motivated to do everything they can to maintain or improve their health. We hope to bring men into the healthcare system at an earlier age so they can take the steps that will keep them active and help prevent the illnesses that commonly afflict men as they age. We want to help identify potential risks such as high blood pressure, high cholesterol, depression, erectile dysfunction, obesity and risky personal behaviors. In that regard, is collaboration with other specialists central to your vision? Absolutely. It used to be that there was the country doctor who took care of all of a patient’s needs, but medicine is so much more complex now. As a urologist and a microsurgeon, my knowledge of cardiology is limited to what I learned in medical school. When I identify problems outside of my expertise, I need to be able to direct my patient to the best possible care. We see this interdisciplinary approach taking off in diabetes, in cancer care and in women’s health, and it makes sense for men to also have a central place where they can meet all of their general-health needs. In our first year, we developed collaborative relationships with UCLA sports-medicine physicians and addiction-medicine specialists, for example, and we are pursuing closer ties with other disciplines to which our patients often are referred, such as cardiology, psychiatry and East-West medicine. Why does it make sense to have urology as the cornerstone for this broader focus? It comes down to Sutton’s law, which is the classic story of Willie Sutton who, when asked why he robbed banks, said because that’s where the money is. Sexual difficulties and urinary difficulties are what initially drive many men to the doctor’s office, and so the urologist has the opportunity to steward them through the medical landscape. If I’m seeing a man in his 20s or 30s for fertility issues, I’m also thinking down the road about his risk factors for other conditions and how we can intervene to reduce them. If I’m seeing a 40-year-old man who is finished having kids and wants to schedule a vasectomy, and I see that he is overweight, I will discuss what he could do to improve his life over the next 10 years to make sure he doesn’t develop heart disease, diabetes or other complications of obesity. In either case, the man is now enfranchised into the medical system, and if he has issues or just needs a routine screening, he’s more likely to return. Why do men tend to be less proactive than women about their health? There are two reasons. One is cultural. Men have been taught to “play through pain,” which often translates to not seeking the care they need. That’s had the unfortunate effect of marginalizing efforts to address men’s overall health in a holistic way. It’s amazing how many men will ignore even severe cardiovascular warnings. The second issue is that men between the ages of 18 and 50 are less likely than women to routinely see a doctor. Women generally see an internist or a gynecologist every year, and so they are regularly screened for hypertension, heart disease and cholesterol, as well as fertility health. Many men don’t have that regular contact, and so they miss out when it comes to pointing out warning signs as well as on counseling to optimize their health. What do you wish more physicians knew about male erectile dysfunction? The first thing is that erectile dysfunction can often be a sign of other health concerns, such as significant cardiovascular problems, so a doctor who is just giving a prescription for an oral medication and not performing a full risk assessment is doing a disservice to the patient. And when it comes to treating the erectile dysfunction, there are lots of very good options that go well beyond the oral medication. Too many physicians and patients give up if the pills don’t work, but those of us who are specialists in sexual medicine can offer more advanced therapies that can have a major impact on quality of life. For more information about the Men’s Clinic at UCLA, go to: urology.ucla.edu/mens-clinic Jesse N. Mills, MD 7 UCLA Physicians Update