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MEN’S HEALTH 37 “There’s still a long way to go in terms of how our service can end up, but in this specialised area of men’s urological health, we really can’t rush.” What goes on in a consultation “We always spend a good amount of time with patients on their first consultation,” Mr Stewart said, adding that this could take 45 minutes to an hour. “Even just understanding what’s going on with them, like for example that they’ve had prostate surgery, can take time,” he continued. “Then you might learn they’re happy to have the cancer gone but they don’t understand what’s gone on, because now they’ve got erectile dysfunction and they’re completely incontinent. Even though they understand they had surgery, the physiology about why it’s all happening can take quite a bit of time to explain. “If it’s just the patient on their own, especially at their first consult, while they might have taken in some of the information, it often just needs a bit of reinforcement at the second consultation, too.” Having discussions about such personal health issues isn’t only difficult for the patient. Pharmacists typically take a year or so to become comfortable talking about penises, erections or ejaculation, and as every patient likes to approach it differently, the pharmacists need to develop a sensitive and adaptable approach. While some patients are bold and matter of fact, some deal with their embarrassment using humour, while others can struggle to even open up about the topic. According to Mr Stewart, the required skills take many months to develop and will continue to evolve as engagement in the men’s health space continues. “I might have an afternoon of four or five blokes, one after the other, and they’re all completely different in the way they talk about their issues,” he said. “Sometimes it might take 20 minutes to break them down before they start telling you their issues. “We see a range of men’s health problems and a lot of our patients have recently, or sometimes not so recently, had their prostate removed. We can take them through penile rehabilitation if they’re in that stage where they can rehabilitate, or they might just be battling with erectile dysfunction or incontinence. “We also see erectile dysfunction and incontinence that are completely unrelated to the prostate. Sometimes it’s simple, sometimes it’s complex. We see blokes with Peyronie’s disease, so that’s a big part of what we do as well. “We also see some blokes with prostatitis or prostate cancer that haven’t had a prostatectomy but might be going through radiation or androgen deprivation therapy. Then, on the other end of the spectrum, we may see blokes with premature ejaculation, too, so it’s very varied indeed.” Overall, the need for men’s health professional services is high, so the opportunity this presents for pharmacies is an excellent one. When Men’s Health Downunder began seven years ago, it had one consult room in a pharmacy and the team made it work well. Much of the learning the team has gone through can be shared. Mr Stewart is willing to talk to other pharmacists wanting to know more about the opportunity men’s health presents. RETAIL PHARMACY ASSISTANTS • JUN 2020