Preventative Medicine in Men’s Health

1. Preventative Medicine in Men’s Health Michael J. App M.D., M.P.H MMPC Internal Medicine and Pediatrics

2. Terminology I. Primary Prevention: Prevents the disease from occurring. e.g. Smoking cessation; the risk of lung cancer. Eating Healthy Foods;the risk of CAD/Heart Disease

3. Prevention • Secondary Prevention: detects disease once it has begun but before it has appeared clinically. e.g. PSA and Colorectal Screening III.Tertiary Prevention: seeks to stop further complications after a disease has become clinically evident.

4. Prevention has now become a central theme of patient care. In the last 20 years there has been a consistent growing demand for preventative services by both Insurance Companies, Patients as well as Gourmet Agencies. (USPHS – Healthy People 2000)

5. Goals of Primary Care Physicians • Rules to follow: Discover and interpret risks to health Effectively communicate this information to patients. Assist patients in desired behavior changes.

6. 50% of mortality can be traced to alterable behavior (lifestyle). Early detection and treatment of several common disorders-HBP, DM, Hyperlipidemia have shown to dramatically reduce morbidity and mortality from these disorders.

7. Go to the Doctor!!!!!!!! • Who goes to the doctor and who do they see? 700 million office visits (2006). 51% Primary Care Physicians 49% Sub Specialist 60% of all visits to primary care physicians are made by female patients.

8. Why the difference? Women vs. Men. Greater emphasis on the significance of a recent symptom. More likely to initiate a referral for a general medical examination. Most common reason for women to see PCP for an office visit June–December 2005 is High Blood Pressure.

9. More likely to adhere to recommended treatment and follow-up. Greater appreciation of the impact for new treatment on the patient’s health. Women are good patient’s.

10. Overcoming barriers to care? Only recently has the organization of Medicare begun to emphasize prevention over treatment, but many men still hold the view of treatment over prevention. Choose a PCP and schedule a baseline history and physical exam if you are new to the practice.

11. Ask specifically about preventative measures that would be appropriate for you based on your age, nationality, and your risk factors. If you are very healthy…..GREAT!!! Still establish a baseline exam as a problem focused visit so that you may outnumber preventative visits 6 : 1. Motivate yourself in good health with your positive belief’s, attitudes, values and self perception of your health and what you want it to be. These all make the difference.

12. Guidelines for routine Health Maintenance for Men. Complete and History and Physical annually. (Especially important after the age of 40). Lifestyle declination to your physician. e.g. Advance directives, Alcohol / Drug Use, Regular Exercise, Limit Sexual Partners, and Tobacco Abuse.

13. Immunizations e.g. Td (tetanus), Influenza, Hepatitis A and B, MMR, Pneumovax, Menactra, Zostavax. Laboratory/Procedures e.g. Cholesterol, Stool blood cards, Colonoscopy, Dexa Scans, Cardiac Stress Testing, Digital Rectal Exams.

14. Closing Remarks The Patient, not the physician, truly initiates preventative care. Preventative care protects health prospectively. “An ounce of prevention, is worth a pound of cure”. Establish a Doctor – Patient relationship, with mutual understanding and participation. Schedule your physical. Schedule a new office visit for prevention.

15. QUESTIONS ?????