Atlanta

"It only hurts when I walk on it." "It's just a little swollen." "I'm too busy."

You might hear excuses like these from your guy when you try to get him to go to the doctor — whether he is in pain or just needs a checkup.

Jenny Dowd can relate. She said her husband, Mark, pops antacids every day to soothe his stomach ailments. "He always claims, 'Oh, it's just heartburn,' or 'Oh, I ate something that didn't agree with me.' I call them his candy, and I tease him because he eats Tums every single day. It's the last thing he does before he walks out the door to go to work," she said.

How long has he practiced his Tums habit? "Years," she said. What's worse, Dowd added, Mark has only visited a doctor once in 16 years, as far as she can recall.

"Men tend to sort of approach life as a series of problems that have to be solved, and if there's not a problem right in front of them, then typically they're not going to try to solve something they can't see," said Dr. Michael Witt, a urologist with Reproductive Biology Associates. "That, from a mind-set standpoint, makes men a little reluctant to do anything until they see something that needs to be done." Along with a touch of male pride, this might account for men's resistance.

Besides, he added, women are used to seeing a doctor regularly — starting with gynecological exams — as early as their teen years.

And when you're thinking about problems that might occur down the line, it might be even harder to persuade men to see a doctor.

"(Men) tend not to be too informed about the need for preventive medicine," agreed Dr. Sandy Carter Jr., an internist. "The most important thing that gives men trouble is coronary artery disease, so we really start addressing risk factors certainly from age 40 on."

For Jackson Moore, a cough, acid-reflux disease and an inability to sleep on his back were unrelated symptoms that he put up with for several years. His wife, Sharon, encouraged him to see a doctor, but he refused until he became a patient of Carter, who discovered the problem was a hiatal hernia. Now, Moore goes for a physical every year, he said.

It's probably not fair to suggest that all men avoid the doctor.

"I'm not going to accept that on face value," said Dr. David Roberts, medical director of Emory Executive Health, a preventive-health program that serves businessmen and women through their companies' participation. "I don't know whether it is gender-specific or whether it is more situation-specific, because I've got some busy, hard-charging executive women who are just as stubborn and recalcitrant as the stereotypical male would be."

Peter Abreu is one of the men who is concerned about his health and that of others in his family.

In fact, it was Abreu's wife, Carol, who avoided doctors. On the other hand, Carol Abreu, a retired flight attendant, gave her husband credit for jump-starting her health care. Carol had a family history of colon cancer, so she was scared what she might find out if she went to the doctor. At age 52, she had never had a physical, she said.

"I was too afraid to go have an in-depth physical. Peter made me," she said.

Luckily for Carol, Peter wore her down until she agreed to go. A colonoscopy detected cancerous cells. And without treatment, her doctors said, she would have died within six months. She is now recovering.

"Now I'm the one that sets up the appointments every year for the physical," Abreu said proudly.

Don't be a nag

Here are some tips about how to have a health-care discussion with your reluctant guy, from Dr. Amy House, psychologist, assistant professor and director of the Women's Behavioral Health Program at the Medical College of Georgia in Augusta.

• Tell him why you want him to go without being critical. For example, you might mention your fears: "It would make me feel better if you would go to the doctor because I'm afraid what the symptoms might mean, and I'm afraid you're not getting the care you need."

• Don't get angry and call him stubborn or lazy. He might just be scared to go.

• Ask him if you can do anything to help, like find a doctor or make the appointment for him. You could also offer to go with him, if that would make him feel more comfortable.

• Ask for family and friends to talk to him, especially if they're undergoing or have undergone similar procedures. But be careful not to gang up on him.

• If you're worried he won't mention all of his symptoms, call the doctor's office before the appointment. Dr. Sandy Carter Jr. said wives of his patients routinely call and tip him off to their concerns.

• Appeal to his sense of being a provider. "You have been a good provider for us. ... One of the best ways that you can continue to be a provider for us is to take care of your own health so that you can be around for the long haul."

n If he resists further treatment or appointments, tell him how important it is to follow the doctor's recommendations. Otherwise, the first visit was a waste of time.

What to expect from a physical

Assuming men are otherwise healthy, physical exams should include the following elements, according to Dr. Larry Fields, president of the American Academy of Family Physicians:

n Complete medical history, including medications, allergies and any high-risk behaviors, such as smoking.

• Assessment of vital signs such as blood pressure, temperature and pulse.

• Checkup of eyes, ears, chest, stomach and testicles.

• A rectal exam (for men over 50), for prostate and/or colorectal problems.

• Neurological tests such as those for memory, reasoning, balance and reflexes.

• Blood count for anemia, blood sugar, liver and kidney functions.

• Urinalysis for kidney diseases other than infection.

A physical may also include screenings for depression and HIV; an EKG, chest X-ray and stress test, depending on family history; and vision and hearing tests for job-related physical exams.

Making the most

of doctor's appointments

• Have your family medical history ready, such as information on diseases of immediate family members (parents, siblings, grandparents).

• Ask your doctor if there is anything you can do to improve your health without medication, such as losing weight, quitting smoking, exercising, eating a low-fat diet full of fruits and vegetables and limiting alcohol.

• Know your numbers. Blood pressure and cholesterol levels can indicate who's at risk for heart attack and stroke, for example.

Top health risks

Of the leading causes of deaths in men ages 25 to 85, some are diseases that can be prevented or minimized with lifestyle changes.

1. Heart disease

2. Cancer*

3. Stroke

4. Chronic respiratory disease

5. Accidents

6. Diabetes

* The American Cancer Society estimates that lung, colorectal and prostate cancers will be the top cancer threats for men in 2006.

Source: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention