The Doctor Is In: Why Guys Don’t Go To The Doctor

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(KPLR) -- About 50% percent of men under the age 50 don’t have a primary care physician.

More than half of men—55 percent—haven’t seen any healthcare provider in the previous 12 months.

Dr. Sonny Saggar talked with Christine Buck about the situation.

You can connect with Dr. Saggar, the Medical Director at St. Louis Urgent Cares, and ask him any questions you like.

1. Compared with women, why are men not going to see the doctor?

Men notoriously avoid doctors, especially men between the ages of 20 and 40.

40 percent of men in their 40s have never even had their cholesterol tested.

  • They’re afraid of what they'll find.
  • They’re not used to it like women are from an earlier age.
  • Men have an invincibility complex.

2. Why should men go to their doctor?

1. Undiagnosed coronary artery disease. Nearly 1 million Americans will have a first heart attack this year, according to the American Heart Association. For more than a third of them, the first symptom will be death. Most victims could have seen the attack coming, especially with the help of their doctors.

Shortness of breath during light activity, or slight chest pain when exercising. This is why most doctors ask about your exercise habits, whether you've been feeling any discomfort (like “muscle strain” or “heartburn”) lately, and if you're able to do as much as you used to. The fact is, most men don't recognize the symptoms of heart disease.

It’s a common thing I've observed, after I see a heart attack, for the person to say they’ve actually been short of breath or more fatigued than usual.

Sometimes, these symptoms last for years before the person has a heart attack. There’s often plenty of time to correct the problem through medication or exercise. You just need to be man enough to start the conversation with your doctor. Are you?

2. Diabetes. Diabetes appears to be spreading like a contagious infection. It has risen in prevalence by 50% over the past 30 years and it's getting more common. Nearly half of American men today either have Diabetes or are on the verge of developing it, according to a new report from the National Institutes of Health. More than a third of them don’t even know it.

Everyone in America should be tested for diabetes. (It’s a simple pin-prick test. No excuses.) Why? There’s just too much at stake. Consider:

• Having diabetes can dramatically your chances of prematurely dying at any age compared with a person who's diabetes-free.

• Diabetes is the primary risk factor of cardiovascular disease in the United States, reducing life expectancy by an average of 13 years. According to a recent study in the Archives of Internal Medicine, if you're diagnosed with diabetes before age 60, your risk of heart attack increases 2.5 times.

• The farther along the disease progresses before diagnosis, the greater your likelihood of eye problems (often resulting in blindness), kidney problems (often resulting in dialysis), and trouble healing (often resulting in amputation).

Here’s the good news: When caught early enough, the progression of diabetes can be slowed or even stopped through simple lifestyle changes, such as diet and exercise.

I do a Diabetes screening in almost all my patients as part of the routine annual physical. For those at higher risk—because they have high blood pressure, cholesterol problems, or most importantly, a family history—screening should begin immediately.

3.Colon Screening. More than 150,000 Americans are diagnosed with colon cancer every year, and 53,000 die annually from the disease. But more than 60 percent of all cases could easily be caught earlier, according to the Centers for Disease Control and Prevention.

Why is this important? Colon cancer is 90 percent curable when caught early. The disease starts when a few abnormal cells in the colon develop into polyps. Then, 10 to 15 years later, those polyps turn malignant and often spread to other parts of the body. But, through regular screening, doctors can find and remove the polyps while they’re still harmless.

You can’t wait for symptoms, which typically come only in the late stages of this cancer.

At Downtown Medicine Internal Medicine, we send all our patients, both men and women, for a screening colonoscopy, at the age of 50 years old, and sometimes even earlier if there's a family history of colon cancer.

4.Aortic aneurysms. More than 30,000 Americans die of aneurysms each year—it’s the 14th most common cause of death in this country. When you hear the word, you probably think of a rupture of an artery in the brain, but abdominal aortic aneurysms are far more common than you think, especially in older men. In fact, according to a study published in the Annals of Vascular Medicine, 5 percent of men ages 65 and older will eventually have one.

Your chances of surviving an aortic aneurysm are terrible: just 6 to 21 percent, depending on the location in the body.

Aneurysms in the belly can often be felt on physical exam, but aneurysms in the chest can’t be felt because of the ribcage. This is why your doctor will listen for a heart murmur, an early symptom of an aneurysm in the making.

If you have a family history of aneurysms, it's important to tell your doctor. A simple imaging study like a CT may be all that's needed.

5.Malignant Melanoma. Skin cancer attacks a disproportionate number of men. In fact, of the more than 3.5 million new skin cancer cases in America each year, more than two-thirds occur in men.

The deadliest form of the disease is melanoma, a cancer of the skin's pigment-producing cells that kills almost 8,000 people each year. One in 39 men (versus 1 in 58 women) will eventually develop melanoma, but don't fret. Early detection can be difficult with other organs in the body, but not so with the skin.

When melanoma first develops, it’s only on the surface of the skin, making it easy to remove and cure, but the longer it goes untreated, however, the more it spreads. That makes the chances of survival much slimmer.

In most cases, you have up to a year to find a melanoma before it will hurt you, which is why dermatologists recommend annual exams. They also advise monthly self-exams. Ask your significant other to help, and then return the favor.

This, men, actually is scary: Despite recent medical advances, the 5-year survival rate for stage IV melanoma is only 15 percent. And if you’ve had just five—that's right, only five—moderate sunburns in your lifetime, your risk of developing the malignant melanoma is double.

3. What can we do to encourage men to go to their doctor?

The best way to get someone to do anything is with adequate motivation. I don’t want to use fear as a motivator, but I think we have no choice in this situation. However, just like with children, there are positive reinforcements one can use to get a man to get a regular medical check-up.

Women (girlfriends, wives, mothers, daughters, sisters) have the biggest influence on men in general. Most men would probably agree with this - publicly or privately. So it’s really up to you women to get your men-folk to go and see the doctor or nurse practitioner at least for that annual physical.