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    Men’s health: A forgotten topic

    Henry Rosevear, MDHenry Rosevear, MD

    UT Blogger Profile

    Dr. Rosevear is a urologist in community practice in Colorado Springs, CO.


    While it may surprise some, my time as a junior officer on the submarine USS Pittsburgh (SSN 720) has served me well in my current profession as a urologist. And I’m not talking about the bad joke I use when patients ask about the transition (“It was an easy transition from working on one tube of seamen to another”); rather, I’m talking about the life lessons. The lesson that seems most appropriate now is the phrase “overcome by events.” Overcome by events is an expression designed to explain how the hours that we spent making intricate plans suddenly changed when presented with the facts on the ground.

    When it comes to men’s health, the upcoming changes to the health care system, whatever they may be, may make my complaints about the forgotten topic of men’s health overcome by events. Regardless, let me give you a few examples of how current policymakers, insurance companies, and certain health care providers seem to have a total disregard for men’s health.

    Also by Dr. Rosevear - The ‘post-truth’ world: How it’s drifting into medicine

    Let’s start with the policymakers. One of the provisions buried in the Affordable Care Act was a requirement that birth control be a covered benefit. For women, that is. Do you realize that vasectomies are not required to be covered? The argument that somehow women should be able to have their birth control covered but vasectomies are not strikes me as short-sighted at best and sexist at worst. I'm not the only one. Numerous organizations are pressing both the federal government and their respective states to broaden this coverage.

    The issue is even making the national press. This is probably a moot point at least on the federal level. While I am still unclear on exactly what President Trump is going to do with health care, I somehow doubt that expanding the federal government's role is high on the list of possibilities. But if we needed an example of federal disregard for men’s health, we need to go no further than this.

    How about the insurance companies? It’s no secret that their purpose is to make money. Further, while the limitations of PSA testing are well known, the prevalence and seriousness of the disease is also well documented. As such, when talking to patients with elevated PSAs who are curious about what to do next, many options exist. One such option is a multiparametric MRI of the prostate. I will concede that it would be inappropriate for me to claim that it is standard of care for all patients with an elevated PSA before proceeding to biopsy, but the data behind such a treatment algorithm is becoming stronger (here is one recent important journal article on concept).

    Next: "Not every patient can afford a $1,000 MRI out of pocket."

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.

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    • Anonymous
      Dr. Rosevear, men's healthcare suffers not only over cost but over getting same gender care where intimate tests and procedures are concerned. The Urology field is a prime example. Many men are foregoing needed healthcare and dying young simply because they've had prior dealings with the healthcare industry, have seen the way the system treats men's privacy and modesty and they simply refuse to just hand over their dignity to the system anymore. Fool me once same on you. Fool me twice same on me. A woman gets her annual mammogram. She's NOT going to have a man doing the x-ray. The medical community has seen to that. There are very few if any men that hospitals allow to do the mammograms. Now lets look at a man. His urologist wants him to get a male related test. His urologist doesn't explain ahead of time how the test is done & who performs the test. More than 95% of men will have their testing done by and in front of women. For many many men, this is unacceptable. All the medical community ever says to the guys is "you don't have anything we haven't seen before." Maybe you have seen it all before but we haven't done this before and we choose NOT to have it done by or in the presence of women. What is the healthcare system doing to address this problem? Are urology departments hiring more male nurses since the majority of urology cases are men or are they going to just keep totally embarrassing men. The system needs to better respect a man's privacy/dignity/modesty concerns. They do it for women without even thinking about it. Or is it the medical community just doesn't care if a few men needlessly die because of the way the medical community treats them. It's time for the medical community to put the same thought and effort into respecting their male patients as they do to their female patients. Regards, Raffie