Evolution of “Men’s Health”
After graduating from my resident training in urology at the Harvard Program in Urology based at Brigham and Women’s Hospital in Boston in 1988, I joined the staff at a sister Harvard Medical School institution, the Beth Israel Hospital (now Beth Israel Deaconess Medical Center), where I had done some of my training as well as a year of research. At the time, nearly all urologists treated everything within our field, including kidney stones, cancer of the prostate, bladder, kidneys, testicles, male sexual problems, urination problems, infertility, and urinary tract infections, to name several of the most common problems.
However, some forward-thinking academic centers were beginning to have their urologists specialize in one or more of these areas. Within my first year of practice, my chief, William DeWolf, MD, told me it was time for us to specialize. Based on my interests and prior research, I elected to specialize in male infertility and male sexual dysfunction.
I didn’t know it, but there is a kind of beauty in going really deep into a subject. Each case becomes fascinating because of small variations that would have been overlooked if I had tried to know everything about everything. I still kept busy with conditions that were common within urology, such as enlarged prostate symptoms and the new epidemic of men being diagnosed with prostate cancer as PSA testing became routine. And so in 1999 I went to the President of my hospital and proposed that we open a Men’s Health center under my direction. I pointed out that every major hospital at the time had a Women’s Health unit, but none offered specialized care for men. He was excited by the idea, and we discussed plans to make it happen. “We’ll be the first in Boston!” he enthusiastically exclaimed. When I asked how long he thought it would take, he replied, “At least three years.”
His answer let the air out of the balloon. I didn’t want to wait. It seemed to me that within the existing hospital facilities I was able to provide state-of the art medical care, but service to patients at that time left much to be desired. So, I left my full-time hospital position to open up Men’s Health Boston (MHB), with the intention of providing the best in both medical care and patient experience. It was the first comprehensive Men’s Health center in the US. I qualify my claim for “first” by adding the word “comprehensive” because a urology colleague, Kenneth Goldberg, MD, in Texas, was already promoting his practice a men’s health center, focusing on erectile dysfunction, male infertility, and prostate problems. Men’s Health Boston offered this too, as well as providing a suite of services that would not be offered by other urologists for many years to come such as testosterone therapy, bone density testing (men with low testosterone are at increased risk for osteoporosis), and psychological counseling.
At the time, the concept of “Men’s Health” wasn’t really on the radar. It would take quite a few years before men’s health centers appeared in hospitals and gained prominence in health articles and medical journals. Despite the lack of public awareness, it was already clear to me that men had important health issues that affected them specifically or predominantly, and there were very few opportunities for them to have these addressed in a way that felt comfortable and respectful to them. My goal in 1999 for MHB was the same then as it is today- to provide to men the very best in medical care together with a first-rate patient experience.