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PRIMARY CARE: Angela Taft, Dorothy H Broom, and David Legge General practitioner management of intimate partner abuse and the whole family: qualitative study BMJ 2004; 328: 618 [Abstract] [Full text]

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Domestic Violence:The difference between emergency physicians and general practitioners

Elaine K Tipper, Adrain A. Boyle   (23 March 2004)

Domestic Violence:The difference between emergency physicians and general practitioners 23 March 2004
Elaine K Tipper, SpR Emergency Medicine Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, Adrain A. Boyle Send response to journal: Re: 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