Here’s Why You Should Feel Confident About Receiving Virtual Care for Urologic Conditions Like Erectile Dysfunction
A Q&A with Hims’ Urology Advisor Dr. Stahl
When it comes to erectile dysfunction (ED) and premature ejaculation (PE), some wonder WHO the medical professionals are that treat these conditions through Hims’ platform and if it’s as safe as receiving treatment in-person. We wanted to give you some background information on what and how urologic conditions are treated, who is guiding the program, and a look into what you can expect to experience on our platform. One of our fantastic Medical Advisors, Dr. Stahl — who is an expert in the field of treating ED and PE — was kind enough to share some really helpful insight, which we’ve included below.
Q: What parts of the human body does a urologist treat?
A: Urologists are highly specialized in the treatment of diseases that affect the genitourinary system. We are experts in problems that occur in the kidneys, bladder, prostate, urethra, penis, and testicles.
Q: What are common conditions urologists can expect to treat regularly?
A: Urologists specialize in the medical and surgical treatment of genitourinary disorders. That means we treat a wide variety of conditions in both men and women that range from kidney cancer, to urinary tract infections, to different sexual dysfunctions. Some of the most common conditions that urologists treat are prostate enlargement, urinary tract infections, kidney stones, and erectile dysfunction.
Q: How much education and practice does a physician need to become a board-certified urologist?
A: Urologists are among the most highly trained doctors. After getting a college degree and completing 4 years of medical school, urologists typically spend 1 year in a general surgery internship, when we learn the basic skills of surgery and how to take care of surgical patients. After that, we complete an additional 4–5 years of residency training in urology. At that point, some of us decide to pursue an additional 1–3 years of fellowship training, where we become highly trained experts in specific parts of urology such as urologic cancer, voiding dysfunction, male infertility, or sexual dysfunction. If you add that all up, urologists spend 5–9 years training AFTER completing medical school.
Q: Do you specialize in a specific type of urology? If so, what?
A: I specialize in male reproductive and sexual medicine, which is also referred to as andrology. It is the part of urology that focuses on the medical and surgical treatment of male infertility and male sexual dysfunctions. I completed two years of additional training after my urology residency learning the very precise and delicate arts of microsurgery and genital reconstructive surgery. I also developed expertise during that time in the medical treatment of men with reproductive and sexual disorders.
Q: What types of urologic conditions are the medical providers providing care through the Hims platform able to both diagnose and treat?
A: Right now, medical providers through Hims can evaluate and treat two of the most common urological conditions that affect men — erectile dysfunction (ED) and premature ejaculation (PE). We hope to expand into offering access to treatment for other common urological conditions soon!
Q: How is diagnosing conditions that medical providers via Hims can treat — virtually–different than diagnosing in-person?
A: The diagnosis and treatment of erectile dysfunction and premature ejaculation by providers through the Hims virtual platform are very similar to conventional, in-person doctor visits in some ways; and of course very different in other ways. Two important similarities are that the virtual evaluations ask patients the same questions that an expert in male sexual health (like me) would ask a patient during an in-person visit; and that the available first line treatments for each condition are the same. That said, there are important differences. The most obvious difference is that an in-person physical examination is not possible during a remote visit. For some conditions that makes a big difference, but it turns out that ED and PE can be safely and effectively treated without an in-person physical examination in most men. Another difference is that the evaluation through the Hims platform occurs in the privacy of a patient’s home at a time that works for them. Barriers to care like embarrassment or needing to take time off from work do not exist in an asynchronous virtual care setting. That makes care for sensitive issues like sexual dysfunction much more accessible and approachable. A third important difference is the Hims platform uses technology to enhance safety through use of a process similar to the checklist that a pilot goes through before takeoff. Answers to all important questions are required before any treatment can be prescribed. This reduces risks relating to doctors prescribing with incomplete information and helps ensure that the treating provider has the information needed to safely and effectively treat each patient. Overall, the treatment experience through the Hims platform is based on well-established, best-practices for the medical treatment of ED and PE.
Q: When would you recommend someone visit a physician in-person vs. virtually?
A: Men with complex medical conditions or those who have failed first line treatments should seek in-person care. Hims is a great platform to get started with diagnosis and treatment of certain conditions, and many men will never need any treatments beyond those that can be prescribed through virtual care. But some men need in-person help, and the medical providers that work through the Hims platform have the expertise and training to identify those men and to make appropriate referrals.
Q: Are treatments provided through Hims as safe as treatment provided by physicians seen in-person? How are they different?
A: Treatment is more than just medication — it also encompasses things like dosing strategies, patient education, and provider-patient communication. The prescription medications available through the Hims platform are the same common medications that can be prescribed by in-person physicians. The Hims platform leverages technology to assist the providers in providing consistent, detail-oriented, expert-driven care for male sexual dysfunctions. Prescribing references that contain the most up-to-date clinical guidelines, provider education modules, and clinical care algorithms ensure that each treating provider has access to information they need to provide personalized, high quality care for each patient. Communication through the platform is digital, quick and easy. As a result, men are able to access care and prescription medications, if appropriate, in an affordable, convenient and modern way that many men prefer to traditional in-person medicine.
Q: In general, why would you recommend someone to consider seeking out a urologist vs. a primary care physician?
A: There are two reasons to see a urologist rather than a primary care physician. The first is obvious — see a urologist if you need or are considering surgery (primary care doctors don’t operate on penises). The other reason to see a urologist, however, is if you need someone with very specific expertise. Primary care doctors are amazing physicians that provide care for an incredible array of conditions. They are perfectly appropriate prescribers of first line treatments for male sexual dysfunction. That said, most primary care doctors are not sufficiently trained in male sexual dysfunction to provide second or third line treatments; and many are not comfortable providing first line treatments in high-risk men. Those are the guys who should see a urologist.
Q: What can people do to maintain good urologic health? Are there any certain supplements or lifestyle recommendations you can share?
A: Male sexual function serves as a barometer for overall and vascular health in many ways. Living a healthy lifestyle that includes exercise, a thoughtful diet, and avoidance of toxic habits like cigarette smoking is important for maintenance of both overall and sexual health.
