Resistance by men to medical care and treatments remains a vexing challenge as evidenced by the presentations of five clinicians at the Massachusetts Medical Society’s 14th Annual Symposium on Current Issues in Men’s Health on Thursday, June 16th.
The annual symposium is sponsored by the MMS Committee on Men’s Health, currently co-chaired by Frederic S. Schwartz, M.D. and Michael B. Bader, M.D., and seeks to promote awareness of men’s health issues and improve the overall health of men through education and information for physicians and other healthcare providers, researchers, and the public. Some 60 health care professionals attended this year’s event, held during National Men’s Health Week.
The opening presentations, on the treatment of Hepatitis C and alcohol dependence, were followed by a discussion on erectile dysfunction and its relationship to cardiovascular disease, and a presentation that reported how a cohort of male patients responded to questions about access to health care. The symposium concluded with a presentation about the health and identity issues transgender patients face when seeking medical care.
In his introductory remarks, MMS President James S. Gessner, M.D. underscored the urgency that surrounds these topics.
“Statistically, we face numerous challenges with regard to male patients,” Dr. Gessner said, “because men continue to be more likely than women to make unhealthy lifestyle choices. One in every five men will suffer a heart attack before they reach the age of 65. We must adopt a dual role as practitioners and catalysts, to treat men and to motivate them to live healthier lives.”
George Abraham, M.D., in his presentation titled Citius, Altius, Fortius: The New Standards of Hepatitis C, declared that “the saddest statistic we face is that while we have conquered HIV, the prevalence of cirrhosis is quite high, and men are increasingly the victims.” He said that liver transplants have increased and liver cancer is common among male patients. The good news, however, is that we are now headed to help cure this problem more rapidly than ever, thanks to medical and pharmaceutical advancements. Yet male patients must make a commitment to recovery and that practitioners must urge them to embark on this path, he said, or reinfection is possible.
Drawing on two American authors – Ernest Hemingway and F. Scott Fitzgerald — as examples of men who battled and later succumbed to alcoholism, Kenneth Hetzler, M.D., in his presentation, Alcohol Dependence and Best Practices for Treatment, explored alcoholism symptoms and treatments. Noting that both Hemingway and Fitzgerald paid a high price for their alcohol dependencies — depression, cirrhosis and, in Hemingway’s case, suicide — he urged physicians to engage in frank dialogues with their patients about their drinking habits so patients can grasp the risks of alcohol dependency and turn to resources for sobriety.
Martin Miner, M.D., cited another American author, Mark Twain, in his presentation, Erectile Dysfunction and Cardiovascular Function: What We Know. Twain’s remark, “You can’t break a bad habit by throwing it out the window. You’ve got to walk it slowly down the stairs,” illustrated what Dr. Miner said is an effective approach to discussing and treating erectile dysfunction, a subject men find difficult to broach. Male patients must take small steps to change their lives, Dr. Miner said, which often include lifestyle changes. Noting that the relationship between erectile dysfunction and cardiovascular health is being clinically explored, Dr. Miner said that working with men to change slowly and understand the implications of their health challenges over time remains a key imperative.
James E. Leone, Ph.D., in his presentation Advancing Health Behaviors in Men: Understanding Men’s Perceptions Regarding Accessing Health Care, urged physicians to work with male patients to “unpack the behaviors” that lead to their resistance of healthcare. These include fear, control, time/convenience, trust, and other issues that emerged from his research as examples of resistance by men to seeking healthcare. “We need to create a more robust dialogue with men,” Dr. Leone said, “to bring men back to being active participants” in their own well-being.
Dr. Kevin Ard, the recipient of this year’s Men’s Health Award from the MMS, followed with a presentation entitled Transgender Identity and Health Issues, noting that LGBT patients have traditionally felt marginalized by the medical profession. He encouraged practitioners to “make their clinical settings more welcoming,” and to use preferred names and pronouns, to ask patients about their identity and sexual orientation, and to remain open to them by avoiding assumptions about their health issues.
Editor’s Note: The slide presentations of Dr. Abraham, Dr. Hetzler, Dr. Minor, Dr. Leone, and Dr. Ard are available here.