Dr. Irwin Goldstein, an internationally known figure in the field of sexual medicine and an institution at Boston University School of Medicine for almost three decades, will leave the school at the end of May. The fate of his Institute for Sexual Medicine, which treats 5,000 patients, remains unclear.
Goldstein, 54, who helped change attitudes about women's sexual dysfunction by aggressively pursuing medical treatments, said he was forced out by top administrators who disagreed with his approach to running the institute. He had tried to establish an independent identity for the three-year-old institute, which he hoped would encourage top universities to establish their own, separate academic departments of sexual medicine.
''I wanted the field to grow and develop, and I went to the dean and tried to work it out where I could . . . gain more autonomy and encourage a multidisciplinary approach," he said in an interview yesterday, his last day as a paid member of the faculty before he starts a one-month unpaid sabbatical next week. ''They didn't want this, and I lost their support. The surprise was how I was treated, after all the years."
A medical school spokeswoman confirmed in a statement yesterday that Goldstein ''made a number of requests to the medical center regarding departmental organization.
''The medical center was unable to reach an acceptable agreement with Dr. Goldstein and therefore decided not to continue his contract," spokeswoman Ellen Berlin wrote. Unlike professors elsewhere, faculty at BU's School of Medicine have no tenure, allowing them to be dismissed at any point.
Goldstein said he is negotiating with several ''fantastic" medical schools and expects to announce where he will set up shop by early summer. ''I'm going to find another place to advance the field," he said. ''It's going to happen; it's just not going to happen here."
The future of the institute, which combines patient care, public education, and research of sexual problems, is unclear, because the original, anonymous donor has the option of withdrawing funding upon Goldstein's departure.
The institute has about 5,000 patients being treated for sexual problems ranging from erectile dysfunction to persistent sexual arousal syndrome, patients and staff members said. Dr. Richard Babayan, chairman of the urology department where the institute is housed, said patients will still be able to seek care from Goldstein's remaining associate, Dr. Ricardo Munarriz.
A longtime colleague of Goldstein's, Babayan praised his contributions and wished him well, but said the medical school made it clear from the start that there would be no independent department of sexual medicine. He said he has ''serious doubts" that Goldstein will succeed in establishing his own department elsewhere, because the specialty is not nationally recognized, and doctors cannot be certified in it.
''He was given great leeway here, but he wanted a separate specialty, that was his ultimate goal," Babayan said. ''I think we made him a fair and reasonable offer, and I wish he had chosen to stay, but I don't think anything was forced upon him."
Some of Goldstein's patients said yesterday they will travel to see their doctor wherever he ends up. Carlos Bernal, a 46-year-old Texas man, said he suffered physically and psychologically from erectile dysfunction for decades before finding his way to Goldstein early this year. The doctor diagnosed his problem as a blocked artery, and performed arterial bypass surgery to correct the problem.
''All the urologists over the years just wanted to pump me full of pills, but they were never interested in finding the root of the problem," said Bernal. ''I was very concerned when he told me he was leaving, because I need to continue my care with him, and he's the person I trust."
Several female patients expressed gratitude to the doctor for taking their problems seriously and searching out physical causes.
''For years, men got treatment and women were ignored, and told it was all in their heads," said Lillian Arleque, 59, of Andover. ''He proved that not to be true. . . . I'm devastated by his departure. It's a huge loss."