The PSA Conundrum: Test or Die

The PSA Conundrum: Test or Die

Patient Imperatives in the face of professional controversy

Patient Imperatives in the face of professional controversy

Virgil SimonsFounder & PresidentThe Prostate Net, Inc.®

What are the odds…What are the odds…

Of dying after being physically attacked - 1:7,336,000

Of being struck by lightning - 1:835,500 Of dying in a plane/train/car accident -

1:6,279 Of having a heart attack - 1:53 Of dying from prostate cancer - 1:36 Of getting prostate cancer - 1:6

Source: The Book of Odds; American Cancer Society

Of dying after being physically attacked - 1:7,336,000

Of being struck by lightning - 1:835,500 Of dying in a plane/train/car accident -

1:6,279 Of having a heart attack - 1:53 Of dying from prostate cancer - 1:36 Of getting prostate cancer - 1:6

Source: The Book of Odds; American Cancer Society

Early Disease Detection Barriers

Early Disease Detection Barriers

U.S. vs European conflict on screening No consensus among U.S. agencies Lack of “Risk” determination Compared to Women:

Men are less likely to utilize the health care system Men are less likely to carry health insurance More likely to delay seeking healthcare

U.S. vs European conflict on screening No consensus among U.S. agencies Lack of “Risk” determination Compared to Women:

Men are less likely to utilize the health care system Men are less likely to carry health insurance More likely to delay seeking healthcare

Defining Barriers to Men’s Participation in

Healthcare

Defining Barriers to Men’s Participation in

HealthcareAttitudinal Barriers

Gender Role Stoicism Work Role StoicismDistrust of the Health Care SystemFatalism: “you’ve got to die of

something.”Maladaptive Self-Reliance: “A ‘man’ takes

care of his own problems.”

Attitudinal BarriersGender Role Stoicism Work Role StoicismDistrust of the Health Care SystemFatalism: “you’ve got to die of

something.”Maladaptive Self-Reliance: “A ‘man’ takes

care of his own problems.”

Health Care Utilization, Gender and Age

Health Care Utilization, Gender and Age

No regular physician by age

Age Men WomenAll 33% 19%

18-29 53% 33% 30-44 38% 22% 45-64 24% 13% 65+ 10% 6%

- Source: Commonwealth Fund (2000)

No regular physician by age

Age Men WomenAll 33% 19%

18-29 53% 33% 30-44 38% 22% 45-64 24% 13% 65+ 10% 6%

- Source: Commonwealth Fund (2000)

Primary Care ImpactPrimary Care Impact

• Decline in doctors entering into Primary Care Medicine

• Resistance to greater use of nurse practitioners

• Continuing shortage of nurses

• Closing of ER’s

• Resistance to “Convenient Care” clinics

• Decline in doctors entering into Primary Care Medicine

• Resistance to greater use of nurse practitioners

• Continuing shortage of nurses

• Closing of ER’s

• Resistance to “Convenient Care” clinics

Economic Effects on Society of Male Health

Disparity

Economic Effects on Society of Male Health

Disparity

Lost time from work Former taxpayers may become tax burdens Possible inability to maintain gainful

employment due to chronic illness Poverty is strongly associated with widowhood Children also may face financial repercussions.

Lost time from work Former taxpayers may become tax burdens Possible inability to maintain gainful

employment due to chronic illness Poverty is strongly associated with widowhood Children also may face financial repercussions.

So…what’s the answer

So…what’s the answer