'Viagra effect' - influence of mass media on patient behavior.
INTRODUCTION: The effects of modern mass media and communication on the public health system are well known. So far however, these different influences of the media have not been objectively evaluated by physician-patient contacts. PATIENTS AND METHODS: In this study we asked urologists, primary care physicians and internists in private practices in Cologne and a rural area (Erftkreis, Germany) to quantify their weekly contacts with patients suffering from erectile dysfunction (ED). The poll was conducted by four separately mailed questionnaires whereas a double counting was avoided. Between the second and third mailing, an unbelievable public attention was seen following the FDA approval of Viagra in the United States. When Viagra was available in Germany, a fourth questionnaire was sent (4 months later) to all practitioners (n = 751). RESULTS: During this time span, there was a statistically (p <or= 0.01; t test) significant increase in weekly physician-patient contacts (WPC; 13.1-19.1 WPC for urologists, 4.4-5.5 WPC for general practitioners/internists) for ED in the region of Cologne-Erftkreis. In the fourth mailing, there was a slight decrease, but overall WPC was still higher compared to the first two mailings (17 WPC for urologists, 5.2 WPC for other specialists). CONCLUSIONS: Our investigation shows that urologists are accepted as the competent advisory partners for therapy with Viagra. This was seen by the higher increase (20.1%) in patient contacts with urologists in comparison to colleagues of other medical disciplines (45.8 vs. 25.7% between mailing 1+2 and 3). In this investigation we were able to demonstrate the effects of mass media on patient behavior.