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September 2, 2014

The future of general practice?

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Pictured at the launch were (L to R): Mr Ted McDermott, consultant urologist; Ms Trish Murphy, psychotherapist; Dr Christian Jessen, sexual health campaigner and presenter of Channel 4’s Embarrassing Bodies; and Prof Wallace Dinsmore, physician in sexual medicine and Chair of the Irish Association of Sexual Medicine

Pictured at the launch were (L to R): Mr Ted McDermott, consultant urologist; Ms Trish Murphy, psychotherapist; Dr Christian Jessen, sexual health campaigner and presenter of Channel 4’s Embarrassing Bodies; and Prof Wallace Dinsmore, physician in sexual medicine and Chair of the Irish Association of Sexual Medicine

Dr Christian Jessen of Channel 4’s Embarrassing Bodies was in Dublin last week for the launch of a men’s health campaign. He spoke with Catherine Reilly about premature ejaculation, sterilisation and Twitter.

 

I love Twitter,” GP Dr Christian Jessen, a host of Channel 4’s Bafta award-winning Embarrassing Bodies series, declares to Irish Medical Times. “But I am right in the middle of a Twitter fight at the moment… ”

Twitter war 

Indeed, as Dr Jessen addressed a Dublin press conference on the issue of premature ejaculation (PE) and sat down to speak with IMT, a miniature Twitter storm was still brewing over his response, tweeted the previous evening, to a Tweet from a woman questioning why it was advised that women should be at least 30 years old before sterilisation was considered. “COS U CHANGE YOUR MINDS” was Dr Jessen’s frank and not particularly nuanced response, although the micro-blogging site is not especially known for facilitating fine distinctions.

Accusations of misogyny followed, in addition to a pretty absurd threat to report him to the General Medical Council (GMC), eliciting a wry remark from Dublin GP Dr Conor McGrane, who tweeted: “Threatening a doc with referral to the GMC in this case is a bit like threatening to tell their mammy.”

Dr Jessen, who retweeted Dr McGrane’s supportive tweet, told IMT that at least the person who had originally asked the question now had an answer.

Demystify sexual health

Indeed, engaging with the public in order to improve health and demystify medicine are at the core of what Dr Jessen is about as a physician. Due to the regularity with which viewers in Ireland can watch Channel 4’s Embarrassing Bodies, as well as Supersize vs Superskinny, a programme that follows the journeys of extreme eaters, which is also presented by Dr Jessen, he is probably one of the most recognisable faces of medicine both here and in the UK, although many fellow doctors may be reluctant to tune-in after their own busy days in consultations.

For the uninitiated, Embarrassing Bodies shows patients presenting to GPs, including Dr Jessen, with various conditions that they were apparently too embarrassed to see their own doctor about. Sometimes the programme follows outcomes for patients referred on to specialists and it has been particularly effective in promoting public discussion on sexual health.

Indeed, Dr Jessen told IMT he believed it had encouraged dialogue between patients and doctors on such issues as premature ejaculation (PE), a condition he discussed at the launch of ‘Take Control’ (www.take control.ie), a new campaign supported by A.Menarini Pharmaceuticals that urges men who think they may suffer from PE to speak to a GP or healthcare professional about it. Prof Wallace Dinsmore, Chair of the Irish Association of Sexual Medicine; Consultant Urologist Mr Ted McDermott and Psychotherapist Trish Murphy, also spoke at the launch on January 21.

“I certainly think it has helped patients actually go and make that first step and say ‘I think I have this problem’,” Dr Jessen said of Embarrassing Bodies. “Men are difficult creatures at the best of times, and they have a certain pride and when it comes to anything sexual, I think we are particularly defensive about that… A lot of GPs are male, and for a man to sit in front of another man and go ‘I don’t perform too well sexually’ is quite a big deal.”

Therefore to witness other people talk openly about their own problems is “massively important”, he said.

More men are presenting with problems such as premature ejaculation and erectile dysfunction (ED) than five-to-10 years ago, said Dr Jessen, who cited the arrival of Viagra (sildenafil) in the late 1990s, as a treatment for ED, as having prompted much more discussion on the issue of men’s sexual health.

“I think television [makes an impact] — we talk about sex so much more, magazines are always writing about it, so I do think men are getting better at coming forward about this sort of thing.”

Dr Jessen said that with new treatments coming on-stream for treatment of PE — which is the most common sexual dysfunction in men, affecting as many as one in five — this condition will fall under a greater spotlight.

But he also felt GPs needed to be “more aware” of such problems and ask patients about their sexual health during general consultations.  “If you don’t ask, the patient may well not tell you… As soon as you have asked, they are far more likely to actually give you an honest answer,” he said.

Meantime, shows such as Embarrassing Bodies continue to play an important role in promoting sexual and general health, said Dr Jessen.

“It is why I am so happy to do what I do in the media, because I do think it encourages people. If you see GPs on telly, like me, talking about this sort of problem and not looking too embarrassed and using down to earth, normal words that everyone can understand, I really think that does help a patient to go on and do it themselves,” he added.

Mixed views

Nevertheless, views on Embarrassing Bodies within the medical community have been “mixed”, he conceded. Some doctors love it; others think the broadcasts lead to an extra influx of previously reluctant patients the following morning (“But you know what? That’s good,” pointed out Dr Jessen), while there are those who think such programmes are not something doctors should be engaging with at all.

“Some people just hate it — they think it is not the sort of thing doctors should be doing on television, it is voyeuristic and things,” said Dr Jessen. “I don’t agree. I think doctors have not been very good communicators in the past and I don’t think we have been very good at relating to the public. In a way, we have been slightly pedestalised. This is not entirely our own fault — I think the public put doctors up on pedestals to start with, but we really need to come down and be a little bit more human and a little bit more interactive and talk a little bit more with people.”

That is where avenues like Twitter come in — despite the previously alluded-to downside. “I see Twitter as a very, very valuable way of interacting with the public,” he said.

His Twitter feed, @DoctorChristian, includes questions from fellow Tweeters, including whether food being considered as a ‘reward’ is a major factor in obesity in general (Dr Jessen thought this plays a part); whether he thinks fibromyalgia is a real disease (Dr Jessen said he does — because it is) and if there is any truth that prostate cancer can be detected by men ‘weeing on a pregnancy test’ (Dr Jessen said “no”).

“I don’t know why other doctors hate it so much,” said Dr Jessen of Twitter.

“I think they think that you can’t answer people’s medical questions like that, you need a full consultation and examination. Actually, no you don’t, that is rubbish and if you look at the sorts of questions I answer, they are perfectly answerable without knowing the person. So I am a big fan and I think doctors should be braver, they should do more online work — you can do a lot of good.”