Jane McCredie: Let's put an end to longer lasting sex

THE SMALL black envelope in my letterbox was marked ADULTS ONLY. In smaller letters, it promised medical information was inside.

Most of us send our junk mail straight to the recycling, but this was clever packaging and I bet I wasn’t the only one to break the seal.

I should have guessed the package came from the Advanced Medical Institute (AMI), a chain of sexual dysfunction clinics famous for spruiking controversial nasal spray and other treatments for male sexual dysfunction.

When I opened my little black envelope, out fell a bright yellow piece of paper bearing the words, “Want longer lasting sex?” — the same message AMI was forced to remove from billboards in 2008 after public complaints prompted the Advertising Standards Bureau to rule it was offensive.

Lifting the flap revealed more: “The confidence you need… the satisfaction she craves! Did you know that untreated PREMATURE EJACULATION can lead to impotence? REV UP YOUR SEX DRIVE WITH THE LATEST SCIENTIFIC DEVELOPMENT…”

The flier went on to promise that AMI’s doctors could help treat impotence arising from diabetes, high blood pressure and depression.

AMI has built an empire on direct marketing of its medical services to men who might otherwise be too embarrassed to seek treatment.

Erectile dysfunction and premature ejaculation are its staples, though more recently it has also turned its sights on a whole new potential market, promoting a “skin application technology” for female sexual dysfunction.

A company representative told a federal parliamentary inquiry last year that AMI had treated about half a million men in various countries during its 16 years in business. About half its current clients were treated through telemedicine — that is a phone consultation, often leading to prescription of medication prepared by AMI’s contracted compounding pharmacist.

It’s a business model that’s based on a loophole in the law. Direct advertising of prescription medicines to the consumer may be banned in Australia, but there is nothing to stop AMI — or others such as the operators of an equally controversial chain of heart check clinics — advertising medical services directly to the public.

And that’s the case even if those services lead to the prescription of a particular medication that just happens to be prepared by a contractually related business.

Does it matter? Well, yes.

Direct marketing like this essentially cuts the GP out of the loop and, with half of AMI’s customers receiving only a phone consult, the potential to miss the other serious medical conditions that can be associated with ED is clearly enormous.

Prof Chris McMahon, director of the Australian Centre for Sexual Health, told the parliamentary inquiry that prescribing medications for sexual dysfunction without the opportunity for a physical examination represented a “casual, cavalier and expedient approach to patient management”.

Is it time we paid some serious attention to how medical services can be marketed in this country?

Jane McCredie is a Sydney-based science and medicine writer. She has worked for Melbourne’s The Age and contributed to publications including the BMJ, The Australian and the Sydney Morning Herald. She is also a former news and features editor with Australian Doctor magazine. Her book, The sex factory, on the science of sex and gender will be published by UNSW Press later this year.

Posted 27 September 2010