What Doctors Know: Reluctance to see doctor among key men’s health issues

What Doctors Know: Reluctance to see doctor among key men’s health issues

Source: University of Mississippi Medical Center


Men have higher morbidity rates in almost every one of the leading causes of death in the United States, a factor leading to a renewed focus on men’s health issues.

Some of the problem stems from basic machismo, a sense that men don’t need to see a physician until something is noticeably wrong.

“Men are less likely to go to the doctor for many reasons,” said Dr. Mike McMullan, director of UMMC’s adult congenital heart program and professor of cardiology at the University of Mississippi Medical Center. “Many of them seem to feel that it’s a sign of weakness, and obviously they do not want to be perceived as weak.

“They feel that likely nothing is wrong and they would feel silly if they went to the doctor and were told that they were fine.”

Traditionally, managing the health care needs of a family also falls to women, said Dr. Diane Beebe, professor and chair of the department of family medicine at UMMC.

“Women are far more likely to go to the doctor, be sure their children go – for both health prevention and for illness — and are the major reason that men go, if at all,” said Beebe.

Statistics from the U.S. Department of Health and Human Services show that men between the ages of 18 to 44 are 70 percent less likely to seek treatment than their female counterparts.

Women are also conditioned at a younger age to see a health care specialist on a regular basis, said Dr. Marino Bruce, director of the Center for Health for Minority Males, part of UMMC’s Myrlie Evers-Williams Institute for the Elimination of Health Disparities.

“Screenings for men happen a lot later in life,” said Bruce. “And because of that, men don’t develop habits of seeing a physician on a regular basis because they don’t have guidelines that encourage early screenings.”

Bruce said men with a family history prostate cancer are often recommended to begin prostate cancer screenings by the age of 40. Yet women have been encouraged to see a women’s health specialist on an annual basis since they were in their teens.

“From the time you’re 18 to 40, there’s really nothing for you if you’re a man unless there’s a health problem identified, like high blood pressure or hypertension, because you have to go back and have those monitored,” Bruce added.

Yet the leading cause of death among males is often preventable, said UMMC physicians.

“The No. 1 cause of death for men is heart disease, and much of the risk factors for heart disease, the patient can’t feel,” said Dr. Zeb Henson, an assistant professor in UMMC’s Department of Medicine whose specialties include hypertension and internal medicine. “They don’t know they’re sick, or they don’t know that they’re unhealthy.”

Henson said blood pressure and cholesterol issues are big things that patients can’t feel for the most part because there are no readily discernible symptoms related to those.

It’s not a daily practice for Henson to see healthy male patients in their 30s visit for a checkup, whereas an obstetrician/gynecologist is likely to see healthy women several times a day, he said.

“Men can dramatically reduce their risk of having a heart attack by knowing their numbers and controlling their risk factors,” said McMullan. “Some risk factors cannot be changed such as age or family history of heart disease.

“However, risk factors such as high blood pressure, diabetes, high cholesterol, smoking, being overweight and being sedentary are all treatable and allow men following a healthy lifestyle to live longer, healthier lives.”

Dr. Roland Robertson spent his medical career working at the G.V. Sonny Montgomery VA Medical Center and UMMC in the school of medicine. But even he was hesitant about going in for an annual checkup on his heart.

“I can tell you if I had not had the regular checkups, my heart problem would have gone undetected,” said Robertson, a professor emeritus of medicine at UMMC. “If it had gone undetected until I was really symptomatic and I couldn’t do anything or could not function well, it could have gone to the point of no return.

“Even myself as a physician, I almost waited too long. “I regret that.”

When asked about his health now, Robertson perks up, saying, “I’m still vertical.” And the 81-year-old said he gets to hang out with his “grandboys,” making each of his trips to the doctor worth it.

Prevention also is key in identifying the onset of other diseases, said Bruce.

“Minority men are more likely to have an earlier onset of chronic kidney disease,” he said. “This form of kidney disease is the leading cause of death for African-American men at the age of 35. For white men, the age is around 50.”

Bruce said that most men don’t know what illness they’re at risk for and that lot of those risks are preventable when seeing a primary care physician on a regular basis.

The scales are further tipped against males because of behavioral tendencies.

“Men are likely to have more of the risky behaviors that lead to poor health outcomes, like smoking and heavy alcohol use,” said Henson. “Most of us, because of the mainstream media, know that we don’t need to smoke, that we don’t need to drink too much. And many men don’t want to go to the doctor to be told that again.”

Robertson said one of his reluctances to get regular checkups was also based on him not wanting to be told, “No.”

“At my age, I detest not being able to do things,” said Robertson. “I do not want to give in to anything. I get fussed at for trying to do more things than I should now, in the physical sense.”

Henson said men also have a perception that nothing is going to happen except a whole bunch of testing when going to the doctor.

“Men think once the testing is done, they receive a big bill for the visit and nothing will come of it.”

But the health risks facing men — nationally and in Mississippi — are too important to remain undiagnosed and ignored.

“Mississippi has the highest death rate from heart disease in the nation,” said McMullan. “African-American men have the highest risk in our state, and Caucasian men are next.

“Yet, there is ample opportunity to make a huge difference in our state by reducing the risk factors that are treatable and having regular checkups with your physician,” McMullan said.

“Our goal is to get Mississippi off the top of the list.”

(WhatDoctorsKnow is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at www.whatdoctorsknow.com.)