May 10 2010
Joined-up government – that one-time Labour buzz-phrase – is obviously a good idea, even if it doesn’t happen that often. Even harder to find, though, is joined-up medical treatment. If you’ve ever had a hard-to-diagnose problem you’ll know what it’s like to see a succession of specialists without any clear strategy emerging as you do more and more tests. Or maybe your doctor has told you to exercise, eat healthily and lose weight, but it can be hard to find a gym or workout routine that understands not just your medical state but also your physical strengths and weaknesses.
Two very different high-end London centres have recently opened aimed at joining up exactly these sorts of dots. If you are looking to fix a nagging problem, they’ll put together a team of experts to focus on it; or if you just want to stay as healthy as possible, they’ll design a bespoke high-performance package.
Viavi, a clinic in Harley Street, has impressive medical credentials. With dark wooden floors and neutral walls, it exudes professionalism and efficiency. There are rooms full of high-tech equipment – CT scanners, machines for measuring cardiovascular fitness and a remarkable device called a spinal mouse that captures pin-sharp images of your spine, revealing the distortions that may underlie back pain or posture problems.
These readings are backed up by exhaustive blood tests that allow the clinicians to peer into every crevice of your metabolism – from cholesterol and blood-sugar levels, to a full screening of your hormones and key health-linked genes, and a check on your mineral and vitamin status. This last test can reveal not just amounts in the blood but how effectively they are working inside cells.
“You may have a textbook diet and high levels of various nutrients in your blood,” says Oliver Patrick, an applied physiologist and executive director of the clinic, “but if in some cells the units that produce energy aren’t able to utilise these nutrients effectively – possibly because of a gene variation – your level of functioning will be poorer than it should be. It’s the kind of thing we can improve.”
Your assessment is also likely to include a check for genomic variations known to be linked with health problems. Some can raise your risk of heart disease, others can make you more prone to chronic inflammation, or particularly vulnerable to the damaging effects of smoking. “Knowing about genes can make a big difference if you need drug treatments,” says Patrick. “We now know that certain drugs work better or worse depending on your gene combinations.” That’s the kind of information you will rarely get from more standard clinics.
As check-ups go, this is impressively thorough but it’s still the sort of level you might expect when paying around £500 for the first consultation. Where Viavi really scores, however, is with its contacts. Both Patrick and chief executive Dr Sabine Donnai have worked extensively in private health companies, such as Bupa and Nuffield Health, and have access to many top consultants.
“The purpose of the tests is to find out what is preventing you from functioning at your best,” says Donnai, a specialist in preventative medicine. Once that’s pinpointed, Viavi uses its contacts to pull together a team to set you on the road to recovery. It’s more like assembling the technicians and actors for a movie than the usual approach of slotting you into an existing medical production line.
“Someone might need a cardiologist, an osteopath and a physiotherapist,” Donnai explains. “But we wouldn’t just find someone who is good; their personality has to be right too. We make sure we choose experts whose style is going to mesh best with the client.”
And the selection process goes even further. “The experts we use have all agreed to be part of a team,” Donnai goes on. “They pass their recommendations to us and we feed them into the plan for the client. It means that clients are not trying to assess top medical advice on their own and – just as important – the experts are not trying to impose their views.”
A good illustration of how this works can be seen in the way the clinic handled a case of ignored stress. “Many of our clients are at the top of their game in business or the City,” says Patrick “and so are at a high risk of burn-out. But, being strong-willed, they usually deny any stress problems and believe they can handle it.
“When a bank director called David had his hormones tested, he showed up as having low levels of the stress hormone cortisol and a related one, DHEA,” says Patrick. “That told us his energy reserves were down and the stress of his job was having a harmful impact.”
But David found that hard to accept, so he spent 48 hours wearing a monitor that measured the way his autonomic nervous system responded to various stressors during the day, and how well he recuperated at night. “He saw that he was responding much more strongly to some things he thought he was handling well,” says Patrick. “This made him more prepared to treat the issue seriously.”
Patrick and Donnai devised a programme to raise his energy and help him handle stress more effectively. They recruited an endocrinologist to confirm the hormone data, a physical trainer and a nutritionist. “David was talking about ‘slaughtering’ himself in the gym with really intense workouts – which was the last thing he needed,” says Donnai. “We recommended something much lower-impact, combined with yoga, to start a rejuvenation process.” Finally the nutritional programme kept tabs on his energy production, making sure first that his cells were taking up the B vitamins and magnesium they needed to generate it. “We monitor clients regularly, so if one approach isn’t getting results we will try another one,” says Donnai.
If Viavi were a car, it would probably be a 5-Series BMW. Lifesmart, the other new centre on the block, would be a more flamboyant personalised marque. The exterior of the red-brick Victorian church on the edge of a housing estate near Regent’s Park is unremarkable, but inside it might be the Beverly Hills home of a star with a passion for gym workouts and complementary therapies.
The colours are strong, the sofas big and squashy, and each locker in the changing rooms has a lacquered door and a personal safe. However, the several gyms are professional in the extreme. The hub is a sleek kitchen where members eat and learn about the foods they need. On the top floor is a sensuous massage room with a spa bath.
Lifesmart is the creation of Carole Caplin, a highly experienced personal trainer, forever known as the style guru to Cherie Blair. In her late 40s, stylish with long black hair, she’s a good advert for her own medicine. She’s warm and relaxed with a knack of making you feel cared for.
“I wanted to create a place that members would feel was home from home,” says Caplin, who is the managing director. “Some want to deal with low energy; others need help recovering from an injury or an operation, some just want to be healthier. We aim to identify underlying problems and help members to deal with them.”
Most of the funding for the club came from one of her former clients, theatre impresario and Everton chairman Bill Kenwright, now owner of Lifesmart. “I’d been going through a bad patch and she offered to help. I’d only flirted with gyms and I knew nothing about New Age-type treatments but in four months she made an enormous difference. I invest in talent and she’s obviously got it.”
Like the team at Viavi, Caplin has a capacious contacts book, and works with both orthodox and complementary practitioners. One of them is the private GP Wendy Denning. “What Carole’s got here is what I’ve always wanted as a doctor,” she says. “Normally when I give diet or exercise advice, patients either ignore it or they’ll go to a health centre or gym and be told something quite different. Here you get diagnosed and walk next door into a highly sophisticated gym and start treating it.”
A key part of that diagnosis involves a two-hour biomechanical assessment by Brett Sanders, a CHEK practitioner (ie, he identifies the root cause of a person’s physical dysfunction then uses corrective exercise and lifestyle coaching to achieve health). “I’ll look at the spinal alignment, degree of curvature, movement patterns and trace how all this underlies any joint or back pain,” he says. “Lots of people have bad posture because of sitting at computers for hours and that can impact all over the body. Rounded shoulders, for instance, can subtly compress the chest and cause pain in the lower back.”
Susan is a 40-year-old executive who was in a bad way when she discovered Lifesmart. An emergency heart operation had saved her life, but afterwards she found there was very little on offer to help her recover fully. “I had very little energy and no idea of how to get back in shape. I was terrified that the slightest exertion would set off my heart problem again. Should I push myself or take it easy? I was too tired to eat more than toast and peanut butter. My doctor just offered me morphine.”
Joining Lifesmart has changed all that. “Carole got me eating properly – just shopping for the food with her was fun – and the exercises Brett worked out for me are making a real difference. I’m doing things now I couldn’t have dreamt of even a couple of months ago. Yesterday I ran up the stairs on the tube.”