Compared with women, men resist seeking medical care, delay or skip preventative screenings, and tend to ignore injury or pain. They are less likely to be vaccinated for COVID-19 or the flu. I’ve wondered why this is so, and the subject came up recently during a conversation with a client. Subsequently, I’ve read about this phenomenon in the press. Most often, his behavior is attributed to cultural and social definitions of masculinity that have led men to view health complaints and medical care as a sign of weakness.
An article published by the American Heart Association cites “misguided masculinity” as the primary cause of men’s reluctance to visit a doctor. Mary Himmelstein, an associate professor in the department of psychological sciences at Kent State University, says that seeking help “means someone’s going to take my ‘man card’ away from me.”1 She also notes that many men distrust the medical system sometimes due to negative personal experiences (e.g., previous medical errors or poor provider-patient interactions).
The Health Policy Partnership, a London-based consultancy, addresses the issue as a combination of masculine stereotypes and a lack of health literacy. An article entitled “It’ll get better on its own,” cites a 2022 survey conducted by the Cleveland Clinic, which revealed that 55% of men say they avoid medical attention because they are “too busy,” afraid of being seen as “weak,” and believe “ailments will heal by themselves.”2 Doctor visits are a low-priority inconvenience.
At the same time, there is a lack of health literacy. “Knowledge of disease warning signs, awareness of symptoms, and the importance of early medical intervention”3 is consistently lower in men than women. Gender interacts with other factors, such as ethnicity and socioeconomic status, which impact proactive prevention, diagnosis, and treatment.
A New York Times article cites the same survey and data.4 The Times’ “Well” newsletter quotes Dr. Joseph Alukal, urologist and director of Men’s Health at New York-Presbyterian/Columbia. “Some men shy away from seeing doctors because they fear receiving bad news.”5 They may also fear invasive examinations, feel embarrassed about sexual performance or bladder issues, and hope to evade a prescription for lifestyle changes. Unfortunately, male health concerns like erectile dysfunction are often harbingers of problems like heart disease, high blood pressure, and diabetes. Dr. Petar Bajic, a urologist at the Cleveland Clinic, uses a car analogy: “If [men are] good about doing regular maintenance on their car, they should be good about doing regular maintenance on their body,” he said. (Instead of an oil change, prioritize a cholesterol check.)6
What should men do beyond getting prompt treatment for an acute illness or injury? In “Speaking of Health,” a Mayo Clinic publication for the public, it is suggested that men over 50 have a yearly physical exam, and those younger than 50, a physical exam every three to five years, even if feeling healthy. The article notes that men should also discuss mental and emotional health with their healthcare team.
The following list of recommended screenings is taken from “Speaking of Health” and edited for length. Go to the link provided below for a more complete description.:7
- Abdominal aortic aneurysm ultrasound screening
- Colon cancer screening at age 45; traditionally, a colonoscopy
- Diabetes test for men older than 45 or who have a body mass index above 25
- High blood pressure test, every two years
- High cholesterol blood test every 5 years
- Lung cancer low-dose CT scan for adults 50-80 who smoke 20 packs per year or more.
- Prostate cancer check starting at age 50
By the way, Steve Jobs originally went to see a doctor for kidney stones. His urologist urged him to have an abdominal CT scan, which revealed a shadow on his pancreas. The diagnosis was a less aggressive form of pancreatic neuroendocrine tumor (pNET). Jobs resisted surgery, relying on diet and alternative forms of treatment, but nine months later, a scan showed the cancer had grown and spread. He finally consented to surgery and other treatment. Jobs died of pancreatic cancer in 2011.
Avoidance and non-compliance are leading to changes in health care today. Per an article in the Wall Street Journal, hospitals are beginning to create centers, often led by their urology departments, to provide male-focused care in a more welcoming environment.8 A visit to the urologist is often first, but the physician can identify other potential issues and refer patients to an appropriate specialist. Medical centers are also designing setups to make it easy to make appointments in one place, rather than in multiple locations to see specialists. “At Cleveland Clinic’s Center for Men’s Health, patients can schedule appointments with multiple providers, such as a cardiologist, endocrinologist, dietitian and urologist, all at the same visit.”9
Men’s health centers also aim to get men to avoid risky practices—such as relying on websites that offer erectile dysfunction drugs without evaluation by a doctor, and unnecessary testosterone treatments. At the same time, video consultations with legitimate practitioners can remove the need to see a doctor face-to-face, alleviating the “too busy” rationale and motivating men to seek help sooner. And according to the American Academy of Family Physicians, a spouse or partner significantly influences whether or not a man goes to a doctor. “To overcome men’s reluctance and remove the stigma of seeking care, health-care organizations have launched social-media campaigns and outreach efforts targeting both men and women.”10 Family matters.
- https://www.heart.org/en/news/2021/06/15/misguided-masculinity-keeps-many-men-from-visiting-the-doctor
- https://www.healthpolicypartnership.com/itll-get-better-on-its-own-men-and-their-resistance-to-seeing-a-doctor/
- Ibid
- https://www.nytimes.com/2023/03/03/well/live/men-doctor-visits.html
- Ibid
- Ibid
- https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/mens-health-checkups-and-screenings-are-key
- https://www.wsj.com/articles/why-men-wont-go-to-the-doctor-and-how-to-change-that-11556590080
- Ibid
- Ibid