Older men more critical of advice from family doctors

Family doctors in Quebec and across Canada are out of sync with the medical concerns of middle-aged and older men – a problem that could be undermining their health, suggests a new national survey.

Although many general practitioners address the persistent issue of medication side effects, they often gloss over other pressing concerns like memory loss and mobility impairment, according to the survey.

“There’s definitely a gap between what men expressed as being of most concern to them and the response they perceived to be getting from health-care providers,” said Dr. Cara Tannenbaum, author of the study.

“I once asked a patient to discuss problems he was having with his incontinence, and he said he didn’t talk about it because he was told it was normal for his age. So if it’s being dismissed, they don’t want to bring it up again.”

Tannenbaum, a geriatrician at the Institut universitaire de gériatrie de Montréal, polled 2,325 men, aged 55 to 97.

Her study followed a 2005 survey of older Canadian women that was published in the Canadian Medical Association Journal.

The survey on men found that 13 per cent believed that doctors addressed their concerns about mobility impairment. Nine per cent said doctors discussed memory loss with them.

The survey observed that the top three medical concerns of men are the same as those of women: mobility impairment, memory loss and medication side effects. However, 88 per cent of women identified those issues at their top three health concerns, compared with 64 per cent of men.

This may be due, in part, to socialization of men that prizes toughness over expressing one’s feelings. In another study by Tannenbaum, she discovered that men often use military metaphors when discussing their health.

The survey also found that 61 per cent of men were concerned about vision loss, 52 per cent about hearing loss and 51 per cent about falls.

The survey did contain some good news: More than 80 per cent of respondents said they had been provided with sufficient information, screening and treatment about serious health problems like stroke, heart disease, diabetes, pneumonia and prostate ailments.

Tannenbaum recommended a “paradigm shift” in the way that health care is delivered, with more emphasis placed on prevention and counselling than treatment of chronic medical symptoms.

She noted that Quebec doctors receive a bonus for spending more time with patients over the age of 85, when in fact, the average Canadian life expectancy for men is 78. She recommended that the bonus be given to doctors for male patients who are at least 70 years old.

aderfel@montrealgazette.com

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