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Women's Health

Physicians Less Likely to Screen, But More Likely to Intervene On Domestic Violence

"Only 19 percent of physicians surveyed reported screening new patients for domestic violence compared with 98 percent for tobacco use, 90 percent of alcohol abuse, and 47 percent for HIV and sexually transmitted disease risks," said Barbara Gerbert, Ph.D., of the University of California, San Francisco. Gerbert was the study’s lead investigator.

However, once the problem of domestic violence was identified, the "respondents reported intervening at comparable or greater frequencies . . . compared with tobacco, alcohol or HIV/STD risks," Gerbert said.

The team’s research found that physicians spent longer time periods counseling identified domestic violence victims than patients identified as having any of the other three health risks.

Between 1.5 million and 3.9 million women are physically abused each year by their intimate partners with domestic violence affecting an estimated eight to 14 percent of primary care patients, according to previous research.

"In addition to death and immediate trauma, domestic violence results in a number of chronic health problems," Gerbert explained, and cited depression, anxiety and substance abuse as some of the most frequently occurring problems.

Only a small minority of physicians ask about domestic violence despite these observations, as well as recommendations for routine screening from medical organizations and domestic violence experts, and repeated findings that appropriate screening can be both effective and beneficial, according to the study.

Gerbert said survey questionnaires were mailed to a random, national sample of 1,200 physicians specializing in internal medicine or family practice. The questions on the 32-item survey centered on four health behaviors: domestic violence, tobacco use, alcohol abuse and HIV/STD risks, she added.

Low screening rates for domestic violence were reported by the 610 respondents, the study determined. At the same time, the physicians reported knowing "less about how to screen for or intervene with domestic violence than the other health risks . . . and, compared with alcohol abuse and STDs, believe they lack appropriate referral resources," said Gerbert.

The responses also indicate that while 86 percent of physicians believe intervening with domestic violence is an essential or nearly essential part of their role, even more (at least 95 percent) feel that way about the other three problems, according to the findings.

However, the study revealed that physicians’ self-described interventions to domestic violence were most intense once identified. Gerbert said that physicians were far more likely to "provide counseling, arrange for follow-up visits or calls, and refer patients to additional resources for domestic violence victims than . . . for patients identified with the other three health risks."

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