Intro: Duly Noted, a health and care podcast is the
official podcast series of Duly Health and Care. Each podcast features
physicians or team members discussing groundbreaking topics and innovations
that help listeners reimagine and better understand an extraordinary health and
care experience.

Joey Wahler (Host): June is National Men's Health Month.
So we're discussing why navigating health is so important for men and how they
can do that. Our guest Dr. Michael Fitzgerald. He's a Family Medicine Physician
for Duly Health and Care. This is Duly Noted, a health and Care podcast.

Thanks for listening. I'm Joey Wahler. Hi Dr. Fitzgerald.
Thanks for joining us.

Michael Fitzgerald, MD: Hey, good morning Joey.

Host: So first, the CDC says, women are 33% more
likely than men to visit a doctor, and 100% more likely to visit a doctor for
annual exams. Now those are some eye-opening stats. So from your experience
first, why do you suppose that is?

Michael Fitzgerald, MD: Yeah, certainly some very
interesting statistics. You know, I think men tend to be less focused on health
as we'll tend to focus on other things in life. Certainly when you we're
younger, we feel well, we tend not to go to the physician. We get distracted by
family commitments, work commitments, and so forth. And again, if you're
feeling healthy, it's like, why go to the physician?

Host: But one thing I'm sure we'll talk about over
the next few minutes is that it's almost as important, if not just as much so,
to see a doctor when you are relatively healthy as when you're not, right?

Michael Fitzgerald, MD: Yeah, Joey, good point.
That's what we try to point out to the patients that we see. We want to catch
things before you have any symptoms. That's when conditions are most treatable
and we see the best outcomes. So very important to get in there before you're
feeling poorly.

Host: So one key here, is of course, establishing a
relationship with a primary care physician and then maintaining that. So for
men in particular, why is that so important and when should scheduling that
usually start, from an age standpoint?

Michael Fitzgerald, MD: So we like to see people
establish with a primary care physician in their early twenties such that they
can get to know the primary care physician, primary care physician can get to
know them. So you're really creating a relationship, so that there can be collaboration
throughout the course of your life with your health status and how you want to
take care of yourself. And the physician then can really get to know you,
understand family history, and be more attentive to things that may be
particular to you that we should be looking for.

Host: So we're talking typically then about a yearly
checkup, right?

Michael Fitzgerald, MD: Annual checkups. Yes,
exactly. You know, they'll go by multiple different names. Complete physical,
annual well visits, routine health maintenance exam, but they're really all the
same. We're looking for conditions that we should be screening for. And the CDC
has recommendations. There's something called the United States Preventative
Services Task Force. That's a mouthful, but they regularly update their
recommendations and they're evidence based so that we stay current with the
conditions that we should be screening for.

Host: Gotcha. So is there anything men can do to
prepare for their annual exam or physical beforehand?

Michael Fitzgerald, MD: Another good question. Yeah.
At times we will draw labs prior to an exam based on standard screening
recommendations as well as if we are alerted to that the patient wants labs
prior to the exam, we can look through their chart and recognize conditions
that we've been following, and we can also add those to the labs to be prepared
for the physical.

Host: So speaking of which, in addition to those
annual physicals, what are some of the important screenings men should be aware
of, especially as they start to get a little bit older?

Michael Fitzgerald, MD: Yeah. So as they start to get
older, you know, we really think of probably in the forties and fifties; that's
when a lot of our larger screenings come into play. You know, I always think of
in your forties, depending on your risk factors and such, we start to screen
for prostate cancer and that's done through a blood test called the PSA,
prostate specific antigen. And again, we'll start at age 40 for very high risk
individuals, most patients need to be screened between the ages of 45 and 70,
and then colon cancer screening. A couple different ways we can do that, but we
encourage colonoscopies to start at age 45 for regular colorectal cancer
screening. And then another one that I think we often forget about is lung
cancer screening. And this should start at age 50 for people who have smoked
more than 20 pack years in their life within the past 15 years, or who are
still currently smoking.

Host: So when we talk about screenings for the things
you just covered, it seems like in recent years, Doctor, there's been much more
attention paid to that say in the media and with medical facilities stressing
it as well. From your experience, are men heeding those warnings? Are they
getting their PSA and they're colon checked when they should or are there's
still people out there that are paying the price because they're not doing
that?

Michael Fitzgerald, MD: Yeah, I mean, I feel that
there's certainly more people that are coming in on a regular basis and we're
happy to see that, but certainly we still find people who have for whatever
reason, decided to wait until later, and that can be a little bit more
challenging cause we have a little bit of catch up work to do. And going back
to, we want to find conditions as soon as they may be present. So earlier the
better is what will always remind patients.

Host: Well, you mentioned some of those conditions
that we just covered. Anything else that men are more susceptible to from an
illness or condition standpoint than women? Since we're focusing today on men?

Michael Fitzgerald, MD: Yeah. Good point. So men will
tend to smoke more than women and also tend to use more alcohol than women. So
we'll see illnesses and conditions related to those two factors, more often in
men than, than in women.

Host: How about a man's family history and lifestyle
choices? Obviously, those are two very different things. One is kind of
predetermined, the other is more within our control. What kind of a factor do
those two things tend to play when we're talking about male oriented
conditions?

Michael Fitzgerald, MD: Yeah. Good point. So again,
we'll go back to modifiable risk factors is what we'll call them. And these are
conditions that we can change as individuals and that can include your dieting,
can include the amount that you exercise. And then of course, going back to
smoking and drinking alcohol. Those are all things that we can counsel patients
on regularly when they see us for their physicals. For family history, nothing
that we can really do about that, but it's certainly things that we will pay
attention to. So certainly for men who may have a more significant family
history of adenocarcinomas, those are the men that we will start to screen
earlier for prostate cancer screening. Colon cancer screening is also adjusted
for significant family histories due to genetic conditions. So those screenings
will tend to start earlier. So good for us to know family history because
again, we can adjust our, our screening for those patients.

Host: When we talk about those things that are within
our control, like watching intake of alcohol or tobacco, adjusting our diet as
need be, maybe talk a little bit please about how a general care physician can
again, be the point person to walk you through what you need to do there.

Michael Fitzgerald, MD: Yeah. So I think in primary
care, we have the luxury of really getting to know our patients and hopefully
they get to know us and feel comfortable with us. So they will tend to open up
and may admit to some of those unhealthy lifestyle choices that they may be
making. And with those, admissions, we can start to counsel them and offer them
assistance as to what we can do to get them on track for a more healthy
lifestyle.

So, for instance, smoking cessation, we're happy to talk
about different ways to help patients quit smoking, whether it may be
pharmacological or a smoking cessation class. I think those are, you know,
simple things that we often forget about as patients, but things that the
primary care providers can remind their patients on an annual basis.

And over time, those reminders add up and we do see positive
effects, meaning that patients will tend to adjust their behavioral habits.

Host: Another advantage of seeing the same doctor on
a regular basis is of course referrals, in case you have to see a specialist,
you may need a referral or you may prefer one. And I suppose in your position
as the physician, you are more comfortable making those when you know someone
and have been treating them for a while. Right?

Michael Fitzgerald, MD: You know, a couple points
there. One, when we walk into a room, you know, inherently, you know your
patient, you know their history. Of course, we always have an electronical
medical record right there with us. But there are things that will be triggered
in the exam that will say, oh, I remember we talked about that a couple years
ago.

And then we can go back, pull that record and really discuss
that visit and how it's pertaining to the current visit. But of course,
certainly referrals and that's the beauty of practicing at Duly, you know, we
have great relationships with our specialty colleagues, and that allows us to
really tailor our referrals for our patients.

For instance, within urology, there's multiple different
subspecialties. In, in our urology department, we have Physicians and APPs who
are interested in different aspects of men's health. So depending on the
patient's issue, we'll send patients to different providers within that same
specialty department.

Host: Couple of other things. If someone is hesitant
going to the doctor because they're fearful of what they may learn, what advice
do you offer them to try to overcome that?

Michael Fitzgerald, MD: I try to make patients feel
comfortable. I think most providers will work with patients and we can do as
little or as much as they feel comfortable with doing. Again, this is really a
visit that's meant to be in collaboration with the patient's preferences is
they take care of themselves.

Host: Finally, just in summary here, Doctor, it seems
overall, one of the real themes of this conversation is the importance of
trust, of the patient trusting their doctor and vice versa. You trusting that
because they've been coming to you regularly, that you know how best to treat
them, whether it's your own personal approach or that of Duly overall. What
would you say is the philosophy in establishing that trust with patients in
general?

Michael Fitzgerald, MD: It's like any relationship.
You know, we want the patients who are seeing us to feel comfortable with us,
supported by us during the visit. And, you know, certainly I will always tell
patients sometimes, physician patient relationship is just like dating.
Sometimes it doesn't work out. And certainly, we will counsel patients. We want
you to feel comfortable. We want you to see a provider that you trust and you
know, we can help facilitate you seeing that provider that you're most
comfortable with. We just want patients to get excellent healthcare. That's the
most important goal.

Host: Interesting analogy, kind of like in case it
doesn't work out, staying on friendly terms with an ex, right? Everybody leaves
friends and you move on.

Michael Fitzgerald, MD: Exactly.

Host: Excellent. Well, folks, we trust you are now
more familiar with navigating Men's Health. Dr. Michael Fitzgerald, a pleasure.
Thanks so much again.

Michael Fitzgerald, MD: Thank you, Joey. Appreciate
it.

Host: Same here. And for more information, please
visit dulyhealthandcare.com. Again, that's D U L Y healthandcare.com. Now, if
you found this podcast helpful, please share it on your social media. And
thanks again for listening to Duly Noted, a health and care podcast. Hoping
your health is good health. I'm Joey Wahler.