Medical Explainer

What Shubh Mangal Saavdhan gets wrong about erectile dysfunction

Erectile dysfunction may be caused by psychological factors like stress but also physiological factors like bad cardiovascular health.

The movie Shubh Mangal Saavdhan is about a real and common couple’s problem – erectile dysfunction. But, as a couples counselor, I do not know if I should celebrate the movie or not. The story offers a dated perspective of the problem and no realistic solutions. In fact, it cannot even bring itself to name the impairment.

Here are four important facts that Shubh Mangal Saavdhan gets wrong or minimises.

First, erectile dysfunction, defined as a consistent inability to achieve or maintain a penile erection sufficient for satisfactory sexual intercourse, occurs in as many as 50-70% men between the ages of 40 and 79. The rate among men under 40 years is lower but not insignificant at between 3% and 9%. So men, like the movie’s protagonist Mudit, are hardly an exception.

Second, Shubh Mangal Saavdhan makes it seem like erectile dysfunction is caused by mysterious and mostly psychological factors. This is a dated and inaccurate assumption. In addition to important psychological causes like stress, erectile dysfunction has a large physiological component, which should not be ignored. Erectile dysfunction has been shown to predict cardiovascular diseases – it is even considered to be an early sign and a reason to get tested for such diseases. Doctors, therefore, recommend that men with erectile dysfunction go to a general physician or a specialist and get examined for cardiovascular diseases and other risks.

Third, the movie seems to imply, that if you have erectile dysfunction, you and your partner are doomed to a life of sexual frustration and celibacy, until there is a spontaneous resolution of the problem. But erectile dysfunction is actually treatable. There are pharmaceutical options that you can and should explore with your physician. Studies have also shown that improving physical health – by increasing one’s level of physical activity, for instance – can also help resolve erectile dysfunction. Any attempt to increase one’s level of physical activity, however, should be cleared by a doctor.

Finally, dynamics between couples can contribute to causing and maintaining erectile dysfunction. Often, erectile dysfunction is a symptom of a bigger relationship problems like conflict and lack of intimacy. Once erectile dysfunction occurs, it reciprocally and negatively impacts both partners. In one endearing scene, the movie’s female lead Sugandha tries to up the level of sexual excitement in the relationship by imitating a scene from a porn film. This is something the movie gets right. ED can contribute to feelings of anxiety, failure, low self-esteem and a lowering of sexual confidence and sexual satisfaction, often, in both partners. Couples also tend to reduce the frequency of their sexual activities, which further reduces their feelings of intimacy in the relationship. So, talking honestly to one’s partner about what is going on, seeking out trusted friends and family members, especially those that may have gone through something similar and seeking couples counseling are all valid solutions.

What can you do?

Men with erectile dysfunction and their partners can expand their sexual repertoire in the relationship. This is not novel advice, but it bears repeating – sex involves more than just penetration. Developing a curious and playful attitude towards sex helps reduce the feelings of disappointment, pressure and failure that get associated with intercourse. For instance, touching each other – not as prelude to intercourse but just because – is a good place to start. It can be the beginning of developing a flexible and expansive couples’ style for intimacy. Exploring oral sex is another avenue for expanding one’s sexual repertoire and can be immensely satisfying.

Experiencing ED can be an isolating experience which can eat away at partners’ confidence, self-esteem and hope for the relationship. It is important to read about and understand ED to identify appropriate solutions.

Partners of men with ED can remind themselves that “it is not about me”. It is important for partners to know that men’s ability to achieve or sustain an erection is not a direct function of their level of attractiveness or adequacy. Worries like “am I not sexy enough?”, “am I not good enough?” or “what am I doing wrong?” although common, only adds pressure and is unpleasant for both partners, and the resolution of erectile dysfunction much less likely.

The writer has a PhD in Couples and Family Therapy and practices as a couples therapist in Mumbai.

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Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

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  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.