A Delicate Situation in Many Ways…
Dr. Tornetta: “In a potential intimate partner violence situation, providers are in a position where they have to perform their routine clinical work but must also delicately inquire about abuse. The situation is complicated if the spouse or partners is with them. The physician needs to ask about potential violence when alone with the patient. If the spouse/partner won’t leave, then one can say something like:
‘As part of my practice I make sure I meet with all of my patients alone for a few minutes, can I please ask you to wait in the waiting room and your wife will be right out?’
OR
‘Mrs. Smith, I’m going to have the technician take you for an X-ray now. Mr. Smith, can you please wait in the waiting room and I’ll have the technician come and get you in a few minutes when your wife is finished with her X-ray.’”
“When speaking with the patient,” says Dr. Tornetta, “assess their immediate safety, be non-judgmental, and avoid the use of stigmatizing terms such as ‘abuse’ or ‘battered.’”
Dr. Tornetta and his colleagues suggest the following as possible ways to communicate with a patient you suspect has been abused:
- The injuries you have suggest to me that someone hurt you. Is that possible?
- In my experience, women often get these kinds of injuries when someone has hurt them. Has this happened to you?
- Violence can be a problem in many women’s lives, so I now ask every female patient I see about their safety in their relationships. Do you feel safe in your relationship?
- From my experience, I know that being hurt physically or emotionally at home is a problem for many women. Is it a problem for you in any way?
- We know violence in the home affects many women and directly affects health. Have you ever experienced being hurt physically or emotionally at home?”
“Also note that it doesn’t have to be the physician who asks these questions. At the AOA meeting, one member explained that at their facility, a female x-ray technician often tells the spouse/partner that it is routine practice for them to wait outside during the x-ray process and these technicians are trained to ask the question.”
