Online ED providers split into two process models. Some, like Roman, require a live video visit with a licensed clinician plus a blood pressure reading. Others, like PeterMD, have a licensed provider review a written intake with no appointment. Both are legitimate prescription pathways. They differ in how much time they take, how much they catch, and who they suit. This comparison is written for the man trying to decide which to use this week.
Side by Side
| Video visit model (Roman) | Questionnaire model (PeterMD) | |
|---|---|---|
| Clinician involvement | Live 10–15 min video conversation | Reviews written intake; may message with questions |
| Blood pressure reading | Required | Not required |
| Government ID | Required | Required |
| Scheduling | Book a slot; often same- or next-day | None; submit and wait for review |
| Time to approval (typical) | Hours to 1 day | Hours to 1 day; can be quicker with no appointment |
| Pricing visibility | Per-dose pricing by strength | Public pack prices before any health questions |
| Product range | Sildenafil, tadalafil, daily formats, Ro Sparks | Sildenafil 100mg, tadalafil 20mg |
| Purchase model | Adjustable subscription, free shipping | Fixed packs, no auto-renew, 48 states |
| Ongoing clinician access | Messaging after prescription | Via account for reorders |
What a Video Visit Actually Catches
A written form captures what you decide to type. A clinician on camera can do things a form can't:
- Ask the follow-up in real time. “You listed tamsulosin — what time of day do you take it?” matters for alpha-blocker interaction, and it gets answered in seconds rather than a day-long message exchange.
- Clarify vague answers. “Sometimes” chest discomfort on a form becomes a specific conversation on video.
- Read what isn't typed. A man who's short of breath on a video call, or clearly older than his stated age, prompts questions a form never would.
- Combine with the blood pressure reading. Roman's BP requirement plus a live conversation is the closest consumer telehealth gets to a real consult. ED is often the first visible sign of vascular disease; a clinician who sees your BP and talks to you is in a position to say so.
- Set the dose properly the first time. Age, weight, medications and previous experience all inform 25 vs 50 vs 100mg, and that's a five-minute conversation.
None of this is about doubting you. It's that ED medication has a short list of genuinely dangerous interactions, and the video model is better at finding them.
Roman affiliate promotion discontinued. Compare current ED treatment options.What the Questionnaire Model Does Well
Speed and simplicity, honestly delivered. There's no appointment to book, so approval can come as soon as a clinician reviews the intake. There's no blood pressure step to stall on. PeterMD in particular shows its prices before you type anything, sells fixed packs with no subscription, and takes HSA/FSA cards at checkout. For a healthy man who's used sildenafil before, knows his dose, and just wants a reliable source with the fewest steps, that's a perfectly sensible process. A licensed provider is still reviewing it and will decline or query if something's off.
Where it's weaker is exactly where the video model is strong: a first-time user who doesn't know what to disclose, a man with cardiovascular history, or anyone on interacting medications is relying entirely on the completeness of what he types.
Speed: The Honest Difference
Questionnaire-only can be faster to approval, sometimes by a day, because there's nothing to schedule. But Roman's video slots are commonly available same- or next-day, and in both models the bulk of the total timeline is fulfilment and shipping, which are the same. In practice the difference is often measured in hours, and it's smaller than the difference between signing up Monday morning and Friday night. Full timeline: Fastest Way to Get an ED Prescription Online.
Who Should Pick Which
Video visit (Roman) if:
- This is your first ED prescription
- You have any heart, blood pressure, liver, kidney or eye history
- You take any medication that might interact, or aren't sure
- You want help choosing between sildenafil, tadalafil, daily dosing or Ro Sparks
- You want a clinician to message afterward for adjustments
Questionnaire (PeterMD) if:
- You've used sildenafil or tadalafil before and know your dose
- You're healthy with no interacting medications
- You specifically want 100mg sildenafil or 20mg tadalafil in a fixed pack
- You want to see the price first and avoid a subscription
- You'd rather not do a video call
PeterMD is the questionnaire-model provider we track. Roman's walkthrough: step by step.
Both Beat the Alternative
A Note on What Neither Model Does
Neither Roman nor PeterMD performs a physical exam, runs routine labs, or replaces a relationship with a physician who knows your full history. For ED medication specifically, that's usually fine: PDE5 inhibitors are well understood and the risk factors are identifiable from history and a blood pressure reading. But ED can be an early sign of vascular disease, and neither telehealth model is a substitute for having your cardiovascular risk properly assessed at some point. A good clinician on a video visit will say so if your history warrants it; a questionnaire is less likely to. That's one more reason the video model suits the man who hasn't seen a doctor in a while.
Our Verdict — September 2026
For a first prescription or any health history, take the video visit. It costs fifteen minutes, often today, and it's the difference between a form and an evaluation. For an experienced, healthy user who knows what he needs, the questionnaire model is a legitimate shortcut with real advantages in price transparency and no subscription. Roman is our default; PeterMD is the right call for the specific man who fits its profile.
Frequently Asked Questions
Is a video visit required for an ED prescription?
Not universally. Roman requires one; PeterMD reviews a written intake without video. Both use licensed clinicians. Requirements vary by provider and sometimes by state.
Which is faster?
Questionnaire-only can reach approval faster because there's no appointment to schedule. Roman's video slots are commonly same- or next-day, so the difference is usually hours to a day. Shipping is the same after that.
Is a video visit safer?
It's more thorough. A clinician can ask follow-ups in real time, clarify vague answers, and pick up on things a form doesn't capture. Combined with Roman's blood pressure requirement, it catches more of the situations where PDE5 inhibitors are risky.
What does the video visit involve?
A 10–15 minute conversation confirming your history, medications and symptoms, and discussing medication options. It's clinical, not personal, and most men find it easier than expected.
Can I be declined after a questionnaire?
Yes. Licensed providers reviewing a written intake will decline or request more information if your answers indicate risk. The written model still involves a clinician's judgment.
Do I need a blood pressure reading for a questionnaire provider?
PeterMD doesn't require one. Roman does. If you have blood pressure concerns or are on blood pressure medication, the reading is clinically useful regardless of which provider you use.
Which should a first-time user choose?
The video visit. A first prescription is when history, dose selection and interaction checks matter most, and a live conversation handles those better than a form.