Docs need training to respond to patients who are abusers

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A study shows doctors are unprepared to intervene when made aware a patient is a perpetrator of domestic violence.

Most doctors say they are unprepared to intervene when they find out a male patient is being abusive to a partner.

Family doctors say they are not well-equipped to deal with patients who they know are perpetrators of intimate partner violence (IPV), particularly if they also provide care to the victim of that violence, a new study found.

Researchers from Boston University’s schools of medicine and public health and from Boston Medical Center (BMC) interviewed primary care doctors from the department of family medicine who had treated male patients known to have been abusive. The results were reported in the Journal of the American Board of Family Medicine.

The majority of doctors said they learned their male patients were being abusive because their female patients, who were victims, disclosed the abuse. However, a number of physicians said in some cases the men disclosed their own abusive behavior in order to get help. Doctors said they felt unprepared to intervene when the men requested help to address their behavior.

IPV includes physical, sexual or psychological harm by a current or former partner or spouse and can occur among heterosexual or same-sex couples.

"Our findings that physicians lack training to intervene with perpetrators of IPV is consistent with recent research that has shown that only 23% of family medicine residency training programs include any training at all regarding how to respond to IPV perpetrators," lead author Brian Penti, M.D., an assistant professor of family medicine and a family medicine physician at BMC, said in the study announcement.

IPV affects millions of Americans, including victims and their children, but Penti said the healthcare system for the most part has avoided addressing the men who are abusers. He said further research is needed to better identify abusers and to develop effective interventions for the primary care setting to assist patients with getting help to stop the behavior.

When doctors are made aware of abuse they should follow the law, which can vary by state, when it comes to reporting. In almost all states, doctors are mandated by law to report suspected or observed child mistreatment as well as elder abuse, neglect and exploitation.

The job of screening patients for domestic violence can be difficult for healthcare providers, but is even more troubling when their hospital co-workers are the victims of violence at home.