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Doctor's office: Men's last stop on ride of pain.

Byline: THE HEALTH FILES By Tim Christie The Register-Guard

Men are tough. We don't need to see a doctor every time we get a little ache or pain. We'll just rub some dirt on whatever's ailing us and call it good.

Granted, if we wake up blind or break a limb, or if that that lump gets much bigger - OK, then we'll talk to a doc.

The notion that some men will stay out of the doctor's office, even if it kills them, is no joke: Nearly one in five men suffering pain or illness will forestall a visit to the doctor "as long as possible," according to a major survey examining men's health.

"Men have a bit more of an air of invincibility," said Dr. Michael Fleming of Shreveport, La., president of the American Academy of Family Physicians.

"We see ourselves as the breadwinner. We can't have something wrong with us. We have to be there everyday. We can't be weak. To go into the doctor frequently is seen as weak."

Springfield Police Chief Jerry Smith was suffering intense abdominal pain while at work in October, but he resisted going to the hospital, his co-workers have said. He finally relented, but when the ambulance arrived, he refused to get on a gurney and insisted on walking out under his own power.

When he got to McKenzie-Willamette Medical Center, he was admitted to the intensive care unit and listed in critical condition for a gallbladder ailment. Smith has since undergone two surgeries and three stays in the hospital. It's not clear when he'll return to work.

Dr. Lorne Bigley, a family doctor at River Road Medical Group in Eugene, speculated that men's reluctance to seek medical care "has something to do with why guys don't want to go the gas station to ask for directions," he said.

"I think there's a reluctance to admit their own mortality," he said.

Sometimes avoiding medical care can have deadly consequences.

In a case reported last year in the medical journal The Lancet, doctors treated a 17-year-old boy for injuries he suffered in a car accident and sent him home. Four days later, he was discovered unconscious at home and was declared dead on arrival at the hospital.

Doctors suspected that undetected internal injuries from the crash killed the boy. But an autopsy found he had died of a blood clot in his lung caused by undiagnosed testicular cancer that had spread throughout his body and created a 5-inch mass on a testicle.

A survey conducted in 2000 by the Commonwealth Fund confirmed that men are less likely than women to seek medical care.

The survey found one in four men didn't see a physician in the year before the survey - three times the rate of women - and one-third said they didn't have a regular doctor to visit when they were sick or needed medical advice, compared with 19 percent of women. The disparity was more pronounced among young men - more than 50 percent of men age 18 to 29 don't have a regular physician.

Asked what they would do if they were sick or in pain, 17 percent said they would wait "as long as possible" before seeing a doctor, and 24 percent said they wait at least a week.

The survey also suggested that doctors don't always do a good job of encouraging their male patients to live heathier lives.

Among men who recently visited a physician, only 30 percent were counseled about smoking, 22 percent about alcohol use, 44 percent about diet and weight and 46 percent about exercise.

When it came to sensitive topics such as sexual health, counseling rates were especially low.

Only 14 percent of men said their doctor talked to them about sexually transmitted diseases.

Fleming, the Louisiana doctor, jokes that whenever he sees a male patient, his first question is: "What does your wife want to know?"

The one thing that seems to motivate men to seek medical care above all else is when a friend who is about their age develops a serious malady, Fleming said. If a man develops prostate cancer, "every friend he plays golf with will be in to be checked," he said.

Every man should at least have a personal doctor, Fleming said. "If men have a relationship with a personal physician they're more likely to be checked out on a regular basis," he said.

Bigley said he tries to foster ties with male patients by making sure they know they're welcome to come when their wife comes in.

"When the husband comes, I talk in plain language and talk as if he's my friend so he doesn't feel intimidated," he said. "That goes a long way toward building trust and they feel more comfortable coming in to see me."

Tim Christie can be reached at 338-2572 or tchristie@


Men don't seem to be as aware as women of the need to get periodic screening tests. Here's the recommendation for prostate cancer from the American Cancer Society and the American Urological Association:

Healthy white men should get annual PSA blood tests starting at age 50. African-American men or those with a family history should start getting annual screenings at age 45.

PSA stands for prostate specific antigens. A PSA blood test is an indicator of prostate cancer.
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Title Annotation:Health; About one in five men, hurting or ill, put off seeing a physician, a survey finds
Publication:The Register-Guard (Eugene, OR)
Date:Dec 15, 2003
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