He was already a self-made man. In 1981, at age 17, he fled his native Vietnam and spent two years in a refugee camp in Thailand before being resettled in Australia, where he earned a medical degree.
Ha said he helped another doctor there open erectile dysfunction clinics before taking the idea abroad. The first U.S. clinic opened in Costa Mesa in 1998, the year Viagra was introduced. Ha correctly predicted that the marketing campaign around Viagra would drive many men to seek treatment for the first time.
There has never been a Boston clinic. Ha said investors chose the name for its "credibility."
Most of the clinics are independent corporations managed by Ha's company. In its best years, Ha said, his company earns a profit of about $1 million.
The company pays him $30,000 a month, he said in a 2008 deposition. He said he and his wife, Kim Tran, earn little from her Las Vegas pharmacy and his stake in some of the clinics.
Over the last decade, Ha has collected more than a dozen properties in Orange County, including two houses for which he paid more than $1.5 million each, property records show.
The enterprise has been targeted in lawsuits.
In a 2003 case in Texas, a man in his 30s said he was not properly warned of the dangers of priapism and so he waited more than a day to seek help from the doctor, who has since left Boston Medical. He ultimately underwent surgery but said he was left impotent, worse off than when he initially sought treatment.
In a 2006 case in Illinois, a man in his 50s was advised by phone to continue injecting himself even after reporting several instances of priapism and an indentation on his penis, according to his lawsuit. The incidents led to a debilitating deformation, according to Dr. Laurence Levine, a urologist who performed surgery in an attempt to correct the problem.
Both cases ended in confidential settlements.
Other men simply sought refunds. One in his 20s was already taking the oral medication Levitra — with good results — when an advertisement brought him to the Philadelphia clinic. "They made it sound like they had a miracle drug, 100% proven," said the man, who spoke on condition of anonymity. "The stuff you want to hear."
He ultimately got a refund, he said, to resolve a claim alleging in part that he had priapism for eight hours after his first injection.
The highest-profile case involves a 50-year-old truck driver named John Henry Howard who waited 36 hours before seeking help for priapism and experienced some loss of function.
In a 2009 trial in Atlanta, he said he had not read information he received explaining what to do in the case of priapism.
The jury concluded that Howard had been fraudulently misled about his options and the risks, and awarded him $9.25 million in punitive and compensatory damages. That was reduced to $7.8 million and is now under appeal.
Howard testified that he had not tried oral medications before seeking treatment at Boston Medical. Several urologists who have treated former Boston Medical patients said in interviews that they have seen many cases in which men were given injections they didn't need.
Ha dismissed criticism from urologists, saying it was part of a battle over who should treat male sexual problems.
Just three of the 18 Boston Medical doctors on the company website are urologists, according to a review of their licenses.
In three cases, doctors were hired despite questionable histories. Dr. Rajesh Puri, a pediatrician who runs the Washington, D.C., clinic, had been caught fraudulently billing Medicare for several years. In Philadelphia, Dr. Gregory McGinley was accused of having an affair with a female patient. Both men, who declined to comment for this article, had their medical licenses revoked but later reinstated.
Dr. John Fina, 66, said he was hired to run the Seattle clinic after recovering from a "hellish" addiction to pain medication — and after being disciplined by state health authorities.
Some doctors, such as 67-year-old Houston allergist Daniel Tuft, were simply looking for less stressful work without the hassle of dealing with insurance companies.
Although he occasionally prescribes pills, Tuft acknowledged that financial incentives favor the sale of injections. He said those incentives do not affect his medical judgment.
Tuft said a few of his patients each year suffer from priapism, but only once did it cause lasting damage — to a man who waited too long to seek help.