ABSTRACT
According to literature, women on average use physician services much more often than men, both in regular appointments and in ambulance related care, leaving men at a serious lack of reporting of health problems. This report, meant for the Department of Health, details the reasons behind this kind of behavior, and gives possible solutions for increasing the rate at which men go to the doctor. The reasons for this development include sociological and psychological factors, such as the male need to seem self-reliant and to have a higher tolerance for pain. The fixed role hypothesis also says that, usually, women have more free time to attend physicians, much more than men can . Recommendations for increasing male attendance in physician services include teaching the importance of regular checkups and being honest about male pride and its effect on physical health.
INTRODUCTION
The Department of Health has requested this report in order to look into sex differences in health care for example, how men do not go to the doctor as often as they should. Sex differences in going to the doctor is a big trend in the medical community; many different psychological factors come into play that leads to the pattern of women using the services of doctors much more than men. Studies say that 64% of doctors visits are usually from women, and they report a higher number of anxiety, depression and emotional problems than men (Tabenkin et al., 2004). According to statistics, women manage to use primary care facilities far more than men do.
The following graph compares the overall rate of ambulatory care visits between men and women:
(CDC, 2001)
Except for surgeries and emergency care, men use ambulatory care much less often than women do. This can leave men to not get as much preventative care; many different factors come into play in male attitudes and male culture that lead to them feeling as if they do not need to go to the doctor. Given the basic lack of interest in seeking out medical care, it is important to notice the effects this pattern can have on men's health, and what recommendations can be made to educate men on the importance of regular health care.
FINDINGS
1. THE FIXED ROLE HYPOTHESIS
The reasons for this trend are not entirely known, but there are many different theories presented in the proper literature. One of the most interesting is the idea of the 'fixed role' hypothesis, which states that "women report greater use of health services because, in the aggregate, they have fewer work and time constraints on their behavior, thus making it easier for them to reschedule activities in order to visit a doctor" (Marcus & Siegel, p. 186). As a result, there is a big part of the trend that can be explained as a simple lack of time because of the rate at which men work.
(CDC, 2007)
2. LACK OF MEN'S HEALTH KNOWLEDGE
Men's knowledge of health matters is usually not great, because of an intentional avoidance of medical science and a need to not admit problems - studies state "18% of men thought a GUM clinic dealt with dental problems, over 50% had no idea what a genitourinary clinic was, and most did not know which sexually transmitted diseases were becoming more common" (Banks, 2001). Men are more likely to do high risk behaviors, while still getting less medical advice about changing these risk factors; "only 29% of doctors routinely provide age appropriate instruction on testicular self examination" (Banks, 2001). As a result, men are often ignorant of the possible seriousness of symptoms, which continues as they get older. Men often 'normalize' symptoms in their head and attribute it to aging, instead of getting advice on that symptom (Adamson et al., 20110). These behaviors place men's health at great risk; the tendency to overlook or explain away potential health issues can often lead to potentially serious medical conditions.
3. SOMATIZATION OF SYMPTOMS IN MEN
Even when men do go to the doctor, it is possible that they do not report their symptoms correctly - this reporting of both men and women are vastly different, with women reporting more symptoms. While women focus on the situation, men focus on the feeling of the symptom itself (Wool & Barsky, 1994). This can leave them less equipped to describe and specify the situation to the primary care physician, leaving them less able to help. According to many, "men are less likely than women to actively seek medical care when they are ill, choosing instead to 'tough it out'" (Hunt et al., p. 108). This fear of seeking out medical care has terrible consequences for men's health; "the effects of heart disease, the greatest cause of early male death, and type 2 diabetes, with which one million people remain undiagnosed, could be reduced if the conditions were detected earlier" (Banks, 2001).
CONCLUSION
With these things in mind, greater help-seeking behaviors in men must be encouraged in order to improve men's health. The fixed role hypothesis may have a large influence in this discovery, as it states that women are simply given more free time to report symptoms and visit physicians, because of their average lack of things taking up their time. Given the amount of time men often spend at work and elsewhere, the reorganizing of life to make room for visits to the doctor is the only way the fixed role hypothesis could play a big factor in increasing the rate of doctor visits in men.
Basically, the tendency for men to avoid doctor visits is a sociological trait, due to deeply held concepts of pride and being 'tough.' These types of myths, though communication, honesty and education, must be fought in order to increase male involvement in their own health. By placing a bigger focus on health than on being tough, it may be possible for men to feel more comfortable with saying that they may need medical help. The basic trend of men using medical services less often than women is not due to a lack of care about health, but a fear about the problems they may have, and an anxiety about seeing them. Finding ways to relieve that anxiety by pushing for early detection (through regular checkups) can go a long way toward increasing male involvement in physician services.
RECOMMENDATIONS
* Education of men regarding importance of physician services
* Proper, age-appropriate education on testicular cancer examinations
* Steps to relieve male patient anxiety about potential illness during general practitioner checkups
* Make doctor visits more convenient for men with more time constraints
* Creation of pamphlets and literature meant to reassure men of importance of regular checkups
* Medical practitioner training to more accurately get true nature of symptoms from men, who may 'sugarcoat' symptoms
References
Adamson, J., Hunt, K., & Nazareth, I., 2010. The influence of socio-demographic characteristics on consultation for back pain - a review of the literature. Family Practice, 28(2), 163-171.
Banks, I., 2001. No man's land: men, illness, and the NHS. BMJ, 323, 1058.
CDC., 2001. Utilization of Ambulatory Medical Care by Women: United States, 1997-1998. Vital and Health Statistics, 13(149), 1.
Hunt, K., Adamson, J., Hewitt, C., & Nazareth, I., 2011. Do women consult more than men? A review of gender and consultation for back pain and headache. Journal of health services research & policy, 16(2), 108-117.
Marcus, A., & Siegel, J. M., 1982. Sex differences in the use of physician services: A preliminary test of the fixed role hypothesis. Journal of Health and Social Behavior, 23, 186-197.
Tabenkin, H., Goodwin, M. A., Zyzanski, S. J., Stange, K. C., & Medalie, J. H., 2004. Gender Differences in Time Spent during Direct Observation of Doctor-Patient Encounters. Journal Of Women's Health, 13(3), 341-349.
Wool, C. A., & Barsky, A. J., 1994. Do women somatize more than men? Gender differences in somatization. Psychosomatics, 35(5), 445.
