Addressing Serious Neurologic Conditions in Men

Eddie L. Patton Jr., MD, MS, MBA, clinical assistant professor, neurology and neurosurgery, University of Texas; neurologist, Mischer Neuroscience Associates

Eddie L. Patton Jr., MD, MS, MBA

Currently, data suggest that upward of 60% of men do not visit their physicians for serious health issues, including a number of neurologic conditions ranging from myasthenia gravis to Alzheimer disease. While this has obvious negative impacts on the patients themselves, it also takes a toll on health care costs and adds to the complexity of the conditions for the physicians who will eventually treat them.

Eddie L. Patton Jr., MD, MS, MBA, clinical assistant professor, neurology and neurosurgery, University of Texas; neurologist, Mischer Neuroscience Associates, has been on a personal mission to provide quality and compassionate neurological care to his patients. Specifically, Patton does so by trying to establish trust and good communication with patients and their families regarding care and treatment, and education on how important regular check-ins can be.

As such, he’s one of the physicians out in the field trying to address this problem. To discuss the challenge further and provide some insight into how physicians can help fix this issue, he spoke with NeurologyLive^® in an interview.

NeurologyLive^®: Why don’t 60% of men visit the doctor for serious health issues?

Eddie L. Patton Jr., MD, MS, MBA: This has been an issue that has plagued the medical community for a while. We sort of knew this data beforehand and some of it, I think, has to go with just the differences as far as men don’t feel, necessarily, that all the time routine maintenance checkups are necessary until something is catastrophic or serious. So that has kind of been the working diagnosis and so forth, and the key is actually getting to them, wherever they are. As, usually, primary breadwinners for the family and primary workers and so forth, there’s always a time issue. I sometimes hear from our male patients, “I work all day” and “I don’t take time off to meet with the physician” and so forth. So, I think those are some of the main issues or obstacles that we see towards men really going in regularly getting those routine evaluations.

In what sort of neurologic diseases and disorders is this an issue?

We see similar trends in things such as strokes, we similar trends in cognitive disorders, like Alzheimer, and again, a lot of this is sort of the attitude of “hey, my memory’s ok, there’s nothing wrong with me.” Same thing with stroke, where they may have just a mild neurological deficit and it’s not taken either seriously, or seriously enough, to get them to the hospital or to seek medical attention. In headaches as well, part of the thing I think with women having a higher proportion of headaches is because it’s diagnosed more in women. Most of the men I see with headaches they tend to be more severe. You don’t want to be seen as weak by having a headache or complaining, so they just don’t go in for things like migraines, which can be easily treated.

How does this impact the clinical community?

It goes deeper than that. If you really want to see and this is what in my community talks—I do community talks to men’s groups in churches and community organizations—particularly to men, one of the things I’ve been recently focusing on is talking about the high cost of health care. I say that “Hey, if you really want to decrease the cost of health care in our country then let’s focus on men preventative health,” because it affects that. If you go in when things are bad or severe, there’s a higher rate of health care costs that are usually associated with medications and so forth. So if you take situations like diabetic neuropathy or a myasthenia gravis, where you can treat that patient early with lower levels of medication or minimum medication—if they don’t get those preventative visits or they don’t come in early enough, then later on things are a lot more severe. And it does make it more difficult for physicians, as they can be more refractory. They’re harder to treat once things have gone to a certain point so that’s how it can not only affect the treating physician but also affect the health care system as a whole.

With preventative care, there’s a lot of benefits to health care across the board from decreasing health care costs and heading off these neurological disorders even before they become that severe where they need frequent visits and a higher level of hospitalizations and medications. So, if we can get more people to go in and get these routine neurological evaluations and or seek neurological care before they become so severe, then I think it will save a lot in health care dollars, it’ll save a lot of missing work from some of these conditions for the patients as well, and the conditions are sometimes easier to treat.

What can neurologists and specialists do to help?

I’m glad you asked that question because that’s the key. What I found to be extremely important is that you have to go to where men are, meaning you have to take the message to the community, whether it be church programs or at the barbershop, sports events—we have to take the message to men. We talk about concussions, I talk about programs dealing with stroke prevention, and how to prevent stroke through maintenance treatment at different churches and other organizations and community organizations. I’ve gotten positive feedback from people later on who said, “I listened to your talk, I set up an appointment and we were able to find this and we were able to find that the reason that I was having this pain in my feet or numbness was because I was developing neuropathy from diabetes.” All that came from just going to them and talking to them in the community and saying, “hey this is what can happen.”

As men, we frequently ignore systems, and neurologically wise—take diabetic neuropathy for instance, you may ignore the numbness and tingling in your toes, but if you hear from a neurologist, “hey that can actually be the first sign of diabetes,” and if that can spur you to go into a doctor and seek help and get it while its early, then that’s a huge win. I found it more effective to go out into the community and talk about some of these neurological conditions and talk about some of these preventative health things and hopefully that will spur a conversation and that will spur more men to go in and seek care.

Transcript edited for clarity.