Research article
Domestic violence compared to other health risks: A survey of physicians’ beliefs and behaviors

https://doi.org/10.1016/S0749-3797(02)00460-9Get rights and content

Abstract

Background: Physicians routinely confront patient risk behaviors once considered private, including tobacco use, alcohol abuse, and HIV/STD—risk behavior. We compared physicians’ behaviors and beliefs on screening and intervention for domestic violence with each other risk.

Methods: Survey of nationwide, random sample of 610 primary care physicians from the American Medical Association Physician Masterfile.

Results: Fewer primary care physicians screened for domestic violence than for other risks (p <0.001); once domestic violence was identified, however, physicians intervened with equal or greater frequency than for other risks. Fewer believed that they knew how to screen or intervene for domestic violence compared with other risks, and significantly fewer believed that domestic violence interventions were successful compared with interventions for tobacco and HIV/STD risks (Bonferroni adjusted p<0.001).

Conclusions: Lower domestic violence screening rates may reflect physicians’ beliefs that they do not know how to screen or intervene, and that interventions are less successful for domestic violence than for other risks. We may improve screening rates by educating physicians that a simplified role, as for other risks, can be effective for domestic violence.

Section snippets

Participants

In November 2000, we mailed a questionnaire to a national random sample of 1200 physicians whose medical specialty was internal medicine or family practice. Questionnaires were returned over the following 3 months. The random sample, drawn from the American Medical Association (AMA) Physician Masterfile (a list of physicians in the United States, regardless of AMA membership status), was obtained from Medical Marketing Service, Inc. (Wood Dale, IL). The sample excluded physicians reported by

Respondents

Of the 1200 physicians sampled, 890 were eligible. Our comparison of this group to the target population revealed no differences in age, gender, specialty, or region (Table 1). Of the eligible physicians, 610 (69%) completed the survey. Respondents differed significantly from nonrespondents by specialty, gender, and geographic region. Respondents differed significantly from the target population by race/ethnicity and year of medical school graduation (for details, see Table 1). Accordingly,

Discussion

The results from this comparative study of physicians’ responses to patient health risks indicate that physicians’ behaviors and beliefs on screening and intervention for domestic violence differ from those for tobacco use, alcohol abuse, and HIV/STDs. Physicians in our study are not nearly screening for domestic violence at the level they screen for other health risks: Only 19% reported screening new patients for domestic violence compared with 98% for tobacco use, 90% for alcohol abuse, and

Acknowledgements

This project is supported by the National Institute of Mental Health (grant R01 MH51580). The research procedures pertaining to the human participants included informed consent and were approved by the Committee on Human Research at the University of California San Francisco (which holds Multiple Project Assurance #M-1169, U.S. Department of Health and Human Services). The approval number is H2582-17483-01.

References (57)

  • J. McFarlane et al.

    Identification of abuse in emergency departmentseffectiveness of a two-question screening tool

    J Emerg Nurs

    (1995)
  • The battered woman

    (1989)
  • T. Pasko et al.

    Physician characteristics and distribution in the U.S.2000–2001 edition

    (2000)
  • J. Prochaska et al.

    Towards a comprehensive model of change

  • J. McFarlane et al.

    Assessing for abuse during pregnancyseverity and frequency of injuries and associated entry into prenatal care

    JAMA

    (1992)
  • Violence by intimatesanalysis of data on crimes by current or former spouses, boyfriends, and girlfriends

    (1998)
  • The Commonwealth Fund

    First Comprehensive National Health Survey of American Women

    (1993)
  • Prevalence, incidence, and consequences of violence against womenfindings from the National Violence Against Women Survey

    (1998)
  • N.E. Gin et al.

    Prevalence of domestic violence among patients in three ambulatory care internal medicine clinics

    J Gen Intern Med

    (1991)
  • R. Martins et al.

    Wife abuseare we detecting it?

    J Womens Health

    (1992)
  • B.A. Elliott et al.

    Domestic violence in a primary care settingpatterns and prevalence

    Arch Fam Med

    (1995)
  • American Medical Association diagnostic and treatment guidelines on domestic violence

    Arch Fam Med

    (1992)
  • Report of the American Psychological Association Presidential Task Force on Violence and the Family

    (1996)
  • Position paper 9211(PP)domestic violence

    APHA Public Policy Statements, 1948-present, cumulative

    (1992)
  • Guide to clinical preventive services

    (1996)
  • Preventing domestic violenceclinical guidelines on routine screening

    (1999)
  • A. Flitcraft et al.

    Diagnostic and treatment guidelines on domestic violence

    (1992)
  • Family violencean AAFP white paper

    Am Fam Physician

    (1994)
  • Cited by (0)

    Information for full-text access to this article can be found at www.ajpm-online.net.

    View full text