Practice patterns in the diagnosis and treatment of erectile dysfunction among family practice physicians

Objectives. To examine the philosophies and practices of the family practit ioner (FP) regarding the diagnosis and treatment of erectile dysfunction (E D). Methods. A prospective study by questionnaire of a group of FPs was perform ed. The Spearman correlation coefficient and proportional odds regression a nalysis were used to measure the relationship between the continuous variab le and ordinal-scale variables. The Goodman-Kruskal gamma test was used to measure the strength of the association between the ordinal-scale variables . Results. Eighty-five FPs completed the questionnaire. All respondents had a t least occasional discussions with their patients about ED. History taking , physical examination, and laboratory data were the most common tools used for diagnosis. Eighty-two percent of the FPs reported being either comfort able or somewhat comfortable in making a diagnosis of ED; 93% believed that only selected patients required more extensive diagnostic workups for ED. Sildenafil was the most commonly used agent. All physicians referred patien ts with ED to urologists at least occasionally. Most referred only after un successful trials with sildenafil. The relationship between the degree of m anaged care penetration and the percentage of patients with ED referred for evaluation to a urologist was not statistically significant (P = 0.402). T he relationship between the number of years in practice and the percentage of patients referred to a urologist for treatment or evaluation was found t o be a negative, but statistically significant, relationship (P = 0.003). Conclusions. FPs are now diagnosing and treating ED on a routine basis. Ref errals to urologists are likely to be made when they are no longer comforta ble treating the problem. UROLOGY 57: 146-150, 2001. (C) 2001, Elsevier Sci ence Inc.