3rd Annual Jefferson Urology Symposium: Men’s Health Forum

© The Canadian Journal of Urology TM : International Supplement, August 2020 Differences in behavior between men and women lead to discrepancies in healthcare needs andutilization. Healthcare avoidance behavior prevents men from seeking screening tests which can diagnose diseases in their early stages and reduces healthcare cost. 1 The unique healthcare seeking behavior of men requires targeted outreaching and health programs to meet their health needs. Programs which target specific groups of men have been shown to be effective if the information is perceived to be individualized and if the medical staff fosters autonomy and shared decision-making. 6 Robinson et al examined the efficacy of targeted men’s health program and note that an important factor for success is the personalization of information to make it relatable to men at different stages of their health journey. This personalization can be achieved by including: resources to support men’s social interactions, encouraging support from peers, promoting ownership over information, and providing support for shared decision-making. 6 Even though many studies have examined the need for a Men’s Health Program, few studies outline the process of developing one. In this article, wewill discuss our experience with creating aMen’s Health Programat Thomas JeffersonUniversityHospital to serve thediverse population of Philadelphia and the Greater Delaware Valley. Urology as a gateway to health Urology may be viewed as the portal into overall male health. 7 Men aremore likely to see anurologist for sexual and urinary dysfunction than see their primary care physician for routine healthcare visits. Aurology office visit should be seen as an opportunity to evaluate aman for risk factors suchas cardiovasculardiseaseanddiabetes which can be discovered during workup of erectile dysfunction. 7 Recognizing the need for an organized approach to Men’s Health, The American Urological Association (AUA) established a Committee on Male Health with the goal “to promote lifelong male health, wellness, and disease prevention through integration of expertise fromurology andother healthcare specialties.” 8 The committee then developed the AUAMen’s Health checklist as a guide to men’s health based on age. The checklist includes age based recommendations for health maintenance, health screening and cancer screening to be utilized by urologists and primary care providers. 8 Our population According to the 2017 US Census, the Greater Delaware Valley ranks as the eighth largest in the nation, numbering 7.2million people. The city of Philadelphia, the region’s economic center, has 1.6 million residents. 9 Data would support a city-wide incidence of erectile dysfunction of 120,000 and a regional incidence of 450,000 men. 10 The Olmstead County Survey found 17% of men age 50-59, 27% of men 60-69, and 37% of men 70- 79 years of age have symptomatic BPH which deserves diagnosis and treatment. 11 The American Heart Association estimates nearly half of Americans have heart disease. CDC data from 2015 showed that 10.8% of adults older than 20 years of age living in Pennsylvania suffer from diabetes, 28.6% suffer from obesity, and 37.9% suffer from heart disease. 12 With such prevalence of urological and non-urological conditions, it is necessary to address the healthcare needs of our population in a holistic approach that ensures patients’ compliance. Prior to the creation of our health program, Philadelphia and surroundings lacked a multidisciplinary Men’s Health Program. Many different types of men’s programs exist. Some are devoted entirely to the diagnosis and management of erectile dysfunction; other programs focus on research. At Thomas Jefferson University, the goal was to develop a multidisciplinary program which focuses on a comprehensive approach toMen’s Health, emphasizing Urology, Cardiology, Endocrinology, Primary Care, Sports Medicine, and Sleep Medicine. Each department at our institution offers a full complement of subspecialistswho are able to respond to an individual patient’s needs, regardless of complexity. For example, within theUrology section of the Program, we offer care in reconstruction, erectile dysfunction, infertility, voiding dysfunction, and oncology. Using the AUA Men’s Checklist as a guide, we developed baseline diagnostic studies for new patients enrolled in the program. Birth of the men’s health program A needs assessment targeting the Greater Delaware Valley was performed with the assistance of a consulting group. The analysis included the volume of patients, established competitors, and insurance demographics. A business plan was developed in strong collaboration with University administration. Of note, our administration provided invaluable support throughout the program’s creation, and continues to help insure its success. Cooperating physicians in each of the key areas were identified who would represent the perceived areas of greatest patient need, i.e. erectile dysfunction, voiding dysfunction, cardiovascular disease, diabetes, sleep apnea, sports related injury prevention and Weiner AND Salib 52