Physician responses to patients experiencing intimate partner violence

INTRODUCTION: While guidelines exist for physicians to identify and respond to patients experiencing intimate partner violence (IPV), no studies describe physician practices of making mandated reports, advising patients about confidentiality limitations, or conducting homicide risk assessment. This pilot study aimed to explore current physician responses to patient disclosure of experiencing IPV. 

METHODS: We sent interview invitations from March to August 2022 to 11 US national medical societies and 118 state chapters for family medicine, general internal medicine, obstetrics and gynecology, emergency medicine, and plastic surgery. We conducted semi-structured qualitative online interviews that were recorded and transcribed. We conducted a thematic analysis to determine codes and themes. 

RESULTS: Participants consisted of ten female and three male physicians with a median of 16 years in practice. Analysis revealed two themes based on self-reported knowledge and actions: (1) limited knowledge and use of mandatory reporting and risk assessment, and (2) reliance on team members due to limited protocol awareness and time. Most participants did not recall reporting requirements, and few physicians described reporting IPV to law enforcement, advising patients of confidentiality limitations, or conducting risk assessments. As a result of time barriers and limited expertise about protocols and resources, participants relied on social work and nursing team members to respond to IPV. 

CONCLUSIONS: Physicians in this sample describe limited knowledge and use of mandatory reporting and safety assessment. These limitations can be further investigated in larger studies to determine the need for trainings that include reporting requirements and for developing IPV response protocols.