Providing a quality service
Continuing professional development: In order to be able to provide a high’quality service to men and couples affected by ED, it is essential to maintain the appropriate knowledge and skills. This task should be approached in a holistic manner; to provide high’quality care, the physician needs to have a wide range of resources in sexology, urology, gynecology, and internal medicine.
While factual knowledge can be obtained from reading and personal study, skill acquisition is more difficult. Many doctors will find talking about sexual issues uncomfortable and struggle for appropriate language that is intelligible to clients without being too simplistic or too crude. Videos have been produced that illustrate the difficulties, but these are no substitute for practical experience. If you are unable to find a suitable skill acquisition course to attend, t ry working in pairs or threes with partners or local colleagues, using case vignettes.
To begin with, discuss the case together, first exploring the clinical issues (which most people will feel more comfortable with) and then the communication issues. Draw up a list of words and expressions used to describe body parts and sexual behavior. What words might be used instead of penis, vagina, sexual drive and desire, erection, lubrication, masturbation, oral sex, intercourse, orgasm, and ejaculation?
Next, when you feel more comfortable, try role-playing the consultation. Take it in turns to act as patient and physician (and observer, if you work in threes). Focus on the communication issues to begin with. The person playing the patient should decide on what language to use and then use it consistently. The person playing the doctor should ensure that they understand the language used by repeating and seeking clarification. For example, if the patient says “I’m having trouble with my arousal”, the doctor might ask “arousal?” or “can you explain to me what you mean by arousal?”, or “by ‘arousal’, do you mean erection?” Involving the extended healthcare team: Other members of your extended healthcare team may have the interest, knowledge and skills to contribute to the assessment and management of men with ED. In many countries, specialist nurses make a major contribution to ED and sexual healthcare; they are often seen by men as more approachable than doctors.
Practice administrative staff may feel uncomfortable about discussing sexual issues, and even find it uncomfortable to pass on information or make appointments for men with ED. Care should be taken to provide them with appropriate information, training, and support, so that they are able to deal with such matters in an open-minded and non-judgemental manner, respecting the confidentiality of affected individuals at all times.
Tags: Body Parts, Case Vignettes, Communication Issues, Continuing Professional Development, Drive And Desire, Factual Knowledge, Gynecology, High Quality Care, High Quality Service, Holistic Manner, Internal Medicine, Penis Erection, Personal Study, Practical Experience, Sex Intercourse, Sexual Behavior, Sexual Drive, Sexual Issues, Skill Acquisition, Study Skill, Threes