New treatment for impotence needs support

Sunday, May 10, 1998

BY LAURA PULFER
The Cincinnati Enquirer

At last, a medical breakthrough for impotence. No, not Viagra. That's yesterday's news.

This development has the potential to help both men and women. And children. And the elderly. It may even improve the lives of that miniscule group of people having sex exactly as often as they want.

In the experimental stage, this new procedure may have unexpected side effects and is being tested by a brave group of volunteers. Even if it works, it could be expensive.

Physicians revolt

About 20 area obstetricians and gynecologists have stood up to an insurance carrier, demanding to be in charge of patient care. They have terminated their contracts with Aetna U.S. Healthcare because they say they're fed up with red tape.

They've told the insurance company to take a hike. They've told Aetna they don't like its rules. These doctors apparently still believe that a physician should be in charge of a patient's treatment.

It's a gutsy move, so I hope they won't think I'm ungrateful when I wonder what took them so long. Why have doctors been letting everybody else tell them how to do their jobs?

For the past several years, most of the important medical decisions have been made by business and government. Sometimes, if they were feeling generous, they would make decisions "in consultation" with physicians. Meanwhile, doctors have been, well, impotent.

Hospitals have been merging and just like every other institution -- from banking to manufacturing -- cutting, cutting, cutting. Facilities, services, nurses. And doctors have been curiously quiet, except at places where it doesn't do any good -- golf courses and cocktail parties.

It's about money, of course.

"Up until now, there's been no force that has caused doctors to look and evaluate cost," Dr. Ronald Drasnin, then president of the Cincinnati Academy of Medicine, said two years ago. He said physicians had begun to form groups to deliver care and collect data.

Some of them apparently have found out what they needed to know.

Gynecologist Molly Katz, who's now president of the Academy of Medicine, said she refused to sign a new contract with Aetna because "you really had to treat your patients differently if they were Aetna patients."

The patient partner

For most women, especially women of child-bearing age, our gyno is our doctor, sometimes our only doctor. The good ones have noticed that we are more than just an egg factory. They've listened when we complained about being tired. They've asked questions when a patient showed up with mysterious bruises.

"Our philosophy," Dr. Katz told the Enquirer's Tim Bonfield, "is that we treat the whole woman."

We like the sound of that, doctor.

Maybe we patients have learned a few things ourselves during "health-care reform." Instead of drinking and smoking ourselves into a stupor and bombing our stomachs with eclairs and gravy, then asking our doctor to fix it -- at our employer's expense -- maybe we are accepting some responsibility for our health.

That'd be nice, wouldn't it? If the patients and doctors would work together on this, maybe we'd be a good balance for the insurance companies and managed-care providers. They've had things their own way for too long now. They've become rich and self-indulgent. You might even say they are an example of too much self-gratification. And we all know what happens if you indulge in too much self-gratification. You'll go blind.

So, maybe this rebellious band of doctors will open some eyes. Patients. Insurance companies. Government. This promising treatment for impotence among physicians and other health-care providers does have one thing in common with Viagra.

It is an oral remedy. That is, other doctors have to speak up.

Laura Pulfer's column appears in the Enquirer on Sundays, Tuesdays and Thursdays. Call 768-8393 or fax 768-8340. She can be heard Monday mornings on WVXU radio (91.7 FM), and as a regular commentator on National Public Radio's Morning Edition. E-mail her at laurapulfer@enquirer.com

PULFER ARCHIVE