Overcoming ‘white coat anxiety’ for a life-enhancing experience at Mayo Clinic’s Executive Health Program

White Coat Hypertension: A condition occurring when blood pressure readings at a health care provider’s office are higher than they are in other settings, such as at home. It’s called white coat hypertension because people who measure blood pressure sometimes wear white coats.

From the time I nearly passed out (did pass out?) getting my kindergarten vaccinations, White Coat Hypertension (Syndrome) has been a part of my life, and a basis upon which I make many medical decisions for myself. Whether it be sports physicals or flu shots, eye doctor exams or dental check-ups (sorry Susan Widick, DDS), my fear of going to the doctor – any doctor – has kept me from taking proper care of myself.

Imagine my utter dismay, then, when the aforementioned Dr. Widick (“the cobbler’s son has no shoes” comes to mind) informed me that she had scheduled a three-day program for us both at the Mayo Clinic Executive Health Program in Rochester, Minn.

I immediately looked up info on the program. Patients spend an intense three days in a comprehensive, streamlined, integrated, multi-disciplinary process aimed at evaluating their health and assessing the next steps for their wellbeing. That meant I’d have a physical and evaluation, blood and urine tests, an ECG and cardiac calcium exam, hearing and vision appointments, a colonoscopy and more. And there would be needles.

Our Executive Health Program Mission: To provide individualized, comprehensive care to meet the unique needs of working executives in the demanding stages of their careers. We focus on preventive health and wellness with timely, coordinated access to multidisciplinary care, including advanced diagnostics, state-of-the-art prevention strategies and therapeutics when needed.

“I’m not going,” I proclaimed. “I’m too busy, I don’t have enough time to prepare. This won’t work.”

The truth? They might discover something wrong. And then what? I might die. Or, worse, have to get a bunch of shots.

White Coat Hypertension (Syndrome)

As mentioned, I’ve known about my Syndrome (it’s not really Hypertension, in my mind; it’s full blown, pass-out-at-the-sight-of-a-needle-anxiety) since I was five years old. Walking out of the doctor’s office with my mother after those early vaccinations, my ears started ringing. My vision grew blurry. And my legs got wobbly. I was going down.

My mom quickly dragged me back inside, notifying staff that I was having an allergic reaction to the shots. They rushed me into an exam room, laid me down, and if I remember correctly administered smelling salts to revive me.

“Oh, he’s having a reaction all right,” the doctor said. (I think it was Dr. Walker, my longtime pediatrician, at his office in the Englewood Shopping District in Independence, MO, not too far from the Harry S. Truman home). I remember the event – vividly – to this day. “He’s having a nervous reaction to the needles.”

Thus, a lifelong fear was born. Remember the simple TB tests in grade school? They were terrorizing to me. Dreaded them for days. Felt woozy waiting in line. Health screenings in junior high with a blood draw? I’d rather get a swat from PE teacher Clyde Kubli (and he had a helluva swing). Getting my eyes dilated for an eye exam or a filling at the dentist were excruciating as well.

Surely you grow out of this, right? Not me. It has continued to this day. I have found occasional relief from utilizing relaxing techniques, first introduced to me by our family dentist. Close your eyes, he’d say, and think about sports or the beach or anything to get your mind off the white coat … and the needle.

And, on some occasions, that worked. I was able to keep my mind at ease and make it through an appointment without a need for a timeout to keep from fainting. More often than not, however, the syndrome struck.

Now, how in the world was I going to make it through 13 doctor appointments and numerous tests in a three-day period at Mayo? At the time I finally agreed to go, I had no idea how I would make it. But I knew I had to.

Overcoming Anxiety

An old boss introduced me to motivational tapes early in my career. Napolean Hill, Zig Ziglar, Earl Nightingale, Brian Tracy … all became fixtures in my car’s cassette player (remember those?). And they really struck a chord. To me, they all boiled down to these related quotes: “You become what you think about” and “Whether you think you can – or think you can’t – you’re right.”

Our mindset, our attitude, our inner thoughts …. these all drive our actions and results. If you think negatively, you greatly increase the likelihood of having negative results. Conversely, if you tell yourself that you are successful – even before you are (especially before you are) – you greatly increase your chances of success.

When it came to doctor’s visits, I became what I thought about. I thought I would get woozy, so I did. I knew I would fail to make it through the visit. So I did.

If I was going to make it through Mayo’s Executive Health Program, I needed a positive inner dialogue and to visualize myself successfully completing the program. And I needed just a little additional mental boost …

… which came in the form of a book I had heard about many years before: Anxiety & Panic Attacks: Their cause and cure, by Robert Handly. Its five basic principles, and positive thinking script, were just what I needed.

  1. Harness the creative powers of your mind to change your thinking
  2. Visualize and affirm to change your mindset, replacing fear with confidence
  3. Utilize rational, positive thinking to visualize the outcomes you desire
  4. Act as if that desired outcome is already reality
  5. Set goals to becoming a positive person

I took the learnings from those old motivational tapes, and the scripts in Anxiety, to visualize myself successfully completing the Executive Health Program and achieving the healthy outcomes I desired. I would have to use those techniques throughout the days at Mayo, as well. The mind is powerful … whether in a positive manner, or negative. I set my mind to a successful visit.

And off to Rochester we went.

We chose to drive from Kansas City to Minnesota as opposed to flying, saving on transportation costs and allowing us the convenience of having our own car packed with our own stuff in Rochester. And by the time you drive to the airport in KC, park, get through TSA, wait for your flight, de-plane, get a rental car or Uber, etc., the six-hour drive and a one-stop flight are about the same time commitment.

We stayed at Marriott’s TownPlace Suites in Rochester, which is affordable and allows an easy walk to the Mayo campus. Almost all our appointments would be in the Gonda or Mayo buildings at the Clinic, so no driving, parking or valet, etc. would be necessary.

The Executive Health Program at Mayo Clinic

For more than 50 years, the Mayo Clinic Executive Health Program has been leveraging the best and brightest minds in medicine to help CEOs, founders, presidents, business owners, and executives maintain good health. The unique, effective, and evidence-based program is designed to help you receive world-lass preventative care and ultimately enjoy many healthy years doing what you love in your personal and professional lives.

These phrases are commonly used in Mayo’s literature for the Executive Health Program:

  • World class
  • Integrated
  • Streamlined
  • Standard setting
  • Customized
  • Comprehensive
  • Dedicated

All of which are true. And so much more.

The program is streamlined to meet the needs of professionals and business executives. Moreso, I think it also navigates the increasingly complex maze of today’s healthcare environment. It’s not a medical concierge service, and you are encouraged to maintain your local primary care provider. The program is laser-focused on providing comprehensive, dedicated and customized care in a condensed timeframe … without compromising quality in the process. In fact, I strongly argue that the care is unmatched, especially with its integration to departments throughout the facility, allowing your coordinating physician to make changes and additions to your schedule as your visit progresses.

Mayo’s Executive Health Program began in the 1970s. In 2013, the program received a boost with a $10 million donation from W. Hall Wendel Jr. Wendel has been a long-time supporter and patient of the Clinic, having undergone two full shoulder replacements and two full knee replacements after a lifetime of marathons and mountain climbing.

“There’s just no feeling like going to the Mayo Clinic,” says Wendel, former president of Polaris who led a management group that purchased the company in 1981. Polaris is a manufacturer of on road, off road, snow and marine vehicles. “The thing that attracts me to the Executive Health Program is that it is geared to executives. It’s very efficient. They have the best in the world, right there. That’s a very reassuring, calming feeling. It’s like coming home.”

The program is available in Rochester, Mn., Scottsdale, Az, Jacksonville, Fl., and London. It takes advanced planning to get everything scheduled and lined up, so prepare in advance.

My Itinerary

Overall, I had 15 reviews, visits, assessments, tests, evaluations, consultations and exams during my three days in Rochester. I want to share what those are to show you the thoroughness of the program, and to see what you can accomplish in this unique opportunity.

  1. Telephone medical information review before leaving KC
  2. Electrocardiogram testing
  3. Blood test
  4. Urine container visit
  5. Medical information review
  6. Evaluation with Internist
  7. Consultation with Ophthalmology
  8. Nurse visit hearing screen assessment
  9. Exercise testing
  10. CT cardiac calcium scoring exam
  11. Consultation with cardiovascular medicine
  12. Consultation with nutritionist
  13. Uroflow procedure
  14. Colonoscopy
  15. Telephone follow-up with Internist

Perhaps I could have scheduled most of those 15 encounters on my own in my hometown. Perhaps. But I certainly would not have taken the initiative myself to do so. And it would have been a 12-month ordeal, not a three-day experience (plus pre- and post-visit consultations via phone). I’ve come away with a newfound interest in my health, and a game plan to enjoy that health for many years going forward.

My Takeaways

What a phenomenal experience! Here are my thoughts:

  • From Lilly greeting us at the entry of the Executive Lounges, to the impressive follow-up afterward – and every scheduled and added appointment, screening, test and consultation in between – the treatment by the Mayo team and attention to detail by the staff were world class.
  • Lilly and the Executive Lounge are truly the front porch of the program. She was there to greet us each morning (the lounge is open 6 am to 6 pm), introduce us to the program, and show us around the lounges. Available are secure lockers for personal items, light breakfast and lunch, healthy snacks, and a comfortable place between appointments. More private areas are available to conduct business as needed.
  • Dr. Scott Collins was my Internist, serving the role of “your dedicated coordinating physician who will take the time to understand any concerns or issues you may have, then act as a guide throughout the entire evaluation process.” Dr. Collins is in the Urology and General Internal Medicine departments, with specialties in the Executive Health Program and the Men’s Health Center. Dr. Collins, who earned his medical degree from the University of Oklahoma, was an outstanding advocate during my visit, and even had empathy for my “white coat” issues.
  • On our last day in Rochester, Lilly provided a selection of books from which to choose as a lasting reminder of our visit. I chose “Live Younger Longer: Steps to Prevent Heart Disease, Cancer, Alzheimer’s, Diabetes and More” by Mayo Cardiologist and cancer survivor Stephen Kopecky, M.D. What a book! Dr. Kopecky communicates in a conversational manner that makes complex cardiovascular issues understandable to the layman. Once I finish reading it, I’m going to read it again to make sure I didn’t miss anything. And I’ve enjoyed listening to Dr. Kopecky and other Mayo specialists on Mayo Clinic Radio.
  • I am on my way to being a reformed, non-healthy-living person. So, I don’t want to be “that guy,” but I’ll be on my soapbox about this program for the foreseeable future. I’m exercising every day, eating right, avoiding sweet tea and sodas, reading all the material, downloading all the apps, and watching the scale reflect a 10-pound loss from last month.
  • Insurance surprisingly covered more than I anticipated it would. The initial program fee isn’t covered, though it may be eligible for your HSA. Your company may even cover that cost. The rest of the medical expenses have mostly been covered by our high deductible plan from Blue Cross Blue Shield of Kansas City.

Most importantly, thank you, Susan. You made me do this. You shamed me into going. As a result, you enhanced my life (which you have been doing for 30+ years already.) Now, you’re supporting my changes and cooking all the right foods to make this last. I remain forever grateful to you.