Society has become far more open in recent decades. Many subjects which were once strictly taboo can now be openly discussed. Yet despite this, many male health issues remain ignored, primarily through embarrassment. Below we look at four common health questions still shrouded in mystery because of a reluctance to discuss them. [Read more…]
By Dr. Jon Elion, MD, FACC and Founder/President of ChartWise Medical Systems
June is Men’s Health Month, when we focus on prevention, detection, and treatment of disease in men and boys. As a cardiologist, it is tempting for me to use this platform to talk about heart disease. Instead, I have decided to push myself beyond that, connecting to my cardiology roots while shooting for some extra bonus points by mentioning coding and Clinical Documentation Improvement.
I saw a patient in the office for follow-up two weeks after an acute inferior MI caused by a right coronary artery occlusion (that would be ICD-10 code I2.11). Remember that the meaning of “initial” and “subsequent” for MIs has changed since ICD-9, where it referred to the episode of care. But under ICD-10, this office visit for the single MI within the previous 4 weeks did not get any special code modifier. As he was leaving, the patient asked me to check his PSA (the Prostate-Specific Antigen which is used to help detect and screen for prostate cancer). Apparently his family doctor normally did this, but it hadn’t been checked in a while. He called a few weeks later to tell me that his insurance company refused to pay for the PSA check, as the test is not indicated in the context of a follow-up visit after a heart attack. It would have been covered if I had documented our discussion and coded for an encounter for screening for prostate cancer (Z12.5). [See how I snuck in a mention of coding and Clinical Documentation Improvement?] [Read more…]
Men’s health has gained prominence as an issue since 1990 as a result of concern that men were having poorer health outcomes compared to women, particularly in preventative health care. Research conducted during the last decade found that men are less comfortable with the health system, understand it less, and negotiate it less effectively than women. The major challenge that becomes an issue in men’s health is that it is hard for primary care providers to promote men’s health before illnesses develop when the men do not visit the provider very often. Men are reluctant to engage in preventative healthcare during their early and middle years, a time that is significant in illness prevention. Taking time off work for health care is often seen as a sign of weakness. Health care providers need to explore ways of making the system “man friendly,” or take the system to those men who are not currently seeing a provider.
The National Center for Health Statistics (NCHS) examined the leading causes of death among men. The majority of causes had links to lifestyle-related behaviors like smoking, poor diet, having uncontrolled or undiagnosed chronic conditions, and taking risks that lead to injury. Most of these causes could have been either prevented or significantly delayed. As advanced practice nurses we understand the importance of preventative health care and its impact on reducing disease and disability. Primary care providers have to look ahead and identify strategies that will play an important role in helping men avoid illnesses.
The findings in the literature supported the need to implement men’s preventative programs in the workplace, gyms, and rural underserved areas. The National Health Disparities Report (NHDR) identified three major barriers to health that affect Americans: the lack of health insurance; the lack of usual source of care; and the perception of need. The lack of health insurance often led men to postpone seeking medical care. Men without a usual source of care had greater difficulty obtaining the needed preventative services such as blood pressure monitoring and prostate exams. Cultural barriers and beliefs also are factors in men’s failure to receive preventative screenings.