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‘You don’t have to be sick to see a GP’


Morgan Liotta


11/06/2024 3:16:12 PM

This Men’s Health Week, a GP with a special interest says normalising consistent health checks with a regular GP is key to improving outcomes.

Man talking to male GP
Men are less likely to engage with healthcare services, including seeing a regular GP.

In Australia, men are less likely than women to seek healthcare services and have a regular GP.
 
This is despite men having a shorter life expectancy than women and dying more often from preventable causes, such as suicide, as well as from disease burden. Engaging in risky health behaviours such as substance abuse is also more common among men.
 
The importance of regular health checks is taking centre stage during this year’s Men’s Health Week (10–16 June), with public messaging reinforcing their importance for the early detection of chronic disease, mental health concerns, and other ailments.
 
But before any of this happens, the man needs to have a GP they trust, according to Dr George Forgan-Smith, a Melbourne GP with a special interest in men’s health.
 
‘Men’s health checks are secondary to men actually getting a regular GP – not just somebody who gives them a certificate when they need a day off work or gives them antibiotics because they have an infection,’ he told newsGP.
 
‘The first priority is that everybody, men included, should have a regular GP, because that way we can stay on top of everything.’
 
Australian males lose more healthy years of life from dying prematurely (54%) than from living with disease and injury (46%), and 49% have one or more of the top 10 chronic conditions. Men are also more than three times as likely as women to die from suicide, and more likely to drink alcohol, smoke tobacco and use illicit drugs.
 
Dr Forgan-Smith said having a regular GP is the first step in preventive health and ongoing harm minimisation. Making regular checks part of normal conversations is key, he says.
 
‘Men aren’t particularly used to going to see their GP, but by having somebody who knows them it means they can have the screening that is required at the time,’ he said.
 
‘You don’t have to be sick to see a GP. But it can be a regular part of your life … to go in and just get simple things checked and make sure everything is okay.
 
‘This applies across the board, but we need to encourage more men to participate in that process.’
 
Incorporating simple interventions like blood pressure checks into their routine and building a long-term relationship with their doctor are things Dr Forgan-Smith would like to see more for his male patients.
 
‘I would love it if at least once a year everybody, men included, would go in to see their GP, get their blood pressure checked, have a listen to their lungs, have a listen to their heart, discuss any issues that are worrying them,’ he said.
 
‘But also, it’s an opportunity for people to be able to have opportunistic screening, like immunisations, as needed.
 
‘We need to get men better trained that it’s normal to just go in and have a chat and get your blood pressure checked. It’s very easy to incorporate into a busy schedule … and I would encourage all doctors to consider, “What’s one simple intervention I could add into this [consult] to make it worthwhile for my patient?”.’
 
While telehealth is a ‘helpful and convenient option’ for some, Dr Forgan-Smith says there are limitations to the benefits a face-to-face consult can provide.
 
‘There’s a lot of stuff you can’t easily do over the phone, for example a blood pressure check,’ he said.
 
‘Currently there is that limitation that you can’t do a Medicare rebate of telehealth unless you’ve seen the person physically for a certain 12 months, and that’s not necessarily a bad thing – it is to try and encourage people to physically get their butts in to see the doctor.
 
‘When you see a person on a regular basis, you learn what they’re like in their normal state, which makes it easier to identify when they’re not in their normal state.
 
‘So to reinforce the idea that by having the same GP you see on a regular basis, they do remember stuff. I remember stuff even if it’s been a year since I’ve seen a patient … and it’s an opportunity to check if any circumstances may have changed.’
 
Heart disease, dementia, mental health and substance use disorders are the leading causes of disease burden for Australian men. In addition, fewer than one in 30 men eat enough fruit and vegetables, and only one in four are not overweight or obese.
 
It is estimated that 43% of Australian males have experienced a mental health problem at some point in their lifetime, but many don’t seek help, including with a GP or other healthcare provider.
 
Acknowledging this, Dr Forgan-Smith has an ‘open-door policy’ for his practice room.
 
‘I would encourage men to consider the GP as part of their team, who is there to help ensure they get through, to keep on moving forward in good health,’ he said.
 
With a special interest in mental health and gay men’s health, Dr Forgan-Smith says his patients from this demographic require targeted healthcare interventions which can be done as part of regular conversations.
 
‘Because of my work in gay men’s health, I see my patients on a much more frequent basis because they’re coming in for PrEP prescriptions, or they’re coming in for a review of their HIV,’ he said.
 
‘So I don’t just do a PrEP appointment, I do a mental health check and a, “Hey, while you’re here let’s quickly go through your medications. Which ones are you currently taking and which ones can I remove from the system because you don’t need them anymore?”
 
‘It helps me keep accurate data. Then, after the medicines I’ll say, “Let’s check your immunisations – are you up to date? Have you had a flu shot or COVID vaccine this year?”.’
 
Additionally for this demographic of patients, Dr Forgan-Smith wants to raise awareness of HPV vaccines.
 
‘We have a generation, maybe two generations, of men who have not been vaccinated for HPV,’ he said.
 
‘For my gay clients, not being vaccinated for HPV means they have a 40 times risk of developing anal cancer and 100 times that risk if they are HIV positive. But for heterosexual men, not being vaccinated for HPV puts them at higher risk of head and neck cancers.
 
‘So I would encourage people to consider getting HPV vaccination as well. We missed two generations of men previously, because it was expensive and that was believed not to be useful for them, but now we know it actually is. And that can be done with a GP.’
 
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