2026/05/21 by Daniel T. Li, Alopi Patel, Gerardo Rodriguez · 1 voice
Health Professions · Medicine · Social Sciences · #Gender Roles and Identity Studies #Male Reproductive Health Studies #Sex and Gender in Healthcare
paper · doi:10.1097/01.asm.0001194288.56700.11
openalex publication_date 2026/05/21 · openalex created_date 2026/05/22 · openalex updated_date 2026/07/23
The public perceives physicians as leaders and caregivers who must abide by the same health priorities they set forth for their patients. Unfortunately, this public perception is far from the truth for many physicians, as seen by the number of physicians suffering substance use, suicide, divorces, and other stress-related complications. Male physicians are in a unique intersection convalesced by several social and genetic risk factors, societal expectations, and household duties. This is not to suggest that men have it harder than women. Instead, we wish to acknowledge that each sex has its own unique challenges that should be recognized and attended to with caution and care, particularly as they move through the stages of their career. Men's health refers to the biological, psychological, and social factors that influence their health across their lives (Table 1). Men experience higher rates of cardiovascular disease, various mental health concerns, and unique social pressures regarding seeking medical or psychological support (Nat Rev Urol 2013;10:606-12). Men are more likely than women to die of cancer and chronic diseases of the heart, blood vessels, lungs, kidneys, and liver, and are also much more likely to die from opioid overdose, alcohol use, suicide, accidents, guns, and assault (asamonitor.pub/4c7gKRm). Male physicians are not immune to these challenges. Table 1 - Health Issues Affecting Male Physicians Across the Career Lifecycle. Table created by Claude AI. Multiple prompts were used, with incremental guidance. Career Phase Medical Training Age ~22-30 Early Career Age ~30-40 Mid Career Age ~40-50 Late Career Age ~50-65 Transition and Retirement Age 65+ Mental Health and Burnout Identity stress and imposter syndrome Sleep deprivation (residency) Early depression onset Stigma vs. help-seeking Burnout escalation Moral injury Untreated anxiety and depression Suicide risk rising Peak burnout prevalence Emotional exhaustion Relationship breakdown Substance use escalation Chronic unaddressed depression Isolation and loneliness Suicide risk continues to rise Loss of identity post-retirement Grief and purposelessness Highest suicide rate of any age group Physical and Chronic Disease Poor diet and irregular meals Sedentary lifestyle begins Testosterone decline starts Obesity and metabolic risk Hypertension onset Back/musculoskeletal pain Sleep disorder Cardiovascular disease risk rises Type 2 diabetes onset Symptomatic hypogonadism Colorectal cancer screening age Peak CVD mortality risk Prostate cancer diagnosis Chronic pain accumulates BPH onset Multi-morbidity Osteoporosis (often undetected) Dementia risk Frailty and falls Reproductive and Sexual Health Sperm quality declining (lifestyle) Testicular cancer peak risk Varicocele often undetected Infertility diagnosis delayed Low libido/early ED Psychosocial burden of infertility Symptomatic low testosterone ED as CVD early warning PSA screening decision Prostate cancer treatment side effects BPH/urinary symptoms Testosterone deficiency worsening Severe hypogonadism Complete ED Osteoporosis from low testosterone Key physical, mental, reproductive, and occupational health risks facing male physicians, stratified by career phase. Conditions represent emerging or escalating risks at each stage. ED=erectile dysfunction; BPH=benign prostatic hyperplasia; CVD=cardiovascular disease; PSA=prostate-specific antigen.Sources: Centers for Disease Control (CDC), National Institute for Occupational Safety and Health (NIOSH), American Foundation for Suicide Prevention (AFSP), Substance Abuse and Mental Health Services Administration (SAMHSA), National Cancer Institute-Surveillance, Epidemiology, and End Results, American Cancer Society Facts and Figures 2025, World Health Organization (WHO), American Institute for Boys and Men, European Association of Urology 2024 Guidelines. Men's health in early career: Finding their footing Residency and fellowship are known to be stress points for all physicians. Compared to female residents, male residents suffer from lower rates of depression and suicidality; instead, they are more likely to experience depersonalization and substance abuse (Ann Intern Med 2022;175:56-64). These risk factors can be exacerbated by their hesitancy to seek support services and treatment. The explanation for why men tend to avoid openly seeking help is a complicated question that has multiple contributing factors, including but not limited to generational differences, biological tendencies, genetics, and psychological contributors (J Fam Pract 1999;48:47-52). Burnout among physicians remains a persistent problem as a national shortage of anesthesiologists and an ever-sicker, older population continue to apply pressure on anesthesiologists entering the workforce. The consequence of burnout has quality, safety, and economic implications. Fatigue, depression, poor quality of life, stress management, and burnout are correlated with greater errors related to patient care. Male physicians are also more likely to experience substance abuse and detachment, which can contribute to lower-quality care and potential for medical errors (Anesthesiology 2020;133:342-9; Perm J 2023;27:160-8). Physician burnout alone has been implicated in an estimated 2 billion cost to the health care industry (Ann Intern Med 2019;170:784-90). Among male physicians, anesthesiologists have some of the highest rates of substance abuse disorders. Their exposure and access to potent opioids, sedatives, and other potent controlled substances explain their risk tendencies to abuse opioids. The combined stressors of training, access, and direct handling of addictive substances expose trainees to a unique vulnerability to develop substance use disorders. The role of being a parent cannot be undervalued, and mental preparation for the expected responsibilities of fatherhood cannot be underestimated. Many will report that the biggest challenge of being a father is the limitations on one's time. A number of health care organizations have expanded parental leave policies to include male physicians. Some organizations provide fathers with unpaid leave and/or job-protected leave, up to about 12 weeks under the Family and Medical Leave Act, that supports bonding with a newborn or newly adopted child (asamonitor.pub/3NWqKni). Men's health in mid to late career: The fog of burnout Cardiovascular disease conditions remain more common in men than women, while preventive health care utilization is less among men than women in the United States (asamonitor.pub/42HUY0S). The psychological rationale for why male physicians often avoid preventive health care is complex. Encouraging male physicians to prioritize their own preventive health care helps them mitigate health risks related to mental and chronic disease, in addition to preventing future reproductive and sexual health concerns. Men face unique biological and genetic risk factors related to the reproductive system, including prostate cancer, testicular cancer, and benign prostatic hyperplasia (BPH). These conditions can affect their quality of life and life expectancy. Neglected BPH is known to impact sleep quality, which can subsequently affect sleep recovery and optimal cognitive function at work (Nat Rev Urol 2013;10:606-12). Department-level support from leadership to include ‘open-forum’ conversations about mental health or seeking confidential and protected access to wellness programs can help normalize challenges all physicians undergo with the adverse effects of stress on individuals and their clinical practice. Colleagues are often the first to notice subtle changes in behavior, performance, or mood before the individuals themselves. Recognizing mental health and physical wellness as normal parts of our professional lives can lead to timely, supportive interventions (Table 2). Table 2 - Five Pillars of Action. Table created by Claude AI. Multiple prompts were used, with incremental guidance. Psychological Safety Physical Health Access Substance Use and Recovery Family and Reproductive Health Leadership and Culture Change Normalize help-seeking and mental health care Build peer support networks for men Remove barriers to preventive care Encourage prostate, testosterone, and cardiovascular screening Protected time for physician wellness appointments Confidential screening and clear treatment pathways Physician health programs with defined re-entry support Peer recovery mentors in sustained recovery Equal paternity leave and support for fathers Acknowledge grief in infertility and pregnancy loss Fertility counseling and sperm banking access Recognize male-pattern distress early Track men's health in wellness metrics Mentorship and support across career transitions Male physicians are 1.4 times more likely to die by suicide than the general male population — yet fewer than 1 in 5 had mental health contact in the year before. Sources: AFSP, CDC, NIOSH, SAMHSA, American Institute for Boys and Men, WHO. Men's health in late career: Not in cruise control Physicians in the late career stage are typically between 55 and 70 years of age. They make up over 20% of practicing physicians – an estimate that will likely continue to increase given the workforce issues occurring in our specialty and in medicine overall. It is largely assumed that physicians at this stage in their careers will be enjoying the fruits of their labor, having worked hard and sacrificed personally and financially to develop expertise, wisdom, respect, and financial independence. Such a misperception is countered by the reality that this stage is often characterized by an ever-increasing workload and intensity, even as this cohort adjusts to the reductions in expected age-related cognitive decline. When approaching 65, physicians may begin to struggle with the perceived loss of identity post-retirement or the expected accrued lifestyle expenses or debt post-retirement, and consequently choose to continue to work, even if part-time. This may be partially evidenced by the delayed retirement age among anesthesiologists in previous years. For male physicians, being aware of these career stages is not enough. There must be intentional planning, as we would expect from our patients when it comes to their health. The topic of physician health and well-being is now commonly recognized among individual physicians and large health care organizations, as evidenced by investments in well-being education and wellness strategies. A major driver of this new focus has been the recognition of the alarming increase in burnout rates among physicians, now affecting them at much earlier career stages. Physicians should not ignore their own well-being, given the ever-present stressors of fatigue, chronic illness, and burnout (Am J Med 2025;138:1490-6). AI Use Disclosure: An AI tool (Claude) was used to create the tables. The authors reviewed and approved all content.Daniel T. Li, PharmD, Medical Student, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.Alopi Patel, MD, FASA, ASA Committee on Physician Well-Being, and Associate Professor, Department of Anesthesiology and Perioperative Medicine, Rutgers-Robert Wood Johnson Medical School, RWJBarnabas Health System, New Brunswick, New Jersey. @alopipatelmdGerardo Rodriguez, MD, Associate Professor, Faculty Anesthesiologist, and CVICU Medical Director, Department of Anesthesiology and Perioperative Medicine, Rutgers-RWJ University Hospital, New Brunswick, New Jersey.