GPs fear Viagra guidelines divide impotent men into the 'worthy or not': Libby Brooks on problems for doctors
LIBBY BROOKS
01/22/99
The Guardian
'INTELLECTUALLY bankrupt, with no scientific basis,' was Laurence Buchman's diagnosis of yesterday's guidelines on the prescription of Viagra .
'I much prefer the Government to do the rationing, but it has to be done logically,' said the north London GP.
He argued that most men who came to him for impotence treatment displayed no obvious physical reason for their condition - meaning they were outside the guideline groupings.
Similarly, Jonathan Reggler, whose practice is in Marlow, Buckinghamshire, believed there was an identifiable medical reason for impotence in only 25-30 per cent of cases.
'These proposals basically divide impotence sufferers into the worthy and the unworthy,' he said. 'If 75 per cent fall outside the specified categories of illness, next the GP must decide how distressed they are. Dobson says this only happens in exceptional circumstances, but all the men who come to see me are distressed about impotence.'
In this final category, the guidelines require a specialist assessment, but this will only put further pressure on an already over-burdened system, argued Dr Reggler. 'Should I refer them to a urologist, to confirm my diagnosis of impotence, or to a psychiatrist, when as their family GP I probably know them better? Does a GP ration by not referring, or refer them pointlessly and overload the system? It's farcical.'
The Government was assuming a profound lack of judgment among GPs which simply did not exist, said George Ray, who practices in Whitley Bay, Tyne and Wear. 'The Government has reacted like this primarily because of cost concerns, prompted by the initial rush for prescriptions. But GPs are intelligent people. We are aware we are working with finite resources and infinite demands, and could have found a balance.'
Dr Reggler added: 'Every now and again a drug comes along that is extremely effective, has few side effects and really changes patients' lives.
'I'm delighted to prescribe Viagra .'
|
