Men’s health: A forgotten topic
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).