The internet has lots of anecdotes about men who don’t — or at one crucial juncture, didn’t — go see the doctor. Some are somewhat amusing, like a father who habitually asks his daughter if he can borrow her antibiotics. But most are terribly sad, like a friend mourning his mid-50s tennis partner, who had long complained about a mysterious back pain, only to eventually discover that he had Stage 4 colon cancer. His friend wrote on Twitter: “[It] had spread into his ribs, head, everywhere. He died very quickly.”
These stories, unfortunately, are all too common. According to a recent survey by the Cleveland Clinic, “physician-dodging” is a disturbing status quo for men between the ages of 35 and 54. Only 43% of that middle-aged cohort reported seeing their doctors for annual physicals. That percentage increases as men get older — when serious illnesses pretty much compel them to see a professional — but even then, it’s treated as a last resort, and many of the patients aren’t on their best behavior. In the study, 65% of respondents said they avoid going to the doctor as long as possible. When they do go, over a quarter of them customarily withhold information from their doctors. Some even admitted to years of lying to their doctors, in fear of hearing a dreaded diagnosis.
While silly on the surface, one final statistic might offer the clearest insight into the psyche of men desperate to avoid scheduling a doctor’s appointment. A reported 72% of men “would rather do household chores” (like clean the bathroom) than visit a physician. Sitcom-dad wisecracks aside, that premise is a useful framing device: an overwhelming majority of men in this country have come to perceive doctor visits as an avoid-at-all-costs chore. It begs some obvious follow-ups: Why do men, and in particular, middle-aged men, hate doctors? What logistical, biological and psychological factors are at play? And what consequences do men face when they refuse to pick up the phone and schedule an appointment?
Based on 2019 data, men work slightly more than women — about five hours more per week. But that incremental difference aside, claims from men that they are “too busy” to take care of themselves are met with incredulity by medical professionals. Dr. Amy Revene M.B.B.S, a general practitioner based in Dubai, says that the vague reasons men list for skipping annual physicals obscure deeper psychological issues. “When researchers probed a little deeper into this alarming tendency,” she tells InsideHook, “they noticed a few common trends. Namely: men are uncomfortable with exams, fearful of a diagnosis, and struggle to shed their ‘macho’ attitudes.”
This sentiment is shared by other experts in the field. Dr. David Samadi — one of the leading prostate surgeons in America, and author of The Ultimate MANual — says it’s all in men’s heads. “It’s purely psychological. Men simply put their health last on their to-do list. They feel squeamish about routine yet important healthcare screenings such as prostate or rectal exams; they just don’t think about the health risks of neglecting appointments; they feel that if they can keep working and being productive, then they’re good with that.”
Men stay far away from offices, clinics, and hospitals, doctors reckon, thanks to a potent cocktail of toxic masculinity and unacknowledged vulnerability. On one hand, men are simply interpolating imperatives they’ve heard all their lives, from fathers, older brothers, coaches, bosses: “Don’t cry.” “Rub some dirt on it.” “Shake it off.” “You’ll be fine.” “Man up.” They’re playacting at a psychological phenomenon known as “superhero syndrome” — if I’m fine, everyone else is fine. So I better be fucking fine.
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When it comes to this point, as family physician Dr. Waqas Ahmad illustrates with a quip, men often take it way too far: “Women go to the doctor when they’re supposed to. Men go to the doctor when their arm has almost completely severed from their body and they can no longer put on enough band-aids (or electrical tape) to keep it attached; then, they say with a heavy sigh, ‘Fine, I’ll go to the doctor if you will quit nagging me about it.’ Just not without stopping for a beer on the way.”
It’s self-reliance and stoicism taken to a dangerous extreme, and ultimately, it’s a performance. Because men are actually terrified. At a certain age, they are all well-aware that they aren’t invincible. Compare it to the stubbornness of an out-of-towner who refuses to ask for directions, or a wobbly-kneed grandparent who always has to shovel his own sidewalk. Underlying this approach is a colossal fear of inadequacy, of replaceability. Observing normal consultation rates, let alone the process itself (you know, not lying to doctors), would mean acknowledging a weakness, and likely receiving some sort of diagnosis. And in the minds of many an aging patriarch, a diagnosis is unacceptable.
That said, it’s perhaps a misnomer to label this a middle-aged issue. The routine itself is assimilated at a much younger age. “Too many young men have a sense of immortality,” says Posterity Health founder Dr. Barrett E. Cowan, who has spent 20 years treating male fertility. “They feel that they don’t need medical care.” This fosters a self-defeating loop wherein one man’s self-assuredness can negatively affect not just his own life, but the lives of those he loves. “In my practice, for instance, most men are not even aware of the fact that when a couple has difficulty conceiving, 50% of the time it is due to the presence of a male factor; but by proactively treating the male, we can increase a couple’s chances of having a child.”
Now, there are some biological realities and societal norms that influence a man’s reluctance to visit the doctor’s office. Unlike women, men can go literal years early in life (as teenagers into 20-somethings) without heading in for annual physicals. That doesn’t mean they don’t have to — just that they have the dubious privilege of throwing their bodies on auto-pilot and then finally taking the wheel back at the brink of fatherhood. Women live a markedly different situation, as Dr. David Beatty, a 30-year GP explains: “Young women attend the doctor for contraceptive purposes. This gets them used to using the service. They know how the appointment system works, they get to know the receptionists, the nurses, the doctors.”
Many women come back for regular checks during pregnancy. They analyze their contraceptive options again after the baby is born. They visit the doctor for the baby’s immunizations and checks. They’re more likely to bring in the children for annual checkups or examinations of various injuries and ailments. This breeds an intimacy with the literal space itself, and more importantly, the process — to trust the healthcare system, one needs to experience it. This is a point doctors home in on time and time again: women are proactive patients. Long before they turn 40, women are used to disclosing information about their bodies, assessing their options and making decisions. The reliance is there, and they literally live longer for it.
It’s true. In the United States, the life expectancy gap between men and women is an astonishing five years. According to the U.S. Centers for Disease Control, the average American man will live to age 76, while the average woman in America will live to age 81. There are some ridiculous reasons for this discrepancy — for example, men are more likely to perish in motorcycle accidents or gun fights. They also have a lot of trouble giving up on red meat. But an overarching theme is the willingness of women to find out exactly what’s going on in their bodies, and plot a course of action to mitigate the risks.
Those risks are real, but they’re not insurmountable. Urologist Dr. Lamia Gabal says, “Things like prostate cancer, colon cancer, hypertension and diabetes can be screened for a while in the early stages, and are still treatable or curable.” It’s important for all men to have the following three doctors: a primary care physician, an internist and a urologist. Quite frankly, that last one should be a dealbreaker for all men — Who the hell wants to wake up three times a night to use the bathroom? Or battle erectile dysfunction for years? — but they’re all necessary. Dr. Samadi asks: “When men neglect their annual physicals, who is keeping tabs on their blood pressure, their cholesterol, their insulin levels? Important health parameters such as these are often ‘silent’ with no symptoms and will only worsen if not diagnosed and then properly managed.”
It’s understandable, in a way: young guys feel untouchable, older guys are set in their ways. Neither wants to hear that they shouldn’t be drinking or smoking or eating cheeseburgers every Saturday. But the dialogue needs to happen nonetheless.
So, how do you convince the man in your life (whether he’s a father, husband, brother or even son) to start seeing the doctor? A workman’s metaphor never hurts. “You’re the general contractor and you’re building a house,” Dr. Jerry Bailey, a functional medicine physician says. “But you need the drywall guys, the plumbers, electricians, HVAC, tilers, framing, roofing. You’re managing everything, but you need the entire team in order to build the dream home.”
He’s right — it takes a village (one that definitely includes a doctor’s office) to get a man to 80 years of age. At the end of the day, this conversation shouldn’t be an admonishment. It should be encouragement. A call to arms. The purest, most sincere form of a man’s reluctance to see the doctor is an honest desire to not trouble or worry those around him. We’ve long viewed that sense of privacy and restraint as noble, even heroic. But it’s time to shift the narrative. Real heroism is living longer. It’s about putting less of an emotional (and financial) burden on your family. It’s facing vulnerabilities — and life’s inevitable realities — head on. And when it’s all tallied up, it means more time spent goofing around with your kid, or playing tennis with an old friend.
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