Preventative Medicine in Mens Health

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Preventative Medicine in Mens Health

• Michael J. App M.D., M.P.H
• MMPC Internal Medicine and Pediatrics

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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

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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.

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• 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)

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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.

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• 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.

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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.

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• 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 JuneDecember 2005 is High Blood
  Pressure.

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• More likely to adhere to recommended
  treatment and follow-up.
• Greater appreciation of the impact for new
  treatment on the patients health.
• Women are good patients.

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• 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.

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• 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 beliefs, attitudes, values and self
  perception of your health and what you want it to
  be.
• These all make the difference.

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• 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.

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• 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.

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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.

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• QUESTIONS ?????