This is Mike. Three years ago, Mike had some digestive issues. After months of misery, Mike finally tried the Whole 30 diet. He felt much better. Mike decided to radically change his lifestyle at the age of 55. He eats only whole, clean food. He just ran his first half marathon.
Two months ago, Mike's digestive issues were back with a vengeance. At first he thought it was the new, raw milk farmer he had contracted for weekly deliveries. But he stopped drinking the milk, and his troubles persisted. Finally, at the repeated request of his girlfriend, Mike saw a doctor.
He has stage IV colorectal cancer.
This is Jensen.
He is a young, successful businessman. He wakes up at 6 a.m. every day to work out.
He calculates his macros in an app on his phone daily. He manages stress with afternoon meditations. He never goes to the doctor because he is the healthiest guy he knows.
One morning his coworker noticed that the side of Jensen’s neck was swollen. Jensen ran to the bathroom to look and then spent the rest of the day Googling possible causes. Finally, deciding it must be a benign muscle strain caused by weight lifting, Jensen decided to wait and see.
Two days later, Jensen was rushed to the hospital, having collapsed. He was in septic shock.
This is Chris.
He's a semi-active father of three who eats pretty well and works out 3-4 times a week in addition to playing golf (though let’s face it, the beer probably cancels out any exercise he did there). He’d like to lose 20 lbs. or so, but he’s about par for the course at the neighborhood pool.
One year ago, Chris started having bad stomach pains. He was suffering daily. He stopped working out at all. He even stopped playing golf. He became depressed. Finally, after daily fights for months, he went to the doctor to stop his wife’s nagging.
It was simple. He had gallstones. After the surgery, he felt amazing and couldn’t believe he hadn’t done it sooner.
Just about everyone knows a man with a story like these, and yet 60% of men still don’t go to the doctor – not even when they think it could be serious. There is plenty of messaging out there prodding, guilting and putting fear into men over not going, and it isn’t working. Are they a lost cause?
The short answer is: they do. Even in the three examples above, Mike, Jensen and Chris all took measures to take care of themselves. All three exercised, all three were aware of their food and at least attempted to eat well.
Statistically speaking, men are twice as likely to exercise as women. They read mainstream publications pushing healthy foods. They use fitness trackers. They just don’t go to the doctor.
Several theories are often posed as to why: is it that men “feel invincible – like it will happen to “someone else” and not them”? Is it a macho thing?
Maybe in part.
But the truth is, no one likes going to the doctor even when they know they should – men or women or children. On this Reddit thread asking men directly why they don’t get in for medical care, none of them said “because I rubbed some dirt in it and it was fine.” Here are some excerpts of what they did say:
- Why are people who are at the bottom of the work totem pole never bending their inflexible schedule or wasting precious time off to go to the doctor to pay them $400, wait 2 hours, then have the doctor spend 5 minutes prescribing a tube of f**ing cream?
- And then having to schedule two more consecutive appointments because the doctor didn't just listen to you the first time and misdiagnosed you. Then guess who is still on the hook to pay the bill for several appointments even though it was the doctor’s screw up?
- F***ing overbooking - if my appointment is at 11:30, see me at 11 f***ing 30. If you wait longer than 30 minutes beyond your appointment time, your visit should be gratis.
More formally, according to this study of both men and women:
Three main categories of reasons for avoiding medical care were identified. First, over one-third of participants (33.3% of 1,369) reported unfavorable evaluations of seeking medical care, such as factors related to physicians, health care organizations, and affective concerns. Second, a subset of participants reported low perceived need to seek medical care (12.2%), often because they expected their illness or symptoms to improve over time (4.0%). Third, many participants reported traditional barriers to medical care (58.4%), such as high cost (24.1%), no health insurance (8.3%), and time constraints (15.6%).
The truth is, both men and women consistently report that they don’t receive personal, responsible care from physicians with revolving doors, high prices, little accountability, ineffective treatment and “Google result” diagnoses that come from judging patients by the numbers instead of the individual.
While it could be argued that it is more “socially acceptable” for women to see physicians than men, that probably wouldn’t be enough motivation for them to endure the same bad experiences with physicians cited above. Women don’t go to the doctor simply because “they can.” No one goes to the doctor unless they think they need to.
According to Kate Brett, lead study author and senior research scientist at the National Center for Health Statistics as quoted in this article:
Women are conditioned from an early age that preventive care -- such things as Pap smears -- are an essential part of women's health, whereas men's preventive care -- such things as recommended annual check-ups -- don't really start until middle age. And women are going to the doctor much more often for acute care, much more than men for such things as colds, the flu, the upper respiratory illnesses.
Amy Allina, program director for the National Women’s Health Network, adds:
It may be that women have already established a relationship with a health-care provider. Certainly women get early training in going to a doctor, often because they are seeking contraception and because they are advised that annual gynecological exams are important for their health. So when they are ill or they need preventive care, it's less of a hassle to go to a health care provider.
Both of these women note that because women in general are more dependent on doctors for preventive care at an early age, they are socialized to seek medical advice from puberty on, whereas men generally wouldn’t need established preventive care until middle age:
If you’re young and healthy, you may not need to visit your health provider as often as you think, as long as no problems arise. Men under 35 who feel good, are generally healthy, and have no family history of serious illness can likely skip annual physical exams and see their providers as needed.
Additionally, there are more established medical initiatives accommodating women than there are for men. According to this survey:
A considerable disparity exists between the prevalence of gender-specific health services, with WHCs being much more numerous than MHCs. All but one leading institution had WHCs compared to less than one-third having MHCs. Our findings also highlight the heterogeneous nature of men's health programs, as they exhibit great variability in program type and focus, yet are all being marketed under the “Men's Health” banner.
On the surface, very little. Short of fabricating a disease that affects young men in the same way that reproductive health affects young women, doctors don’t have a way of conditioning men to seek doctors in the same way women do. Moreover, men’s health centers and initiatives likely won’t improve until the audience (i.e., men who go to the doctor regularly) is established. And we have already pointed out that guilt, nagging and fear are not good motivators for men in general, as that messaging already exists.
But just because men cannot be conditioned in the same way does not mean that health care cannot be made more accessible to them. Here are some ways men could be influenced:
- Put health care in easy reach. As one user stated on the afore-mentioned Reddit thread: “Put it near a mechanic and I'll get my oil changed while I am being seen, and I'd go every 6,000 miles.” Keep your offices open when theirs are closed. Stick to appointment times. Maybe even consider concierge services and go to them.
- Offer more personalized care related to their interests. As mentioned above, men exercise more than women. Post health care messaging at the gyms where men are already considering their health – let them know that staying strong means staying in the game.
- Simplify the experience. Women overcome the general obstacles to health care because they have the advantage of experience with a complicated system. Men are, by comparison, laymen. Billing should be presented in the most simple terms, decisions and diagnoses should be clearly explained, patient portals should be easy to access. Women would not complain about these improvements, either.
- Be accountable. Accountability means establishing trust. With any other brand in any other field, Marketing 101 says admitting your mistakes in the short term is the key to the long game with consumers. Doctors tend to rely on the idea that people will always need them. This is generally true for women, as they usually must rely on doctors for years regarding their reproductive health at the very least. But for men who need them less, there are no shortcuts to establishing that relationship.
- Offer promotions that target men and inspire them to come back. Open your clinic on a Saturday and offer free physicals by appointment. Limit those appointments. Take the time to get to know every guy who comes in for an exam. Make him feel like you are his doctor, personally.
- Create partnerships with local brands and businesses with strong male followings. This goes along with putting health care in reach, promotions and personalized care – have a presence in gyms, coffee shops, restaurants and grocery stores. Making preventive care feel like an organic part of their lives and lifestyles.
Ultimately men need to feel included and seen by the medical community before they will learn to seek doctors as a solution to their problems. By implementing the above strategies, a relationship can be forged that will hold up to some of the inevitable downsides to health care.