‘Man Up’ asks why men are reluctant to seek healthcare

Dr. Paul A. Bluestein felt pain in his chest and instinctively knew what was wrong.

It had to be coronary artery disease, the physician thought, noting that the deadly heart disease runs in his family.

The pain kept flaring up, often striking when he got out of bed in the morning. Yet, in spite of knowing what it was, what it had to be, he did nothing about it.

"I thought 'This can't be happening to me.' It just wasn't happening. I had work to do. I was too busy," said Bluestein, the senior vice president and Chief Medical Officer of Connecticare.

Ten days later, he had such acute pain in his chest that he fell to the floor and couldn't get up. He couldn't deny it anymore. The disease had literally knocked him down.

He had an angioplasty done and is feeling much better now. But he readily admits that denial kept him from going to the doctor even when he knew better.

Bluestein shared his story at the State Capitol at a roundtable discussion on why men are more reluctant to seek preventative care than women and what can be done to eliminate the disparity.

The panel discussion, called  "Man Up," focused on ways to get men and the people who care about them to figure out why men refuse to seek medical help.

State Comptroller Kevin Lembo organized the panel as part of a broader Man Up campaign he has launched after noticing troubling trends in state employee health statistics. Lembo, who manages administers the state's health care plan, saw that men were much less likely to use preventative health services than women, perhaps scared off by colonoscopies and other tests.

This has troubling implications. In 1920, women lived on average one year longer than men, he said. Now, men on average die almost six years earlier than women, both in Connecticut and nationally. Men also are much more likely than women to develop the most serious chronic conditions, such as heart disease, cancer and stroke.

During the discussion at the Legislative Office Building, panelist Matthew Lesser shared his story as a cancer patient. The 29-year-old state representative said he began to feel some odd discomfort in his chest last year. He decided to see a doctor about it, fighting off the instinct he'd had drilled into him since childhood to 'tough it out' or 'walk off' any discomfort. He was persistent, though, and was eventually diagnosed with testicular cancer. He has since been treated and is now cancer-free.

In addition to these cultural barriers, panelists said men are often reluctant to take time off from work to see a doctor, don't have a relationship with a primary care doctor, or are worried about wasting the doctor's time over something that might turn out to be a minor problem.

Some men simply don't have health insurance and turn to the hospital emergency room for medical treatment. Many hospitals, however, won't do surgery for serious conditions, such as prostate cancer, unless the patient has health insurance, said panelist Curtis D. Robinson.

"What do you do if you don't have a primary care doctor or if you don't have insurance? You go home and you die," Robinson said.

Robinson, of the Curtis D. Robinson Men's Health Institute at St. Francis Hospital and Medical Center, said he has started an outreach project to test men in greater Hartford for prostate cancer. If they test positive, the surgery is done for free. Since the project started three years ago, they have tested 3,000 men and saved the lives of 40 of them.

The panel discussed other ways to try to reach men, such as perhaps taking a marketing approach to reach patients, dispensing medical care online and by email  and making more use of "minute clinics" in retail centers and pharmacies.

Lembo said the Man Up campaign also has come up with a health maintenance guide for men similar to a maintenance schedule for a car. The guide has a schedule of prevention screenings, dental cleanings and physicals by age to help men stay on top of preventative care.

Dr. Muhammad Qureshi, director of Adult Medicine for United Community & Family Services, suggested that physicians try to do as many tests and services as they can when men come in for a visit.

Physicians on the panel also said doctors should be vigilant not to discriminate, intentionally or not, against patients based on race or old age.

When the lively, 90-minute session ended, Lembo said it is clear that more of such discussions are warranted.

"We're committed to this for the long haul," he said.

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