Physician attitudes and behaviour regarding erectile dysfunction in at-risk patients from a rural community
Eric Perttula
Michigan State
University/College of Human Medicine (Flint Area Medical Education) and
Hurley Medical Center, Flint, Michigan, USA
Correspondence to: Kimberly R Barber, Hurley Medical Center, Research Department 8W, One Hurley Plaza, Flint, Michigan 48503, USA
Accepted 4 August 1998
Erectile dysfunction affects many men in the United States. A
34% prevalence is estimated among male family practice patients. It is
associated with a loss of self-image, self-confidence, and even chronic
anger. Several risk factors increases the risk of erectile dysfunction.
Prevalence is increased by 20-40% in patients with diabetes,
hypertension, and those over 65 years old. While erectile dysfunction
is generally acknowledged as an important health problem,
misconceptions remain as to the need for clinician-initiated discussion
regarding the issue. A retrospective chart review of patients at three
health clinics in a predominately rural area was conducted. Subjects
(n=102) were those at risk of erectile dysfunction who had undergone a complete physical exam between October
1995 and December 1996. All physician encounters were examined for
documentation of physician inquiry about erectile dysfunction. A survey
of physician perceptions on initiating discussions of erectile
dysfunction was also conducted. Physician-initiated discussion of
erectile dysfunction was documented in 17% of patients with
hypertension, 18% with diabetes mellitus, and 30% of patients > 65 years. The physician survey (11 respondents) showed 27% reported asking all male patients about erectile dysfunction at routine physical, while 45% reported asking 80% of their male patients. A
`lack of time' or belief that the `patient will initiate
discussions' was cited by several practitioners as reasons why
inquiries were not initiated. All physicians in the study agreed that
sexual function is an integral part of overall health. They either
overestimated the percentage of patients asked about erectile
dysfunction or they had not documented results consistently.
Keywords: erectile dysfunction; physician attitudes
© 1999 by The Fellowship of Postgraduate Medicine
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