The role of general practitioners in the management of erectile dysfunction—a qualitative study CJ Ng 1 *, WY Low 2 , NC Tan 3 and WY Choo 2 1 Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2 Health Research Development Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; and 3 College of Family Physician, Singapore The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as ‘pushing’ for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient’s background. International Journal of Impotence Research (2004) 16, 60–63. doi:10.1038/sj.ijir.3901141 Keywords: role; erectile dysfunction; general practitioners; Malaysia Introduction Erectile dysfunction (ED) is a men’s health issue that is receiving overwhelming attention in the recent years. Although studies have shown that up to 52% of the male population aged 40–70 y had some degree of ED, 1 data from the National Health and Social Life Survey had found that only about 1 in 10 men with ED between 18 and 59y of age actually went to a physician for consultation regarding their sexual dysfunction. 2 There are many reasons why these men were not seeking treatment. 3 Some men may not be bothered that they have ED, while others may be apprehensive about the available treatment options as a result of inaccurate media attention, or shame. The attending physicians have an important part to play too. The results of a US survey of 500 adults aged 25y and above showed that up to 71% ‘thought their doctors would dismiss any concerns about sexual problems they might bring up’. 4 The physi- cians may not be well equipped with the necessary skills to deal with these problems. Even those who are knowledgeable regarding ED, their attitudes and perceptions of the disease and therapy may influence their ability to carry out an effective consultation. This would in turn influence the detection and management of patients presenting with ED. 5 With the aging population and increasing inci- dence of atherosclerotic conditions such as diabetes mellitus, doctors, especially general practitioners (GPs), would be expected to manage more patients with ED in their daily practice. Therefore, it is important for us to examine the role of GPs when they manage patients with ED, and to understand the factors influencing their decisions. Methods This qualitative study used focus group discussions (FGD) and in-depth interviews (IDI) to gather verbatim comments from the GPs. This study was conducted based on 28 GPs practising in Klang Valley, an urban area in Malaysia. Participants were recruited via convenient sampling on a voluntary basis. The inclusion criterion for participants was that they had managed patients with ED and had prescribed some forms of anti-ED drug before. The GPs were selected from a list of private clinics and a hospital-based outpatient clinic within Klang Valley. They were invited through invitation letters followed by tele- Received 16 June 2003; revised 28 July 2003; accepted 29 September 2003 *Correspondence: CJ Ng, Lecturer, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. E-mail: ngcj@um.edu.my International Journal of Impotence Research (2004) 16, 60–63 & 2004 Nature Publishing Group All rights reserved 0955-9930/04 $25.00 www.nature.com/ijir