___________, MD

Chief Health Officer

_________Inc.

Dear Dr.____________:

Thank you for your letter of April 28, 1999, that called attention to Viagra abuse by one of my patients. You mentioned that a 1996 survey found that, on average, American males have sexual intercourse five times per month. In addition, a clinical trial found that men taking Viagra successfully attempted sexual intercourse an average of 5.9 times per month. I find this new knowledge invaluable.

I was astounded to learn of the Viagra abuse going on right here in Glendale, Ariz. I was appalled to realize that one of my patients used eight (8) Viagra tablets in November 1998, instead of the sanctioned 5.9 tablets. You can rest assured that I will leave no stone unturned to reverse this egregious perversion. I have formed Viagra Abusers Anonymous and instigated the 12-step program. I have also formed Viagra-Non for the wives of the abusers and Allied Youth VA for children.

I discussed the current Viagra situation with my colleagues, who were amazed to learn of this serious subclinical problem. I discovered to my dismay that we had been remiss in not counting the number of Viagra tablets used monthly by our patients. An alarming thought occurred to me. What if some of the men were using the Viagra tablets for practice or a full dress rehearsal instead of the main event?

We brainstormed the problem and solutions using the nominal group technique. Some suggested that maybe the guilty person was merely catching up. Some wondered if the Viagra offender was failing 2.1 times per month. Do the studies assume 100 percent effectiveness? Some suggested a system of credits whereby the underusers could transfer or sell their options to Viagra to interested parties. A derivatives market could be established. What about the underperformers? Shouldn't we do something to help them? Some suggested turning the matter over to the religious right, who could lobby for appropriate legislation. There were some suggestions for Viagra Police, who could spot-check all males over 50 for possession of more than 5.9 tablets of Viagra.

I thank you again for the wake-up call. I will carry on the crusade against Viagra abuse until the war is won and the last Viagra abuser is brought to justice.

Sincerely,

Ted J. Stuart Jr., MD, MBA

CEO, Northwest Family Physicians, Ltd.