1. Barriers to Men’s Healthcare Patient Imperatives in the face of professional controversy Virgil Simons Founder & President The Prostate Net, Inc.®

2. Pathways to Cancer  Awareness  Access  Environment  Lifestyle  Culture  Genetics  Every cancer is different  Awareness  Access  Environment  Lifestyle  Culture  Genetics  Every cancer is different

3. National Healthcare Quality Report - 2007 “Preventive healthcare lags significantly behind other gains in healthcare.” Access to care and information varied widely between racial/ethnic groups and by socio-economic status Source: www.ahrq.gov “Preventive healthcare lags significantly behind other gains in healthcare.” Access to care and information varied widely between racial/ethnic groups and by socio-economic status Source: www.ahrq.gov

4. The Prostate Net  Survivor led non-profit corporation (1996)  Multi-focal service matrix  Focus:  Education  Intervention  Research  Deliver value  Survivor led non-profit corporation (1996)  Multi-focal service matrix  Focus:  Education  Intervention  Research  Deliver value

5. Listening to the Audience: ARS initiative

6. On-going Concerns  “Lack of educational efforts”  “Will screening be part of healthcare reform”  “...men of color MUST take care of themselves”  “the quality of the faculty was over the top”  “more time for advanced disease needed”  “Lack of educational efforts”  “Will screening be part of healthcare reform”  “...men of color MUST take care of themselves”  “the quality of the faculty was over the top”  “more time for advanced disease needed”

7. Defining Barriers to Men’s Participation in Healthcare  Attitudinal Barriers  Gender Role Stoicism  Work Role Stoicism  Distrust of the Health Care System  Fatalism: “you’ve got to die of something.”  Maladaptive Self-Reliance: “A ‘man’ takes care of his own problems.”  Attitudinal Barriers  Gender Role Stoicism  Work Role Stoicism  Distrust of the Health Care System  Fatalism: “you’ve got to die of something.”  Maladaptive Self-Reliance: “A ‘man’ takes care of his own problems.”

8. Early Disease Detection Barriers  U.S. vs European conflict on screening  No consensus among U.S. agencies  Lack of “Risk” determination  Compared to Women:  Men are less likely to utilize the health care system  Men are less likely to carry health insurance  More likely to delay seeking healthcare  U.S. vs European conflict on screening  No consensus among U.S. agencies  Lack of “Risk” determination  Compared to Women:  Men are less likely to utilize the health care system  Men are less likely to carry health insurance  More likely to delay seeking healthcare

9. Primary Care Impact Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics

10. Complicating the Issue  Women vs. Men  Comparable incidence and mortality  Research funds - 3X for breast cancer  Public health staffing - inconsistent  Government commitment - no agencies  Media focus - inordinately female focus  Men don’t communicate  Women vs. Men  Comparable incidence and mortality  Research funds - 3X for breast cancer  Public health staffing - inconsistent  Government commitment - no agencies  Media focus - inordinately female focus  Men don’t communicate

11. The Benefits of Positive Men’s Health to the Community  Reducing or controlling rising health care costs through preventing costly, advanced disease  Reducing economic costs of preventable male illness, including lost time from work, disability, diminished income, and reduced work productivity  Increased attention to men’s health ultimately holds the potential to bolster and uplift the health status of both genders  Gender health is not either/or, It’s both or neither  Reducing or controlling rising health care costs through preventing costly, advanced disease  Reducing economic costs of preventable male illness, including lost time from work, disability, diminished income, and reduced work productivity  Increased attention to men’s health ultimately holds the potential to bolster and uplift the health status of both genders  Gender health is not either/or, It’s both or neither

12. Expectations  Survivorship:  What is being done to extend my life NOW  Focus:  On the patient, not the system  Results:  Need balance between the future and present  Think Globally:  Utilize data and results from the rest of the world  Survivorship:  What is being done to extend my life NOW  Focus:  On the patient, not the system  Results:  Need balance between the future and present  Think Globally:  Utilize data and results from the rest of the world

13. So…what’s the answer