Transcript Document

July 2012
Young men & the GP: a shared anxiety?
Dr Matthew Booker
NIHR Academic Clinical Fellow in General Practice
Honorary Senior Lecturer in Medical Education
School of Social & Community Medicine
Name of Presentation
28 September 2011
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Some comments from young men about
pre sent. Ficimus apid modi blam sinvele ssiminvenda
access
to uta
GPdolorib
appointments
– interesting?
dolore
il etur,
pist.
Et “Access
pliqui te to
por
audipic imporatio
appointments
seemseverum
OK, butes
notvel
sure I
ideribusant,
comnis
estinvendit
would know
why I want
one?” volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
“Seems fine. I’m not someone who needs the
doctors though, so bit tricky to comment”
Name of Presentation
28 September 2011
What have these people done for Men’s
with
Ovit a ped ut relationship
et harumqui te et
quetheir
non GP?
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
Name of Presentation
28 September 2011
How does the role/perception of men (particularly
Ovit
a ped
ut etinharumqui
te affect
et queconsulting
non
young
men)
the family
pre
sent. Ficimus apid modi blam sinvele ssiminvenda
behaviour?
dolore il etur, uta dolorib pist.
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
Name of Presentation
28 September 2011
“Its all about cancer these days.”
Ovit a ped ut et harumqui te et que non
pre“Sooner
sent. Ficimus
or later,apid
the modi
more blam
times sinvele
you go, ssiminvenda
you
dolore
il etur, uta dolorib pist.
are going to hear something you don’t want to.”
Et pliqui te por audipic imporatio everum es vel
a nice
enoughvolori
chap, ditati
but he
doesn’t
ideribusant, “He’s
comnis
estinvendit
ipsam
num
half sinvelibea
hark on about
the negativity”
volo de volupta
conseditem
ipsam.
“Its all about risk. ‘Your risk of this
problem.... Your risk of that problem.’ I
don’t generally like taking risks!”
Name of Presentation
28 September 2011
Why do young men attend their GP?
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
Musculoskeletal
dolore il etur, uta dolorib
pist. (injuries)
Mood, sleep, depression, psych
Et pliqui te por audipic
imporatio everum es vel
Testicular (non-STI)
ideribusant, comnis estinvendit volori ditati ipsam num
STI
volo de volupta sinvelibea conseditem
ipsam.
Chronic Medical
Misc GU
Skin
MI
Name of Presentation
28 September 2011
Why do young men say they attend their GP?
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta
dolorib pist. (injuries)
Musculoskeletal
Chronic Medical
Et pliqui te por audipic imporatio everum es vel
Skin volori ditati ipsam num
ideribusant, comnis estinvendit
volo de volupta sinvelibea
conseditem
ipsam.
Mood,
sleep
Minor Illness
Abdo pain
Drugs
STI
Name of Presentation
28 September 2011
If we compare a selection of consultations, there are
Ovit a ped ut et harumqui te et que non
why?
pre differences….
sent. Ficimus apid
modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
Consultation code
Self-reported
Musculoskeletal
(injuries)
(injuries) imporatio everum
Et pliquiMusculoskeletal
te por audipic
es vel
Mood,
sleep, estinvendit volori ditati
ideribusant,
comnis
num
Chronicipsam
Medical
depression, psych
volo de volupta
sinvelibea conseditem ipsam.
Skin
Testicular (non-STI)
STI
Mood, sleep
Chronic
Medical
Colds and flu
Misc GU
Skin
MI
Abdo pain
Drugs
STI
Name of Presentation
28 September 2011
Ovit a ped ut et harumqui te et que
non
Chronic
pre sent. Ficimus apid modi blamMedical
sinvele ssiminvenda
Drugs
dolore il etur,Musculoskeletal
uta dolorib pist.
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
Mood
Dermatology
Testicular, STI,
GU
Name of Presentation
28 September 2011
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
Testicular disease as a ‘case study’
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
Is testicular cancer actually Name
such
a
of Presentation
headache?
28 September 2011
Ovit a ped
et harumqui
et que non
Lessutthan
1% of all te
cancers
pre sent.
Ficimus apid
modi 2k
blam
sinvele ssiminvenda
Incidences
of approx
mark
dolore il etur, uta dolorib pist.
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
Name of Presentation
28 September 2011
400
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
350
300
250
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
200
150
100
50
0
0 to 05 to 10 to 15 to 21 to 25 to 30 to 35 to 40 to 45 to 50 to 55 to 60 to 65 to 70 to 75 to 80 to 85+
04
09
14
20
24
29
34
39
44
49
54
59
64
69
74
79
84
Young Male’s GP Attendance Rates
Name of for
Presentation
28 September 2011
Chronic Medical Problems
0.9
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
0.8
0.7
0.6
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.
0.5
Asthma
Diabetes
0.4
Epilepsy
0.3
0.2
0.1
0
12y
13y
14y
15y
16y
17y
18y
19y
Name of Presentation
28 September 2011
Anxiety
Ovit
a ped -vsut et benefit
harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
Anxiety
about
tends to be highest in the least
dolore
il etur,
uta testicular
dolorib pist.
informed and the youngest (Dray, 2011)
(i.e. ignorance is NOT bliss on this one….)
Et pliqui te por audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
Have we come full circle in raising awareness to suppressing
volo anxiety?
de volupta
ipsam.
(eg sinvelibea
Casey et al,conseditem
2010)
(i.e. has publicity and awareness made people needless
worriers?)
Name of Presentation
28 September 2011
Should we ask the question?
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
Doil etur,
you perform
testicular
self examination?
dolore
uta dolorib
pist.
But te
then,
if I askimporatio
that question
toes
allvel
men, what
Et pliqui
por audipic
everum
other questions
should Ivolori
ask all
men
to pick
ideribusant,
comnis estinvendit
ditati
ipsam
numup
orsinvelibea
less common
diseases?
volo serious
de volupta
conseditem
ipsam.
– Are you breathless in the pollen season?
– Do you ride a motorcycle in the rain?
– Do you use a band-saw without glasses????
Name of Presentation
28 September 2011
The ‘problem’ & the ‘problem’ culture
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
Young men feel GPs are there only to focus on problems and
immediate needs
Et pliqui te por audipic imporatio everum es vel
No ‘in road’ to the surgery, unlike young women (who have
ideribusant,
comnis estinvendit volori ditati ipsam num
cervical screening, family planning etc etc…)
volo de volupta sinvelibea conseditem ipsam.
Young men sonsistently rate access to GPs as more difficult
than young women in exactly the same circumstances
“Derrick’s abandonment quotient”
The context is a barrier… seeing the GP admits ‘illness’
Name of Presentation
28 September 2011
Primary Care in diverse environments
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore
il etur,
utatodolorib
pist.
Need
to start
get GPs
into other environments, to
normalise the interaction (particularly with young men)
Schools,
colleges,
secure
environments
Et pliqui
te por
audipic
imporatio
everum es vel
ideribusant,
comnis estinvendit volori ditati ipsam num
?Sports clubs
voloOut
de of
volupta
conseditem
ipsam.
context,sinvelibea
but none the
less plausible
environments –
shopping centres?
Some slightly more boundary pushing environments
Church groups, working with other agencies
Name of Presentation
28 September 2011
Ovit Responses
a ped uttoetECM
harumqui te et que non
“GPs are
central the
successful
of self-actuated
responsibility for
pre sent.
Ficimus
apid
moditransition
blam sinvele
ssiminvenda
healthy living that takes place from childhood to adulthood”
dolore
il etur, uta dolorib pist.
HfAC
Et pliqui
te por
audipic
imporatio
everum
esservices
vel in the
“At 12-13
years...
Integration
with primary
health care
ideribusant,
estinvendit
ditati ipsam
num
transition tocomnis
adolescent
health... And involori
the monitoring
of pubertal
physical
voloand
de emotional
voluptadevelopment”
sinvelibea conseditem ipsam.
“At 14-15years, GP services should be promoted (along with ‘health shops’
and young peoples’ clinics) in the context of self-management, healthy
lifestyle promotion and the maintenance of disease free living”
Name of Presentation
28 September 2011
Ovit
ped ut et harumqui te et que non
The afuture...
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
Steering away from just ‘problems’
Linking the GP as a person with other education contexts
Et pliqui te por audipic imporatio everum es vel
Forging links with support services
ideribusant, comnis estinvendit volori ditati ipsam num
‘in roads’
for men,conseditem
particularly young
men
voloFinding
de volupta
sinvelibea
ipsam.
Pushing the collective consciousness
Name of Presentation
28 September 2011
Ovit a ped ut et harumqui te et que non
pre sent. Ficimus apid modi blam sinvele ssiminvenda
dolore il etur, uta dolorib pist.
[email protected]
Et pliqui te por
audipic imporatio everum es vel
ideribusant, comnis estinvendit volori ditati ipsam num
volo de volupta sinvelibea conseditem ipsam.