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We read with interest the recent paper by Taft et al.(1) It highlighted
the difficulties of dealing with patients and their families who have been
exposed to intimate partner abuse or domestic violence (DV). We have found
that, as well as differences between individual GPs, there are significant
differences between medical specialties.
We recently conducted a survey looking at the difference in attitudes
between General Practitioners and Emergency Physicians towards screening
for DV. We used regional training days to identify participants. The
questionnaire contained five statements shown below:
111 questionnaires were distributed. The overall response rate was
57%. There were 26 GP and 37 Emergency Physician respondents. The mean age
was the same in each group. Results are shown in the graph below.
Neither group appeared to be keen on screening all patients for DV.
This could be explained by GPs feeling that screening has low positive
predictive value. Many physicians might assume domestic violence results
in trauma, therefore Emergency Physicians may believe that they encounter
cases of domestic violence more often than GPs. It should be borne in mind
though, that not all patients suffering domestic abuse will attend at the
time of injury or even have been subjected to physical violence. A GP is
more likely to be consulted by a patient with depression, fatigue and
anxiety – hallmark symptoms of domestic violence.[2] Patients who are
suffering domestic abuse are unlikely to be detected except by routine
inquiry.[3] The different case mix seen by the two groups may alter
perceptions and opinions.
For those of us working in the emergency department, this survey has
shown that Emergency Physicians have a good awareness of the presence and
importance of DV and may well be more receptive to training and a routine
inquiry programme for dealing with DV patients.
REFERENCES:
1. Taft A, Broom DH, Legge D. General practitioner management of intimate
partner abuse and the whole family: qualitative study. BMJ 2004;328:618-0
2. Bradley F, Smith M, Long J, O’Dowd T. Reported frequency of domestic
violence: cross sectional survey of women attending general practice. BMJ
2002;324:1-6.
3. Hayden SR, Barton ED, Hayden M. Domestic violence in the emergency
department. How do women prefer to disclose and discuss the issues?
Journal of Emergency Medicine 1997; 15(4):447-451.
Domestic Violence:The difference between emergency physicians and general practitioners
Dear Sir,
We read with interest the recent paper by Taft et al.(1) It highlighted
the difficulties of dealing with patients and their families who have been
exposed to intimate partner abuse or domestic violence (DV). We have found
that, as well as differences between individual GPs, there are significant
differences between medical specialties.
We recently conducted a survey looking at the difference in attitudes
between General Practitioners and Emergency Physicians towards screening
for DV. We used regional training days to identify participants. The
questionnaire contained five statements shown below:
111 questionnaires were distributed. The overall response rate was
57%. There were 26 GP and 37 Emergency Physician respondents. The mean age
was the same in each group. Results are shown in the graph below.
Neither group appeared to be keen on screening all patients for DV.
This could be explained by GPs feeling that screening has low positive
predictive value. Many physicians might assume domestic violence results
in trauma, therefore Emergency Physicians may believe that they encounter
cases of domestic violence more often than GPs. It should be borne in mind
though, that not all patients suffering domestic abuse will attend at the
time of injury or even have been subjected to physical violence. A GP is
more likely to be consulted by a patient with depression, fatigue and
anxiety – hallmark symptoms of domestic violence.[2] Patients who are
suffering domestic abuse are unlikely to be detected except by routine
inquiry.[3] The different case mix seen by the two groups may alter
perceptions and opinions.
For those of us working in the emergency department, this survey has
shown that Emergency Physicians have a good awareness of the presence and
importance of DV and may well be more receptive to training and a routine
inquiry programme for dealing with DV patients.
REFERENCES:
1. Taft A, Broom DH, Legge D. General practitioner management of intimate
partner abuse and the whole family: qualitative study. BMJ 2004;328:618-0
2. Bradley F, Smith M, Long J, O’Dowd T. Reported frequency of domestic
violence: cross sectional survey of women attending general practice. BMJ
2002;324:1-6.
3. Hayden SR, Barton ED, Hayden M. Domestic violence in the emergency
department. How do women prefer to disclose and discuss the issues?
Journal of Emergency Medicine 1997; 15(4):447-451.
Competing interests:
None declared
Competing interests: No competing interests