Domestic violence exacts terrible human and economic costs from our society. Physicians could help battered women tremendously if they screened to uncover patient victimization, validated victims' experience, documented the occurrence and effects of violence, and referred victims appropriately. Many prestigious professional and governmental organizations believe these are appropriate health care activities for physicians. However, studies show that physicians and patients rarely discuss this vital issue. There are many barrier to physicians' inquiring about domestic violence, as well as barriers to battered women disclosing details about their situation to physicians. Because of these barriers, physicians often misdiagnose battered women, prescribe medications inappropriately to them, and contribute to their feeling of hopelessness and isolation by appearing to not notice or care about their plight. Surprisingly little is known about the barriers that prevent battered women and physicians from speaking about domestic violence. The investigators propose a two-phase study to examine this issue. Phase I will consist of in-depth interviews with a San Francisco Bay Area sample of 100 emergency medicine physicians, 100 obstetrician/gynecologists, and 100 primary care physicians (general internist and family practice physicians), oversampling women from each specialty. Phase II activities will consist of recruiting and conducting in-depth interviews with a heterogenous sample of 543 battered women, 181 from each of three ethnic groups--Caucasian, African American, and Latina.
This research aims to identify the barriers that prevent physicians and battered women from discussing domestic violence, and to ascertain the characteristics of physicians and battered women patients that contribute to making such discussions more likely. This information will be invaluable to future interventions enabling women to receive the best possible health care.
