half-day physical examination. A physical includes preventive care, education, wellness planning as well as tests not found in most wellness exams. 

INOVA VIP 360 also offers more comprehensive physical options like the Executive Health Exam, which checks off even more boxes. Physicians offer testing in vision, resting ECG, blood and urine tests, an advanced cardiac lab panel and pulmonary function tests. Patients also undergo a fitness evaluation and nutrition analysis and have access to vaccines, colonoscopies, skin cancer screenings, 3D screening mammograms, metabolic testing, Hepatitis C screening, and more. 

PartnerMD’s concierge medicine practice has seven offices in Virginia, Georgia, Maryland, and South Carolina. Its Richmond area and McLean offices offer options for an enhanced five-hour and eight-hour physical. Patients can expect more advanced lab work through Cleveland HeartLab, screenings, and consultation. 

For their primo upgraded physicals, more than 30 options customize exams, like a chest X-ray, a CT heart scan, a pelvic ultrasound, or even a golf swing assessment and consultation.

This article originally appeared in the June 2024 issue.