"DIRECT CONNECTION" IS MADE BY MPT TO SERVE ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

[*] LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

[*] >> JEFF: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION."

JUST AHEAD TONIGHT, IT IS MEN'S HEALTH MONTH.

WE'LL GET TIPS THAT ALL MEN NEED TO KNOW ABOUT COMING UP.

FIRST THIS WEEK, SCHOOL IS OUT, SUMMER IS HERE.

AND THE CROWDS ARE FLOCKING TO OCEAN CITY.

JOINING US TO ANSWER YOUR QUESTIONS TONIGHT IS OCEAN CITY MAYOR RICK MEEHAN.

Mr. MAYOR, THANK YOU FOR JOINING US.

I APOLOGIZE WE DID NOT FLOCK TO OCEAN CITY BECAUSE THE FORECAST WAS A LITTLE BIT IFFY TONIGHT.

>> I UNDERSTAND THEY'RE PREDICTING SOME BAD WEATHER BUT IT IS BETTER WHEN WE ARE BOTH STANDING DOWN BY THE INLET OVERLOOKING THE BEACH.

>> JEFF: I KNOW, I CAN'T EVEN SMELL THE FRENCH FRIES FROM HERE.

LET ME BRING UP FIRST SOMETHING THAT'S GOING TO CHANGE.

WE TALK ABOUT, YOU KNOW, SUMMER IS STARTING.

SCHOOL IS OUT.

JULY 1 IS SATURDAY, I BELIEVE, AND THAT IS THE DAY THAT MARIJUANA BECOMES LEGAL IN THE STATE OF MARYLAND.

WHAT IS THAT GOING TO MEAN?

CAN SOMEBODY WALK ON THE BOARDWALK STANDING AT A BUS STOP LIGHT UP IN OCEAN CITY?

WHAT CONTROL, IF ANY, DO YOU HAVE OVER THAT?

>> WELL, REALLY, IT IS GOING TO BE CHALLENGING.

THE STATE LAW DOES LEGALIZE RECREATIONAL MARIJUANA.

BUT IT STILL CANNOT BE USED IN PUBLIC PLACES.

YOU CANNOT SMOKE IT OUTSIDE ON THE BEACH.

YOU CANNOT SMOKE IN PUBLIC.

YOU ARE NOT ALLOWED TO SMOKE MARIJUANA IN A PUBLIC AREA, INSIDE PUBLIC BUILDINGS ON SIDEWALKS, STREETS RVELGT, PUBLIC TRANSPORTATION.

IT'S VERY SIMILAR WITH REGARD TO THE RULE TO ALCOHOL.

AND I REALLY DON'T KNOW IF THE STATE HAS DONE A GOOD JOB GETTING THAT MESSAGE OUT.

I'M SURE A LOT OF PEOPLE ARE VERY CONFUSED RIGHT NOW ABOUT WHAT THE RULES ARE GOING TO BE.

IT IS GOING TO BE CHALLENGING.

BECAUSE I THINK THERE IS A LOT OF PEOPLE THAT NUMBER ONE MIGHT IGNORE THE RULES.

BUT CERTAINLY THAT AREN'T AWARE OF EXACTLY WHAT THE RULES ARE.

AND IN OCEAN CITY, WE ARE THE SECOND LARGEST CITY IN THE STATE RIGHT NOW.

WE EXPECT OVER 300,000 PEOPLE THIS WEEKEND AND A LOT OF THESE PEOPLE, MAYBE HALF ARE FROM OTHER JURISDICTIONS OR OTHER STATES WHERE RECREATIONAL MARIJUANA OR CANNABIS IS NOT LEGAL.

SO IT'S GOING TO PRESENT SOME CHALLENGES FOR OCEAN CITY.

>> JEFF: HAS THE POLICE DEPARTMENT THERE PLANNED FOR THIS?

YOU KNOW, THERE WAS AN INCIDENT A FEW YEARS AGO, MAYBE SOME OVERZEALOUS ENFORCEMENT OF ANTI-VAPING RULES ON THE BOARDWALKS AND PEOPLE WERE TASED.

IS THERE A PLAN, IF YOU HAVE PEOPLE, MAYBE IN THE SMOKING AREA, MAYBE SOMEWHERE ELSE, WHO WON'T PUT DOWN THE JOINT?

>> YEAH, AGAIN, TOUGH QUESTION.

I'M NOT SURE WE WERE REALLY OVERZEALOUS AND THE CASE, BUT IN THE PAST, YOU KNOW, WE FOLLOW ALL THE PROPER PROTOCOLS IN OCEAN CITY WITH REGARD TO HOW WE APPROACH PEOPLE, HOW WE INFORM THEM OF THEIR RIGHTS, WHAT THE LAWS ARE.

AND WHAT THE CONSEQUENCES ARE WHEN THEY BREAK THE LAW.

ALL OF OUR LAW ENFORCEMENT OFFICERS NOW HAVE BODY CAMS AND THAT'S REALLY HELPED TO MAKE A DIFFERENCE.

AGAIN, JEFF, IT'S GOING TO BE CHALLENGING.

YOU KNOW, WE ARE GOING TO TRY TO EDUCATE EVERYBODY AND THEN, WHAT YOU ARE GOING TO GET ARE OTHER INDIVIDUALS WONDERING WHY PEOPLE WEREN'T TICKETED OR WHY THEY WEREN'T ARRESTED.

SO WE ARE GOING TO HAVE TO MITIGATE THAT.

AND IT'S GOING TO BE VERY CHALLENGING.

BUT WE ARE GOING TO DO THE VERY BEST WE CAN TO HANDLE THIS THE PROPER WAY AND MAKE SURE, YOU KNOW, WE GET THE WORD OUT AND WE ENFORCE THE RULES THAT WE CAN.

YOU KNOW, THIS IS A STATE LAW.

THIS LAW WAS ENACTED BY THE LEGISLATURE.

IT WAS THE RESULT OF A REFERENDUM VOTE BY THE CITIZENS OF THE STATE OF MARYLAND.

SO, YOU KNOW, WE ARE GOING TO WORK THROUGH IT.

IT'S JUST THAT I DON'T REALLY THINK A LOT OF INFORMATION HAS BEEN GIVEN TO THE GENERAL PUBLIC AS TO EXACTLY WHAT THEY CAN AND CANNOT DO ON JULY 1.

>> Jeff: LET'S REMIND OUR VIEWERS, IF YOU HAVE A QUESTION FOR OUR MAYOR, YOU CAN CALL THE LIVE QUESTIONS AT MPT.ORG.

YOU CAN-- LET'S LOOK AT THE BIG PICTURE OF OCEAN CITY, STRONG ECONOMY, BUT GAS PRICES HAVE GONE DOWN A BIT.

THAT'S A GOOD MIX FOR THE BUSINESS OF THE BEACH.

>> IT IS.

AND WE HAVE HAD A GOOD SPRING.

THE WEATHER COULD HAVE BEEN A LITTLE BIT BETTER.

UNFORTUNATELY WE HAVE HAD A LOT OF NORTHEAST WINDS FOR A WHILE AND THEN A LITTLE BIT OF RAIN.

AND EARLY IN THE SEASON, IT DOES AFFECT US BECAUSE, YOU KNOW, WE HAVE A LOT OF WEEKEND BUSINESS.

NOW WE ARE MOVING INTO THE PART OF THE SEASON WHERE WEEKLY BUSINESS IS PREDOMINANTLY WHAT WE ARE GOING TO BE SEEING AND BUSY WEEKENDS AS WELL, WHEN PEOPLE JUST COME DOWN FOR THE TWO OR THREE DAYS.

SO WE ARE REALLY GETTING INTO THE MEAT OF THE SUMMER RIGHT NOW.

SO FAR THINGS HAVE BEEN GOOD INDICATORS, OUR ROOM TAX AND OTHER ECONOMIC BAROMETERS HAVE BEEN UP.

SO WE ARE HOPING TO CONTINUE THAT THROUGHOUT THE SUMMER OF 2023.

>> Jeff: IT FEELS LIKE, FINGERS CROSSED, THE PANDEMIC MAY BE IN THE REARVIEW MIRROR, AT LEAST FOR NOW.

HOW DID THE PANDEMIC CHANGE OCEAN CITY?

YOU HAD PEOPLE WHO WERE FORTUNATE TO MAYBE HAVE A SECOND HOME THERE, FORTUNATE TO BE ABLE TO WORK REMOTELY WHO SPENT MORE TIME AT THE BEACH THAN THEY USED TO.

DO YOU SEE THAT CONTINUING, ANY OTHER TRENDS HELD OVER FROM THE PANDEMIC?

>> WE DO SEE THAT CONTINUING.

AND BEING ABLE TO WORK FROM HOME AND DO YOUR JOB DIFFERENTLY THAN YOU DID PRIOR TO THE PANDEMIC.

I THINK THAT HAS STAYED.

WE HAVE SEEN A LOT OF PEOPLE THAT CAN WORK REMOTELY RELOCATE.

THEY HAVE A SECOND HOME AND MADE THAT THEIR PRIMARY RESIDENCE OR BOUGHT A PERMANENT RESIDENCE IN OCEAN CITY.

THE OTHER THINGS WE HAVE SEEN-- NOT MANY TALK ABOUT IT.

IT SEEMS LIKE A LONG TIME AGO FOR US HERE IN OCEAN CITY BUT A LOT OF OUR BUSINESSES MADE ADJUSTMENTS.

WE HAVE A LOT MORE OUTDOOR SEATING IN RESTAURANTS.

A LOT OF OUR RESTAURANTS DURING COVID ADJUSTED THEIR HOURS, SHORTENED THEIR HOURS MANY OF THEM FOUND THE BETTER BUSINESS PLAN WOULD BE TO CLOSE A LITTLE EARLIER, MAYBE JUST TO SERVE BREAKFAST AND LUNCH OR LUNCH AND DINNER.

SO YOU SEE SOME CHANGES.

OUR BUSINESSES ARE VERY ASTUTE AT ADAPTING TO THE CIRCUMSTANCES AND A LOT OF THOSE THINGS CARRY OVER AND REALLY HELPED IMPROVE THEIR BUSINESS MOVING FORWARD >> JEFF: WHERE DO YOU SEE INVESTMENTS BEING MADE IN RESTAURANTS, OTHER BUSINESSES, BUT ALSO CONSTRUCTION OF CONDOS AND HOTELS?

WE ARE STARTING TO SEE SOME REDEVELOPMENT IN TOWN, MOST OF WHAT YOU WILL SEE AS FAR AS DEVELOPMENT IS REDEVELOPMENT AND WE ARE STARTING TO SEE SOME OF THAT.

THERE ARE SOME BIGGER PROJECTS THAT ARE BEING PROPOSED AND THAT'S GOOD.

TYPICALLY THAT WOULD BE OLDER HOTELS THAT, YOU KNOW, HAVE OUTLIVED THEIR USEFULNESS AS FAR AS ACCOMMODATIONS AND NEWER BUILDINGS BEING PROPOSED SO THAT'S A REAL POSITIVE.

I'VE TOLD YOU BEFORE, JEFF, WE HAVE ALWAYS BEEN VERY FORTUNATE IN OCEAN CITY TO CONTINUOUSLY REBUILD OUR CITY SO THAT WE NEVER GREW OLD ALL AT ONCE AS SOME RESORT COMMUNITIES DID.

SO VERY PROACTIVE.

YOU ARE SEEING SOME SMALL DEVELOPMENT IN THE WEST OCEAN CITY AREA AS WELL.

I THINK YOU ARE GOING TO SEE THAT CONTINUE PROBABLY FOR THE NEXT COUPLE OF YEARS.

>> Jeff: MAJOR INVESTMENT COMING THAT I KNOW YOU HAVE MIXED FEELINGS ABOUT WITH OFFSHORE WIND BEING LICENSED BY THE STATE GOVERNMENT, THE FEDERAL GOVERNMENT.

GOVERNOR WES MOORE IS 100% BEHIND THIS AS A JOB CREATOR AND A SOURCE FOR CLEAN ENERGY.

HAS OCEAN CITY'S VIEW ON THAT CHANGED AT ALL?

>> WELL, I THINK MAYBE OUR VIEWS SOMETIMES MISINTERPRETED.

WE SUPPORT THE GOVERNOR'S PLAN.

WE SUPPORT EVERY GOAL THAT THE GOVERNOR WANTS TO REACH.

WE SUPPORT THE INVESTMENTS IN THE BALTIMORE HARBOR, THE INVESTMENT IN THE PORTS THROUGHOUT THE STATE, THE NEW JOBS, THE CLEAN ENERGY, WHICH WE ALL SUPPORT.

YOU KNOW, THE OTHER INVESTMENTS, MONETARY GAINS BY PEOPLE.

WE SUPPORT ALL OF THAT.

AND YOU WANT TO KNOW, JEFF, ALL OF THAT COULD STILL BE DONE IF THEY MOVE THE WIND FARMS JUST A LITTLE FURTHER TO THE EAST.

NOTHING WOULD CHANGE.

THAT'S WHAT IS FRUSTRATING TO US IS THAT THEY'RE PROPOSING-- NOT PROPOSING, THEIR PLAN PRESENTED BY U.S. WIND WOULD HAVE THE WIND TURBINES 11.9 MILES OFF OF OUR COAST AND THESE TURBINES HAVE NOW GROWN, THEY'RE FOUR TIMES THE HEIGHT OF THE TALLEST BUILDING IN OCEAN CITY.

ALL WE ARE ASKING, AND HAVE ASKED FOR THE LAST SIX YEARS, IS THEY BE MOVED A LITTLE BIT FURTHER TO THE EAST BECAUSE NOTHING ELSE THAT THE GOVERNOR OR THE LEGISLATURE WANTS TO ACCOMPLISH WOULD CHANGE IF THAT HAPPENED.

>> Jeff: TAKE A PHONE CALL.

THIS IS NAME-- THIS IS JAMES.

THANK YOU FOR THE CALL.

GO AHEAD.

>> I HAVE A QUESTION ABOUT WORCESTER COUNTY PUBLIC SCHOOLS, IT'S COME TO MY ATTENTION THAT THERE IS A $4.5 MILLION BUDGET GAP AND I WAS JUST CURIOUS, DOESN'T WORCESTER COUNTY GET A LOT OF PROPERTY TAXES FROM OCEAN CITY BECAUSE OF THE HOTELS AND CONDOS?

AND IF THAT'S THE CASE, WHY IS WORCESTER COUNTY PUBLIC SCHOOLS HAVE SUCH A HUGE BUDGET DEFICIT?

>> Jeff: JAMES, THANK YOU.

>> THAT'S A GREAT QUESTION AND YOU ARE ABSOLUTELY RIGHT.

APPROXIMATELY 59% OF THE COUNTY BUDGET COMES FROM REVENUE FROM THE TOWN OF OCEAN CITY.

AND THE TOWN OF OCEAN CITY DID NOT SUPPORT THE COUNTY'S BUDGET CUTS WITH THE BOARD OF EDUCATION.

AND WE DO NOT THINK THAT WAS THE PROPER WAY TO GO.

WE HAVE SOME OF THE BEST SCHOOLS IN THE STATE IN WORCESTER COUNTY AND A LOT OF THAT IS BECAUSE OF OCEAN CITY, AND WE HAVE BUILT NEW SCHOOLS THROUGHOUT THE COUNTY AND THE TOWN HAS ALWAYS SUPPORTED THAT BECAUSE WE BELIEVE A STRONG COUNTY IS BUILT ON GOOD EDUCATION.

WE HAVE GOOD LAW ENFORCEMENT, HOSPITALS, THOSE TYPES OF THINGS THAT MAKE THIS AREA SOMEWHERE PEOPLE WANT TO LIVE OR RELOCATE TO.

I AGREE WITH YOU.

WE DO NOT SEE WHY THE COUNTY MADE THOSE DECISIONS.

AND WE ARE FULLY COMMITTED TO SUPPORTING THE BOARD OF EDUCATION OF WORCESTER COUNTY.

>> Jeff: I HAVE A LITTLE LESS THAN A MINUTE.

I KNOW THERE ARE A LOT OF PEOPLE WATCHING US WHO LOVE THE BEACH BUT MAYBE THEY'RE A LITTLE MISGUIDED AND THEY GO UP TO THE DELAWARE OR JERSEY SHORE OR MAYBE DOWN TO THE OUTER BANKS.

WHAT ARE THEY MISSING IN OCEAN CITY?

>> WELL, I THINK OCEAN CITY IS THE COMPLETE PACKAGE, YOU KNOW, WE HAVE THE MOST BEAUTIFUL BEACH, THE WIDEST BEST MAINTAINED BEACH CONSISTENTLY.

AND WE HAVE SOMETHING TO OFFER FOR EVERYBODY: THE BOARDWALK, ALL THE AMUSEMENTS, YET AT THE SAME TIME FINE RESTAURANTS, GREAT GOLF COURSES, SO MANY OF OUR AMENITIES ARE GEARED TOWARDS FAMILIES AND KIDS, EVEN THE RESTAURANTS IN OCEAN CITY, THE MAJORITY OF THEM HAVE PLAYGROUND AREAS AND OUTSIDE AREAS.

I MEAN I THINK OCEAN CITY OFFERS A LARGE RANGE OF DIFFERENT TYPES OF ACCOMMODATIONS.

WE ARE REALLY BUILT TO ACCOMMODATE FAMILIES OF ALL DIFFERENT DESIRES HERE AT THE BEACH AND REALLY, THIS IS THE PLACE TO GO AND, YOU KNOW, USUALLY WHEN SOMEBODY COMES HERE THEY COME BACK.

>> Jeff: WE HAVE TO LEAVE IT THERE.

THE NEWLY RE-ELECTED MAYOR OF OCEAN CITY.

THANK YOU VERY MUCH.

>> THANK YOU, JEFF.

>> JEFF: AND JOINING US TO TALK ABOUT YOUR HEALTH IS Dr. JOSHUA STARR PRIMARY CARE PROVIDER AT THE UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON DOCTOR, THANK YOU VERY MUCH FOR JOINING US.

IT IS MEN'S HEALTH MONTH.

SO AT THE OUTSET HERE, GIVE US A COUPLE OF THINGS THAT YOU WANT ALL MEN TO BE THINKING ABOUT.

>> THANK YOU FOR HAVING ME, JEFF.

IT'S A PLEASURE TO BE HERE TODAY AND SHARE SOME BASIC INFORMATION WITH YOUR VIEWERS AND LISTENERS.

I THINK FIRST AND FOREMOST, HAVING A DOCTOR ON A REGULAR BASIS IS, I THINK, AN IMPORTANT THING FOR MEN AND ANYONE IN GENERAL AS THEY GET OLDER BUT PARTICULARLY MEN FOR WHATEVER REASON, WE HAVE A TENDENCY TO AVOID DOCTORS.

AND I THINK THAT WE HAVE A TENDENCY TO SELF DIAGNOSE, LIKE A LOT OF PEOPLE.

SO I THINK HAVING A MEDICAL DOCTOR TO BOUNCE SOME IDEAS OFF OF, ASK QUESTIONS AND FOLLOW UP ON A REGULAR BASIS IS A REALLY GOOD IDEA, IN MY OPINION.

SOME OTHER BASIC THINGS, I THINK THAT ARE IMPORTANT AS WELL, REGULAR PHYSICAL ACTIVITY, WE HAVE TO MOVE.

WE SPEND TOO MUCH TIME SITTING AND WE ALL HAVE, I THINK FAR TOO SEDENTARY JOBS SO MOVEMENT IS SOMETHING I REALLY TRY TO TALK TO MY PATIENTS ABOUT.

SOME IS BETTER THAN NONE.

ANY TYPE OF MOVEMENT IS BETTER THAN NO MOVEMENT.

SO I THINK MOVEMENT IN GENERAL IS REALLY GOOD.

AND THEN LAST THING I THINK IS REALLY IMPORTANT AS WELL IS JUST, YOU KNOW, MAKE YOUR OWN FOOD AS MUCH AS POSSIBLE.

COOK AT HOME WHENEVER YOU CAN.

BUY WHOLE INGREDIENTS.

TRY TO STAY AWAY FROM THE PROCESSED STUFF.

I THINK THOSE ARE PRETTY BASIC THINGS THAT HOPEFULLY A LOT OF PEOPLE CAN DO ON A REGULAR BASIS.

>> Jeff: A LOT OF THINGS WE CAN DIG INTO THERE.

LET'S START WITH THE IDEA THAT MEN, MORE THAN WOMEN, TEND TO AVOID GOING TO THE DOCTOR.

IS IT BECAUSE IT COSTS MONEY?

IS IT BECAUSE SOMETIMES IT'S INVASIVE?

IT MAY HURT?

IS IT A MASCULINITY THING?

WHY DO WE DO THAT?

>> I THINK IT'S LIKE A LOT OF THINGS IN LIFE, MULTI-FACTORIAL.

IT DEPENDS ON THE INDIVIDUAL, DEPENDS ON WHERE THEY'RE FROM, DEPENDS WHAT CULTURE THEY GREW UP IN, DEPENDS ON THEIR FAMILY UNIT, PERSONAL EXPERIENCES THAT THEY'VE HAD.

HOW THEY TEND TO COPE WITH STRESSFUL SITUATIONS.

I BELIEVE THERE WAS A STUDY LOOKING AT HISPANIC ADULTS BY THE PEW RESEARCH GROUP RECENTLY, THAT SHOWED THAT ABOUT 50% FOUND IT CHALLENGING TO FIND A DOCTOR.

FOUND THE WHOLE PROCESS OF TRYING TO FIND A MEDICAL PROFESSIONAL COULD BE DAUNTING SO I THINK CULTURE PLAYS A ROLE.

AS I SAID, I THINK COPING MECHANISMS, WE ALL-- NOT WE ALL BUT A LOT OF PEOPLE TEND TO USE AVOIDANCE AS A COPING MECHANISM WHETHER THAT'S BECAUSE OF A PERSONAL EXPERIENCE THEY HAD WITH A DOCTOR OR THE MEDICAL SYSTEM OR FAMILY MEMBER'S PERSONAL EXPERIENCE WITH THE MEDICAL SYSTEM OR THEY'RE JUST AFRAID, YOU KNOW, OR THEY'RE IN DENIAL OF SOME SORT OF SYMPTOM AND WOULD RATHER NOT ADDRESS IT AND WOULD RATHER AVOID IT.

I THINK THAT TIME PLAYS A HUGE ROLE AS WELL.

I'M A PARENT.

I'M A HUSBAND.

YOU KNOW, I WORK FULL TIME.

AND TIME IS AT A PREMIUM, SO IT IS VERY CHALLENGING TO CARVE OUT SOME SPACE IN MY DAY.

OR I MAKE IT SEEM LIKE IT'S MORE CHALLENGING THAN IT IS.

I THINK WE HAVE TO PUT A PRIORITY ON OUR HEALTH.

SO FAR TOO OFTEN IT'S JUST NOT A PRIORITY.

>> Jeff: YOU MENTION THE IMPORTANCE OF ACTUALLY HAVING A DOCTOR.

PRIMARY CARE HAS CHANGED A LOT.

I MEAN IT'S BECOME A LITTLE BIT MORE OF A FACTOR.

YOU ARE SEEING A LOT MORE S ASSISTANTS, NURSE PRACTITIONERS.

YOU ARE A YOUNG DOCTOR.

YOU CHOSE FAMILY MEDICINE IN MEDICAL SCHOOL.

WHY DID YOU DO THAT?

>> THERE'S SEVERAL ANSWERS TO THAT QUESTION, I THINK.

ONE IS THAT IT'S INCREDIBLY VARIED.

I DON'T LIKE DOING THE SAME THING EVERY DAY.

I LIKE SOME VARIETY IN MY LIFE, SO I THINK DOING THE SAME THING FOR AN ENTIRE WORK DAY FOR AN ENTIRE WEEK FOR THE REST OF MY LIFE WOULD BORE ME TO DEATH.

SO FAMILY MEDICINE DEFINITELY HAS THE VARIETY I ENJOY.

I ALSO THINK THAT THERE IS A PERSONAL TOUCH, I THINK, THAT I TRY TO GIVE IN MY PRACTICE AS WELL.

JUST HAVING CONVERSATIONS WITH PEOPLE, GETTING TO KNOW PEOPLE, DEVELOPING A RAPPORT THAT I DON'T THINK YOU CAN GET IN CERTAIN SPECIALTIES, LET'S SAY.

NOT TO SAY THAT YOU CAN'T GET THEM BUT JUST FOR ME, FAMILY MEDICINE IS FOR THOSE REASONS.

>> Jeff: I DON'T MEAN TO DIMINISH THE IMPORTANCE OF NURSE PRACTITIONERS, THEY'RE HUGELY IMPORTANT.

AND IF YOU HAVE A STREP THROAT OR SOMETHING, THEY HAVE PROBABLY SEEN MORE OF IT THAN ANYBODY ELSE, RIGHT?

BUT THE IMPORTANCE OF HAVING, MAYBE IT'S NOT GOING TO BE AN INDIVIDUAL THESE DAYS.

MAYBE IT'S GOING TO BE A PRACTICE THAT YOU CAN BECOME A PATIENT OF AND YOU GET TO KNOW THE PEOPLE AT THE FRONT DESK AND THAT GETS YOU ON THE PATH TO GREATER HEALTH, GREATER MEDICAL CARE.

>> YOU KNOW, I TRAINED IN ILLINOIS.

I ACTUALLY GREW UP IN CANADA.

I PRACTICED MEDICINE IN CANADA.

I HAD MY OWN PRACTICE FOR A HANDFUL OF YEARS BEFORE I ULTIMATELY MOVED BACK TO THE AREA TO BE CLOSER TO MY WIFE'S FAMILY AND HELP RAISE OUR CHILDREN AND EVERYTHING.

SO I HAVE SEEN BOTH SIDES OF HEALTHCARE.

I WOULD AGREE IN SOME RESPECTS, IT DOES SEEM A LITTLE MORE LIKE A FACTORY, AS YOU SAID.

MAYBE A LITTLE DEPERSONALIZED AT TIMES.

I THINK E.M.R.s AND INFORMATION SHARING CERTAINLY HELPS DOCTORS WHO ARE MAYBE NOT YOUR PRIMARY CARE DOCTOR BUT WORK AT THE SAME OFFICE, ACCESS TO YOUR MEDICAL INFORMATION AND GET TO KNOW YOU A LITTLE BIT SO THERE IS A LITTLE BIT OF A HISTORY THERE BUT WOULD I AGREE WITH SOME OF THOSE THINGS, THAT IT IS A LITTLE BIT OF A CHALLENGE.

>> Jeff: MEMBERS OF MINORITY GROUPS CLEARLY FREQUENTLY STUDY AFTER STUDY HAVE WORSE OUTCOMES, HAVE-- ARE MORE SUSCEPTIBLE TO SOME COMMON PROBLEMS.

IN YOUR PRACTICE, DO YOU SEE THAT?

WHAT FACTORS CAN YOU THINK ABOUT THERE AND HOW SHOULD WE ADDRESS THOSE DISPARITIES?

>> WELL, THAT'S PROBABLY A LITTLE BIT MORE THAN JUST A MEDICAL QUESTION.

I THINK THERE IS A NUMBER OF DIFFERENT FACTORS THAT LEAD TO SOME OF THE DISPARITIES, YOU KNOW, ACROSS CULTURES AND IN THE UNITED STATES AND IN OTHER COUNTRIES AS WELL.

AGAIN, I THINK SOME OF THEM ARE PARTICULAR TO A CERTAIN, YOU KNOW, ETHNIC BACKGROUNDS.

HISPANICS, FOR INSTANCE, THEY HAVE A CULTURE THAT IS-- TENDS TO BE A LITTLE MORE WE KEEP SOME OF OUR MEDICAL INFORMATION TO OURSELVES, WE DON'T TEND TO GO SEE A DOCTOR.

CERTAINLY THERE ARE SOME INDIVIDUAL AND CULTURAL DIFFERENCES AMONGST GROUPS.

I ALSO THINK THAT THERE IS, AGAIN, I THINK YOU LIKE TO SEE PEOPLE IN GENERAL, AT LEAST I SEE A LOT OF PEOPLE IN MY PRACTICE THAT LIKE TO SEE ME BECAUSE I'M YOUNG, BECAUSE, YOU KNOW, WHEN I TEND TO SEE A LOT OF YOUNG MEN BECAUSE THEY WANT A DOCTOR THAT LOOKS LIKE THEM, THAT IS EXPERIENCING SOME OF THE SAME MEDICAL PROBLEMS AS THEM OR LIFE CHALLENGES AS THEM.

SO I THINK IN PART MAYBE IT'S THERE ARE NOT ENOUGH DOCTORS THAT HAVE CERTAIN, YOU KNOW, BACKGROUNDS THAT MAYBE SOMEBODY CAN RELATE TO.

SO I THINK THAT PLAYS A ROLE AS WELL.

AND THEN THERE IS A NUMBER OF OTHER FACTORS I THINK THAT GO BEYOND, I THINK JUST THE MEDICAL SIDE OF THINGS THAT I THINK CAN PLAY A ROLE FOR SURE.

>> Jeff: DO YOU FIND THAT MEN COME IN AND TALK ABOUT A SYMPTOM AND IT DIDN'T START YESTERDAY?

IT STARTED, YOU KNOW, NINE MONTHS AGO AND THEY'RE JUST NOW GETTING UP THE COURAGE OR FINDING THE TIME TO CONFRONT IT?

>> IS THERE ANY OTHER WAY THAT MEN PRESENT WITH SYMPTOMS?

I FEEL THAT IS THE MAIN WAY MEN COME IN WITH SYMPTOMS.

I COMMONLY HEAR THIS AND HAVE I EXPERIENCED IT MYSELF IN MY OWN PERSONAL LIFE.

IF THAT THERE IS NEXT WEEK OR NEXT MONTH WHEN I HAVE SOME TIME, EYE GO I WILL GO SEE THE DOCTOR.

THAT IS ALL TOO COMMON FOR MEN IN THEIR 30S, 40S, AND 50s TO COME SEE ME AND SAY THEY NEVER HAD A PRIMARY CARE DOCTOR BEFORE.

>> Jeff: YOU WONDER HOW CAN SOMEBODY'S PARTNER FAMILY MEMBER ENCOURAGE SOMEBODY.

MAYBE THEY KNOW THERE IS A SYMPTOM.

MAYBE THEY DON'T.

BUT THEY KNOW THIS PERSON HAS NEVER SEEN A DOCTOR.

THEY HAVE NO IDEA WHAT THE BLOOD PRESSURE MIGHT BE, WHAT OTHER ISSUES MIGHT BE LURKING.

I'M WONDERING WHAT YOU COULD SAY THAT WOULD HAVE A POSITIVE IMPACT AND WOULDN'T, YOU KNOW, BACKFIRE BECAUSE GUYS, WE DON'T REALLY LIKE BEING TOLD WHAT TO DO EITHER.

>> RIGHT.

RUN THE DANGER OF BEING A LITTLE PUSHY.

WELL, I THINK THAT CONTINUING TO, YOU KNOW, IT'S A FINE LINE FOR SURE.

YOU DON'T WANT TO BE ANNOYING.

YOU DON'T WANT TO BE BOTHERING THE PERSON BUT I THINK AT THE SAME TIME, YOU KNOW, IT'S IMPORTANT TO MAKE SURE THAT THEY UNDERSTAND THAT THERE IS-- THAT HEALTH SHOULD BE A PRIORITY.

THAT THERE ARE CONDITIONS THAT EXIST THAT MAY NOT HAVE ANY SYMPTOMS.

ONE THING THAT COMES TO MIND THAT I DEAL WITH ALL THE TIME IS HIGH BLOOD PRESSURE.

I TRY TO EXPLAIN TO PEOPLE THAT YOU PROBABLY DO NOT KNOW THAT YOUR BLOOD PRESSURE IS TOO HIGH OR TOO LOW UNLESS IT IS THROUGH THE ROOF SKY HIGH OR CONVERSELY INCREDIBLY LOW.

THAT LEAVES A LOT OF VARIABILITY IN BETWEEN AND I THINK THERE IS A REASON WHY IT IS A SILENT DISEASE IN A LOT OF CASES BECAUSE YOU ARE NOT GOING TO KNOW IF IT'S HIGH OR LOW OR AFFECTING ANY OF YOUR ORGAN SYSTEMS OR ANYTHING LIKE THAT.

>> Jeff: LET'S BOIL THIS DOWN A LITTLE BIT FOR MAYBE THREE CATEGORIES.

THIS MAY BE TOO BROAD.

BUT YOUNG GUYS, MIDDLE AGED GUYS, OLDER GUYS.

WHAT SCREENINGS, WHAT BASIC CHECKUP STUFF WOULD BE REASONABLE IN THOSE CATEGORIES?

>> I'LL SAY THAT IT SHOULD BE INDIVIDUALIZED.

BASED ON AGE AND DEMOGRAPHICS AND, YOU KNOW, BACKGROUND AND FAMILY HISTORY, I THINK FOR YOUNG MEN IT'S IMPORTANT JUST TO KIND OF GET YOUR FOOT IN THE DOOR AND ESTABLISH WITH A PRIMARY CARE DOCTOR.

YOU KNOW, I THINK A LOT OF PEOPLE COME IN AND IT'S, AGAIN, IT MAY BE THE LAST DOCTOR THEY SAW WERE THEIR PEDIATRICIAN BECAUSE THEIR PARENTS SET UP THE APPOINTMENTS FOR THEM.

IF YOU ARE YOUNG, IN YOUR 20s OR 30S, IT'S IMPORTANT TO GET ESTABLISHED WITH A PRIMARY CARE DOCTOR AND JUST COME IN FOR A CHECKUP.

TALK TO THEM ABOUT MAYBE SOME SMALL THINGS THAT MIGHT BE ON YOUR MIND.

MAYBE YOU DON'T THINK ARE NECESSARILY CONCERNING.

BUT LET THE DOCTOR BE THE JUDGE.

I TRY TO ERR ON THE SIDE OF CAUTION AND TELL PATIENTS, I WOULD RATHER YOU COME IN WITH A SILLY QUESTION TO TALK TO ME FOR A FEW MINUTES THAN LET IT GO AND MONTHS DOWN THE ROAD OR YEARS DOWN THE ROAD, IT TURNS INTO A BIG ISSUE BECAUSE YOU NEVER MENTIONED ANYTHING IN THE FIRST PLACE.

SO I THINK JUST GETTING YOUR FOOT IN THE DOOR IS IMPORTANT.

I THINK, AS YOU GET OLDER INTO MIDDLE AGE, SOME HEALTH SCREENINGS THAT ARE IMPORTANT CAN BE THINGS LIKE COLON CANCER SCREENING.

I THINK THAT WOULD PROBABLY BE MY NUMBER ONE THING BECAUSE IT'S A TOP THREE CANCER IN THE UNITED STATES.

AND WE HAVE VERY GOOD SCREENING TOOLS FOR ASSESSING WHETHER OR NOT SOMEBODY IS AT RISK OR HAS DEVELOPED EARLY STAGES OF COLON CANCER.

SO THAT ONE DEFINITELY, TYPICALLY STARTS AT THE AGE OF 45.

IT USED TO BE 50.

AND WE HAVE TRADITIONAL SCREENING TOOLS SUCH AS A COLONOSCOPY AND WE HAVE A NEWER COLO GUARD TESTING OR FIT TESTING THAT CAN BE DONE A LITTLE LESS INVASIVELY FROM THE COMFORT OF YOUR OWN HOME.

I WOULD SAY THAT SOME OTHER TYPES OF SCREENING CAN BE THINGS SUCH AS PROSTATE CANCER SCREENING FOR THE RIGHT INDIVIDUAL.

WE KNOW THAT RATES ARE HIGHER IN AFRICAN-AMERICAN MEN.

AND WE ALSO KNOW THAT RATES ARE HIGHER IN PEOPLE THAT HAVE A FAMILY HISTORY OF PROSTATE CANCER.

I THINK THAT IF YOU ARE A SMOKER, YOU CAN CERTAINLY TALK TO YOUR DOCTOR ABOUT LUNG CANCER SCREENING, WHICH IS A NEWER SCREENING TOOL THAT WE HAVE FOR CERTAIN INDIVIDUALS WHO HAVE SMOKED FOR A PERIOD OF TIME.

I ALSO THINK THAT SKIN CANCER SCREENING IS A USEFUL THING AS WELL, DEPENDING ON THE INDIVIDUAL.

AGAIN, I THINK WE DO MOST OF OUR DAMAGE TO OUR SKIN AND OUR BODIES TO BE PERFECTLY HONEST, AT A YOUNG AGE BEFORE WE KNOW ANY BETTER.

BUT I THINK THAT FOLLOWS SUIT WITH SKIN CANCER SCREENING AS WELL.

I THINK ONE THING I WANTED TO MENTION, AND SHOULD NOTE WITH REGARDS TO SCREENING TESTS IS THAT SCREENING TESTS ARE, BY NATURE, FOR PEOPLE WHO HAVE NO SYMPTOMS.

SCREENING TESTS ARE NOT INVESTIGATIVE.

IF YOU WERE TO COME INTO YOUR DOCTOR AND SAY I'M HAVING CHEST PAIN OR SHORTNESS OF BREATH AND WE WERE TO RUN A TEST ON YOUR HEART, THAT WOULD NO LONGER BE CONSIDERED A SCREENING TEST.

IT'S MORE OF A DIAGNOSTIC TEST.

I THINK CERTAIN SYMPTOMS SHOULD DEFINITELY BE MENTIONED TO YOUR DOCTOR AS WELL.

THINGS I MENTIONED LIKE CHEST PAIN, SHORTNESS OF BREATH, CHANGES TO YOUR ENERGY LEVEL, FATIGUE, CHANGES TO YOUR WEIGHT, ESPECIALLY IF THEY'RE UNEXPLAINED, AND YOU HAVEN'T MADE CHANGES TO YOUR DIETARY HABITS OR EXERCISE ROUTINE.

CHANGES TO YOUR URINARY HABITS AS WELL.

I WANT TO EMPHASIZE THE IMPORTANCE OF REGULARLY TOUCHING BASE WITH YOUR DOCTOR.

I THINK THAT'S AN IMPORTANT SCREENING TOOL.

>> Jeff: Dr. JOSHUA STARR.

JOINING US FROM THE JOINING US FROM THE UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER.

>> THANK YOU VERY MUCH.

>> Jeff: THAT IS "DIRECT CONNECTION" FOR THIS WEEK.

WE ARE BACK WITH "STATE CIRCLE" AND THE LATEST ON AMERICAN POLITICS JOIN US FRIDAY NIGHT AT 7 P.M. DO REMEMBER TO FOLLOW US ON TWITTER@MPT NEWS AND HIGHLIGHTS OF RECENT PROGRAMS, YOU CAN VISIT OUR VIDEO WEBSITE WHICH IS VIDEO.MPT.TV.

FOR ALL OF US AT MPT, THANK YOU FOR WATCHING AND HAVE A GOOD NIGHT.

* YOUR HEALTH SEGMENTS ARE A CO-PRODUCTION OF MARYLAND PUBLIC TELEVISION AND THE UNIVERSITY OF