Physicians' response to victims of domestic violence: toward a model of care.
Even though current domestic violence guidelines, such as those published by the AMA in 1992, attempt to relieve physicians of the "full burden of intervention," they continue to call upon physicians to play a large role in identifying, intervening in, and following up on case of partner abuse. In this paper, we define a limited domestic violence role for physicians which furthers the direction recommended by the AMA and which complements exemplary programs. We propose simplifying and limiting physicians' tasks to Asking patients about abuse; providing Validating messages, acknowledging that battering is wrong and confirming patient worth; Documenting presenting signs, symptoms, and disclosures; and Referring victims to domestic violence specialists (AVDR). By drawing on the literature and our own experience, we show how focusing the physician's role on these four taks is consistent with exemplary programs and expands on ideas put forth by experts for addressing domestic violence in health care settings; reduces barriers for physician interventions with victims; offers a realistic approach for physicians, reducing unrealistic educational demands; and complements managed care trends in contemporary health care.
Division of Behavioral Sciences, University of California San Francisco, 94117, USA. gerbert@itsa.ucsf.edu
Barbara
B
Gerbert
James
J
Moe
Nona
N
Caspers
Patricia
P
Salber
Mitchell
M
Feldman
Karen
K
Herzig
Amy
A
Bronstone
D000328:Adult; D000574:American Medical Association; D018585:Battered Women / Q000523:psychology*; D003142:Communication; D019548:Crime Victims / Q000523:psychology*; D004282:Documentation; D005260:Female; D006801:Humans; D019221:Mandatory Reporting; D008403:Mass Screening; D008487:Medical History Taking; D017146:Models, Organizational; D010819:Physician's Role; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000592:standards*; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards*; D013179:Spouse Abuse / Q000175:diagnosis* / Q000517:prevention & control; D014481:United States