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Over the last 5 years, we have developed a comprehensive, multispecialty, hospital-based men's health center, and we believe that the following five elements are the keys to its success.
Photo courtesy of Bill Murphy/Lifespan
Edward Karpman, MDThe interest among urologists in developing a men’s health center (MHC) has been increasing over the last several years. There are several reasons behind this push. Urologists are realizing that we’ve missed a golden opportunity to be gatekeepers to men, similar to what gynecologists have become to women-their primary care doctors. While many urologists are trying to appease their referring physicians to maintain referral patterns, gynecologists have benefited from direct self-referral by patients because most women view their gynecologist as their primary care physician.
Another reason for this recent trend is that urology as a specialty is not well defined in the public’s eye. If you ask a person on the street, “What does a urologist do?,” many will answer that we are urine doctors. This lack of understanding by laypeople suggests that urology is in need of re-branding, and men’s health is the perfect term that encompasses the breadth and scope of our male-oriented practices.
Finally, due to apathy among urologists, we have lost control of some of our traditional disease states, and we need to bring these conditions back into the urologic fold. The best examples are hypogonadism and erectile dysfunction. As surgical subspecialists, we have neglected these two primarily medical conditions and allowed a variety of non-urologist physicians to develop injection and longevity clinics around the country under the auspices of a “men’s health center.” Every urologist I have spoken to about this issue is aware of these types of clinics in their city and every urologist has a devastating story to share of the substandard care these clinics provide our patients.
In 2010, we started our hospital-affiliated men’s health centers at El Camino Hospital in Los Gatos, CA with the purpose of providing men a truly comprehensive program to deal with the diseases of aging and to address the aforementioned problems. At the time, there was a paucity of information and guidance for a physician who wanted to develop an MHC.
Over the last 5 years, we have developed a comprehensive, multispecialty, hospital-based MHC, and we believe that the following five elements are the keys to its success.
An MHC program can be virtual or brick and mortar. We chose to develop the latter, as we feel it is important to provide men a truly dedicated destination to be seen by their physicians. Even though all of the physicians in our center-from primary care and key specialties-had separate successful practices, we brought them all under one roof. We did this on the hospital campus and in collaboration with the hospital.
The physical space was remodeled with a masculine decor, flat-screen TV, and male magazines. The idea was to create an atmosphere where guys felt comfortable-a “man-cave” feel. The clinical space has a separate entrance from other hospital services, yet is easily accessed from the main campus.
Photo courtesy of University of Utah Health Care
We chose to collaborate with our hospital rather than start a center independently because an affiliation with a local hospital has many advantages when starting a men’s health program. Hospitals offer resources, marketing, networks, and legitimacy. Hospitals are viewed as altruistic organizations and are respected in their communities, bringing immediate credibility to an MHC.
Many men’s health diseases such as erectile dysfunction, Peyronie’s disease, and hypogonadism can be viewed by the public as sexual quality of life (but not “serious”) conditions. Collaborations with a hospital can add legitimacy to treating such conditions and distinguish your MHC from other stand-alone men’s health or “shot clinics” in your community.
The field of men’s health deals with diseases of aging that many men will encounter. Cardiovascular disease, urologic issues, and sleep disorders can make up the majority of problems for which men seek help as they get older. However, men will also need help from gastrointestinal, orthopedic, ophthalmologic, and psychiatric/psychological specialists, to name a few.
The breadth and scope of men’s health is so wide that it is impossible for any single specialty to master all of the needs. It is precisely for this reason that a collaborative effort is needed for a successful men’s health program. We invited all interested physicians to share space in the men’s health clinic to promote the concept of a one-stop men’s health center.
An example of how we strove to bring all of these programs under one roof is the development of a hospital-based sleep disorders program. Sleep disorders such as obstructive sleep apnea are extremely prevalent in our communities, occur more commonly in men than women, and are confounding factors in many conditions we treat daily, such as nocturia, hypogonadism, and sexual dysfunction. Our sleep disorders program was borne out of the frustration of sending hundreds of men for referrals to stand-alone sleep labs for testing, only to get back a confusing polysomnograph report without interpretation or follow-up and to hear patient complaints that the lab was located in a strip mall next to a fast-food restaurant.
Our response to this dilemma was to work with the hospital to build its own sleep disorders lab, recruit a board-certified sleep specialist, and have him see patients alongside us in the MHC.
One of the main reasons that men, and any patient for that matter, come to a specialized center is to receive the most sophisticated and cutting-edge therapy available for their condition. An MHC is seen by patients as a place to get this type of care. As the leaders in urologic men’s health, urologists have the ability to offer not only the proven and tested methods for men’s conditions, but also to be the first to provide newer, more sophisticated cutting-edge treatments.
Unlike many injection clinics, we don’t give every man generic testosterone injections, but a choice of short- and long-acting injection therapy, subcutaneous pellets, and FDA-approved transdermal gels. We also don’t just treat the obvious “low T,” but evaluate the patient’s bone health, sleep quality, prostate health, and sexual function.
Likewise, we don’t treat all men suffering from erectile dysfunction with intracavernosal injection therapy, but offer them a full spectrum of medical and surgical treatment options while also ascertaining their comorbid conditions, such as cardiovascular disease. Most importantly, we can deal with any complications that arise from these therapies, unlike the injection clinics we see sprouting up around us.
A successful MHC needs to let its surrounding community know that it exists and is there to take care of the needs of men in the community. A marketing campaign is a good way to get the word out about the services provided. Marketing an MHC can be costly and is another reason why collaborating with a hospital can be beneficial to your success. Most hospitals have set aside budgets for marketing hospital service lines, and men’s health is no different from cardiovascular, orthopedic, or women’s health service lines when it comes to funding for marketing.
One of the unique outreach programs we started was an annual men’s health fair, which runs the day before Father’s day every year. The fair includes booths for all of the specialists involved in the MHC, providing a great opportunity for patients to come by and inquire about the various specialties. We also invite industry to showcase the “tools” we use in our practices to diagnose and treat men’s health conditions. We do this in a festive environment with food, music, valet parking, and prizes for the attendees.
In summary, men’s health centers are here to stay because we, as urologists, understand their value, and our communities have shown a desire for specialized centers for men. As outlined and described above, five key elements have made our center successful, but other factors can play an important role as well. We feel strongly that we will see increasing interest by urologists in the future in support of men’s health programs around the country.
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