Here's a question for medical science: How do you get a man to go to a doctor?

        “I guess that would be before he's sick, right?” asks Dr. Georges Feghali, an internal medicine specialist and assistant medical director at Good Samaritan Hospital.

        Some men get a physical once a year. And some see doctors only when they're unconscious or in too much pain to argue their wives out of driving them to the emergency room.

        We asked our experts for their best advice, and, briefly, we break it down into three categories:

        Guilt. “Honey, I don't know what the kids and I would do if you weren't here to take care of us because you ignored those chest pains and had a fatal heart attack, just like your father, uncles and grandfathers on both sides.”

        Diagnosis by association. “A guy I went to high school with has colon cancer. Maybe I should get a colonoscopy.”

        Nagging. “I prefer to call them persistent reminders,” says Dr. Robert Finley, an internist with University Medical Associates and UC Physicians.

        Physicians credit wives and girlfriends with getting their men to see doctors. “They actually present it that way: "My wife thinks you should look at this.' "My wife thinks I'm depressed,' ” says Dr. Finley.

Excuses, excuses

        There are a number of reasons some men are so reluctant to see their doctor. Some try to claim they don't have time. “I tell them there are 8,760 hours in a year and for them to say they don't have two hours to take care of themselves is ridiculous,” says Dr. Keith Melvin, an internist with Alliance Primary Care.

        And some are squeamish about shots and screenings.

        And some men don't want to look weak in front of their women. When Dr. Melvin had to have a biopsy to check for prostate cancer in 1999, he took his mother to the hospital with him, not his wife.

        “I didn't want the woman to know how macho I was not,” he says. He had cancer. He got treatment. Now he speaks to groups on the importance of screenings.

        “If you're not here, it won't matter how macho you are,” he says.

        Men's health risks are different, points out Dr. Mark Bibler, an internist with Alliance Primary Care and the University of Cincinnati.

        “Men have different preventive health care needs than women do,” he says. Women are advised to get Pap smears and pelvic exams annually, along with breast exams.

        For men, annual screenings for cancers begin at age 50. At some point in their 20s, men should get their blood pressure, blood sugar and cholesterol levels checked.

        If the results are normal, a man can see his doctor when he's sick or injured, at least until he's 50, Dr. Bibler says. At 50, it's time for the annual physicals. Some doctors, including Dr. Melvin, say men need screenings for diseases with strong genetic factors — hypertension, high cholesterol, diabetes and some cancers — annually.

        “At 40, 45, most of these guys are likely to have hypertension, especially in the African-American community,” Dr. Melvin says. “And we know that by the time we find diabetes, it's probably gone untreated for five, 10 years.”

One woman's message

        It's easy to make jokes about men's reluctance to seek care, but the results can be tragic. Christopher Balkema complained about persistent heartburn for years. Once in a while he'd see a doctor, get some medicine, and not say anything more when the medicine stopped working.

        When he and his wife, Simone, and three sons moved to Clermont County from New Mexico last year, Mr. Balkema injured his back. When the pain got to be too much, he and his wife went to the emergency room and got pain medication. When the pills didn't work, they made an appointment with Dr. Finley.

        At the end of the appointment, Mr. Balkema mentioned the heartburn. Dr. Finley prescribed two weeks' worth of medication and told them he wouldn't prescribe more without a follow-up exam.

        Tests revealed that the heartburn was actually esophageal cancer that had spread to the spine. Mr. Balkema died in February, .

        nearly a year after he was diagnosed. He was 41.“If you really want men to go to the doctor, emphasize these three boys who lost their dad and this mom who has no idea how to be a single parent,” she says.

        Health care “wasn't a priority” for Mr. Balkema, his widow says, but he usually did what he was told. When his back hurt so much he couldn't stand, “he was putty in my hands,” she says.

        “And if you're not going to get a physical every year, make sure you have good life insurance, because if you're not going to be preventive, there's a very good likelihood you're going to die before your time,” she says.
       

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