Nasal delivery on the nose. Credit:Robert Pearce

Chris McMahon, the director of the Australian Centre for Sexual Health, told the hearing that AMI was ''concerned with its balance sheet rather than patient need'' and that the practice of prescribing medicines over the telephone was a ''casual, cavalier, careless and expedient'' approach.

David Handelsman, Concord Hospital's ANZAC Research Institute's head of andrology, said AMI's advertising was pernicious and destructive, and its claims of efficacy for its erectile dysfunction treatments were a carefully constructed legal fiction.

Professor Handelsman told the hearing he had first come across Mr Vaisman more than a decade ago, when he was sitting on a Health Care Complaints Commission inquiry called by the NSW Government into an earlier Vaisman company, On Clinic. ''I've got to say, one of the most scarifying experiences as a medical practitioner I've had, seeing just how low quality this sort of medical care can be.''

David Malouf, Urological Society of Australia and New Zealand vice-president, said he believed AMI displayed serious ongoing inappropriate clinical practice lacking accountability. He said he had treated some former AMI patients who suffered painful priapisms (prolonged erections), including one 17-year-old boy who had been prescribed penile injections.