Men are out of sorts and out of the surgery

Published on Wednesday 11 June 2008 10:28

Men are four times less likely to go to their GP than women, despite suffering significantly worse health. So why won't men take their own health more seriously?

HAVE you ever noticed how so many blokes moan and groan when they are ill as if they have the worst symptoms in the world?

Yet, when a visit to the doctor is suggested, they suddenly clam up and are determined to soldier on with their agony alone. It's been said that one reason men don't go to their GP is because surgery hours aren't male-friendly and they can't get time off work.

But the evidence is that there is still a macho culture which makes some men reluctant to seek help for their problems. During national men's health week, the charity Men's Health Forum is trying to raise awareness of such issues.

Mark Ward, national coordinator of Men's Health Forum Scotland, says men are four times less likely to go to their GP than women.

He says: "They will hang on till the last minute before going to seek help. A lot is to do with how men are perceived. The traditional things we attribute to men – being strong, independent, able to look after themselves – run counter to being able to seek help and support.

"By beginning to address those stereotypes and what it means to be a man, we make it easier for men to engage with health services."

Women tend to have better relationships with their doctors, seeing them for contraceptive advice, during pregnancy and with their children. They also attend surgeries for baby clinics, breast screening and cervical smears.

Dr Dean Marshall, a GP in Dalkeith for 14 years, doesn't buy the argument that health services aren't set up for men. "That's true to a certain extent, but I think it's a lot to do with men being unwilling to face up to things. I frequently get men dragged in by their wives.

"Men frequently don't consider their own health and when they have a problem put their head in the sand a bit. I just think it's the way men are. It's a male thing rather than a Scottish or UK thing."

One way that has been suggested to get men to seek medical help is by offering healthcare in the workplace. Dr Marshall is not wholly convinced.

"A lot of problems I see with men are things related to their work and I think it's unlikely men would address that at work. For example with alcoholism there'd be lots of concerns about confidentiality.

"For general health checks, perhaps a nurse in work would be effective, but it wouldn't address all the problems."

The recent commencement of evening and early morning surgery hours is another route supposed to make it easier for working men to see a doctor. But, again, Dr Marshall is sceptical that it will solve the problem. "It's just started and I'm already hearing people aren't taking up the appointments offered.

"It sounds like a good idea, but I think it's a change in culture that's needed. The bottom line isn't about access – it's the way men think and the way they are.

"The message is getting through to the younger men. The problem is with those who are 40 and above who are set in their ways.

"Men often put everyone else before themselves. That's the way you're brought up in some cultures, to be the breadwinner."

When we imagine men's health issues, we tend to think of things like prostate and testicular cancer, and mental health problems, with men accounting for 75 per cent of suicides.

Dermot Gorman, NHS Lothian consultant in public health, says there is an even wider range of issues to consider.

A new screening programme for bowel cancer, for instance, is a step in the right direction. The programme began last month with home-testing kits being sent to men aged 50-74.

Another NHS Lothian initiative expected to impact particularly on men's health is its efforts to take smoking cessation classes into the workplace. Among the places to be targeted are various factories and the Royal Mail depot at South Gyle, all of which have largely male workforces.

Mr Gorman says: "There are some places men congregate where we try to intervene. Health is not generally about going to the GP, it's about encouraging people to lead a healthy lifestyle."

Perhaps there lies the crux of the problem. If men led healthier lifestyles to begin with, they might avoid some conditions that need medical help.

Mark Ward adds: "An important message to get out to men is that improving and maintaining good health doesn't have to mean you radically change every aspect of your life. Doing small things on a regular basis can have a massive impact. Not smoking, drinking responsibly, eating a healthy diet – there's a lot of benefit to be had without a major effort."

Until we have a major culture change in which men feel it is socially acceptable to ask for help, we may just have to smile and pass them the painkillers.