Well Man clinics — useful reassurance or complete con?

Women go for regular health screenings and all-round check ups — so why shouldn't we men? Aren't they a great way of teaching us to look after ourselves better? Won't they spot potentially serious problems at an early stage? Certainly the private health sector seems to think so, as it opens ever more clinics throughout the UK. But some experts disagree, arguing that Well Man checks are a waste of money and even potentially harmful. Who's right? Malehealth.co.uk checked them out….

My Well Man check

Dan Fielder stripped to the waist (and beyond) at his local BUPA Health Screening Centre. He lived to tell this tale:

On Tuesday night, I left my office at about 8.45 pm, was easily talked into a couple of pints of lager in the pub, and at home sat up till 1.30 am smoking a recreational substance and watching Friends videos. My way of unwinding on a typical weekday evening, I might say. I thought little of it.

By next afternoon, as I began my full "Well Man check-up" at a BUPA Health Screening Centre, I was thinking of little else. Over the course of more than three hours, I was jacked up in the medical equivalent of a pit lane and subjected to a battery of tests. My weight and height and muscle strength were measured (the latter sadly below average). I gave of my blood and urine, breathed into a tube to test my lung capacity, sat in a small booth listening out for high-frequency noises, and pedalled on an immobile bike as my aerobic fitness was measured (another disappointing score). My chest was pummelled; my eyes were tested; and, yes, my balls were cupped.

Did I feel like a laboratory rat? Actually, no. I felt like someone who had gone through life paying as little attention to his own well-being as he thought he could get away with; someone who was now being asked to confront some key facts about his current health and — not to put too fine a point on it — longevity.

The BUPA testing, a costly procedure with all the one-on-one comforts of the private sector, has two main aims. You are screened for any treatable health conditions you may currently have, and you are given information and lifestyle advice to help you reduce the risk of future disease. As far as I can see, most men have long seen it as their task to live in denial of the possibility of either eventuality. As a health journalist I ought to know better — indeed I do — but somehow, through the years of smoking and heavy drinking, I never quite got round to acting on the knowledge. Illness — as most men would agree — is something that happens to other people.

So for me, this screening provided a salutary jolt. I was relieved to discover that I had scraped through relatively unscathed from the excesses of my last decade and a half, but concerned to see that most of the big risks lay ahead of me — just not that far ahead any more. (The BUPA doctor pointed out to me that if I come again when I'm 40 — fewer than eight years away — I can expect a finger up my bum, commemorating the start of the prostate years …). When I kept protesting that I had just joined a gym through work, the repeated unspoken comment seemed to be: "And not before time …".

Taking into account my age, sex and family history (my dad had attacks of angina and eventually died from a heart attack at 63), my BUPA consultant focused on my key area of risk: heart disease. He pulled out a cunning document known as a "CHD prediction score sheet for men". You note down where you stand on all the contributory factors — smoking, diabetes, cholesterol levels, etc. — and tot up how much you — yes you! — are at risk.

Quietly the doctor explained that the two key risk factors are "being male" and "getting older" (get out of those if you can), and that although I am currently in a relatively low-risk band, other factors such as family history and my occasional smoking could easily tip me into a risk band beyond my years. "Your risk over the next ten years of angina or a heart attack is 4.5%," says his report. "Age is on your side but to further improve your risk stopping smoking completely, regular exercise and reducing alcohol intake are all helpful steps."

My consultation time with the doctor, a patient and gentle man who seemed, incredibly, to have enough time to answer all my questions, was also an opportunity to raise other nagging health queries. Whether you're worried about panic attacks following a bereavement or a lingering fungal infection (don't ask), this is the moment to raise the question — and better still, if you have a tendency to be reticent about such things, to raise it with someone you need never meet again.

Overall, my BUPA experience was a blend of the reassuring and the disconcerting. Reassuring because I now have it in black and white that my heart and lung function, vision, hearing and blood tests are normal. Disconcerting because the very fact that these things are normal now wouldn't be worth noting if there wasn't a strong chance that one day some or all of them will be not be normal at all, as a result of which I will experience pain and incapacity. Inevitably one is led to reflections on the precariousness of one's own health, and ultimately, the reality of one's own mortality.

BUPA suggests exercise strategies and stress management and relaxation techniques as practical answers to such morbid questions. Hopefully, too, all that medical attention will help me to think more consciously about the actual impact of how I live on how well I feel. I've reached a time in life where I've begun to take a real interest in looking after my health, so this screening provided a welcome reinforcement of that goal. True, £350 is a lot to pay to be told you need to stop smoking, but in some cases perhaps the very heftiness of the sum will help men turn good healthy intentions into achievable lifestyle realities. Now, where's that gym card?

What tests are on offer?

Each clinic offers its own selection of tests, depending on its resources (and yours! — medical tests don't come cheap, especially in the private sector), your age and your key health risk areas.

The range of tests is likely to include:

• A lifestyle assessment — looking at your diet, exercise levels, whether you smoke, how much alcohol you drink, etc.
• Medical history — both personal and family.
• Height and weight measurements.
• Blood pressure.
• Cholesterol levels.
• Urinalysis — for diabetes and kidney infections.
• Hearing and vision.
• Lung function.
• ECG (electrocardiogram) — a test to detect heart problems.
• Prostate — this will normally include a digital rectal examination (i.e. the doctor will feel your prostate via your anus) and a blood test for PSA (prostate specific antigen), an indicator of prostate disease. Unless you have symptoms, or a family history of prostate problems, these tests won't normally be performed if you're under 45.
• Bowel cancer (a test to detect blood hidden in the faeces of men over 45).
• Chest X-ray (if you're a heavy smoker).
• Testicular examination.
• Muscle strength and joint flexibility.
• The doctor may also examine your skin, ears, eyes, throat, chest and abdomen.

Well Man checks — the pros and cons

Well Man checks are highly controversial. Here are the main pros and cons:

What the experts say

Should I have one?

Use these key points to decide:

• Well Man checks provide useful motivation and information for men who've never paid much attention to their health ....

   

  ... BUT if you already know about the benefits of diet and exercise, and follow a lifestyle that minimises your major health risks, then you'll probably learn little that's new.

• If you're worried about a particular health problem then a check that eliminates your concerns can be reassuring ...

   

  ... BUT other tests may throw up minor, "clinically insignificant" abnormalities, causing needless worry.

• You'll always be grateful for a screen which detects early an abnormality requiring clinical treatment ...

   

  ... BUT be aware that such instances are relatively rare, and — depending on the condition — early detection may well not affect the outcome.

• A screening which offers a "clean bill of health" can be a great confidence booster and stressbuster ...

   

  ... BUT there's no substitute for paying attention to your lifestyle, as well as learning to listen to your body for any potential problems.

• FINALLY: Can you afford a Well Man check? Most are provided by the private sector and are costly. Remember — you can see your GP for nothing if you're worried about any aspect of your health.

Where can I get a Well Man check?

BUPA — Full Health Screen

Web site: www.bupa.co.uk

Location: 34 screening centres nationwide

Cost: £350

Tel: 0800 616 029

Cromwell Hospital — Executive Health Screen

Location: west London

Cost: £363

Tel: 0207 460 5856

The London Clinic — Well Man Screen

Location: central London

Cost: £158 (Full Male Health Screen £330)

Tel: 0207 616 7746

Marie Stopes — Well Man Screen

Web site: www.mariestopes.org.uk

Location: Leeds, London, Manchester

Cost: £75

Tel: 0845 300 8090 (London: 0207 388 0662)

Medicentre — Well Man Screen

Web site: www.medicentre.co.uk

Location: 5 clinics in central London, 1 in Kingston (Surrey)

Cost: £138 (Individual Full Health Assessment £378; with exercise ECG £405)

Tel: 0870 600 0870

Nuffield Hospitals — Well Man Screen

Web site: www.healthscreening.org.uk

Location: 45 hospitals nationwide

Cost: £148 (Full Health Assessment £323; with exercise ECG £403)

Tel: 0845 671 3000

Open For Men — Health Check

Location: Lewisham, south London

Cost: Free (NHS)

Contact details: 0207 635 1111

Dan Fielder

Have your say about Well Man clinics

Have you had a Well Man check? If so, was it useful? Or was it unnecessary and expensive? Do you think Well Man checks should be more widely available, perhaps on the NHS? Should every man be encouraged to have one? Tell us what you think.