Many preventable causes of death can be detected in primary care, according to researchers.
However, many men are reluctant to visit their physician, according to findings from the MENtion It Survey, conducted at the Cleveland Clinic. Of the 1,174 men surveyed, 85% said that they would rather go shopping with their wife or domestic partner than visit a physician. Another 72% indicated that they would rather clean a bathroom than go the doctor.
Healio Primary Care asked Brad Gill, MD, a urologist with Cleveland Clinic, about the survey, and to share his clinical pearls on getting more men into the PCP’s office and how to discuss important health issues with them. – by Janel Miller
Q: Why are MENtion survey findings worth noting?
A: As physicians, we sometimes deal with health issues that are not comfortable or exciting to for men talk about, such as weight loss, exercise and smoking. Of the approximately 1,200 men we asked, 82% said they try to stay healthy to live longer for friends and family who rely on them, but only 50% of these men said they engage in preventive care.
Among the results of the Cleveland Clinic's MENtion It! survey: one in five men asked had not been completely honest with their physician in the past and half said they participate in preventative care.
Regardless of the reason a man has for not discussing them or trying to prevent them, these results suggest that the majority of men wait until symptoms start showing before they mention to their doctor that something is wrong. And in some instances, that will be too late to be treated successfully. So, it’s important to get men into the office on at least an annual basis and get them to actively engage in routine health screening.
Q: The MENtion survey showed that 20% of men have not been completely honest with their physician in the past. How can a PCP get a male patient to be more forthcoming about their medical history?
A: I have found that the key to success in this area is by gently introducing humor (ie, saying something like “things aren’t really working like they used to, are they?”) as you greet the patient.
These comments often bring a chuckle from him and help establish that you, as the physician, know why he is there. I also find it helpful to correlate the issue with something most men like, and ask him “If your car started making noises, would you take your car into the shop immediately or wait until it becomes a major issue? It’s the same thing with your body.”
If he is still bashful, explain the commonality of the condition being treated, what your purpose as the doctor will be and why it is so important to discuss the condition, which may be symptomatic of another health problem.
Q: What are your clinical pearls on giving male patients bad news?
A: You need to be direct, but also take your time to discuss the condition. For many patients, the information you give them in these instances is a lot of information to process. You need to remember that the patient may not retain everything immediately, so I try to allocate as much time as possible with these patients. They may ask a lot of questions. You need to be there to provide assurance, help navigate and manage the condition.
Q: Walk our readers through a conversation where a PCP convinces a patient to come back for care.
A: Tell patients that a lot of men encounter the obstacles and hurdles that they are facing. Let the patient know you’re there for them, that you are in their corner and that you want them to get well. That’s a key to success for this area.
Q: What lessons can the medical community learn from the MENtion survey data?
A: Many females get their first Pap Smear that checks for cervical cancer when they are teenagers undergoing their first gynecological exam. This procedure usually detects the disease in its early stages and is instrumental in ascertaining how far the disease has spread.
A comparable example to men would be the PSA screening that can detect prostate cancer. Unfortunately, men and teenaged boys don’t always have a life-altering moment as the first gynecological exam, so it is up to the male patient to start the entry into the health care system as young adults. PCPs should be doing everything they can to get men into the doctor’s office by the time the patient in his 20s or 30s.
Cleveland. 2019 Cleveland Clinic MENtion It Survey Results Overview. https://newsroom.clevelandclinic.org/wp-content/uploads/sites/4/2019/09/2019-Cleveland-Clinic-MENtion-It-Survey-Results-Overview.pdf. Accessed Sept. 9, 2019.
Disclosure: Gill reports no relevant financial disclosures.