There is an oft-repeated, but false, myth that Super Bowl Sunday is the worst day for violence against women. Would that it were that easy. Domestic violence doesn’t care what day it is. It is an every day (and everyday) problem of individuals, families, and society as a whole. The solution to domestic violence cannot, by definition, take place only within the family unit. It is a public health issue if ever there was one.
Domestic violence has been written about extensively, so there’s really no point in going into the whole issue here, but to give a little perspective from one physician….
If you give them a chance, people confide in their doctors. Some people respond to direct questions, but most respond better to the opportunity to speak. While I do ask a number of open-ended questions to patients, I have a tendency toward “efficiency”. But I make it clear in a number of ways that I am open to hearing whatever my patients have to say. (As an aside, you also have to know how to cut off the chatters, but that’s another article). My style seems to lead to quite a bit of “door-knobbing”, that is, as the patient is holding the door knob to leave, they give a, “by the way, Doc (insert very serious issue here)”.
Domestic violence often falls into the door-knobbing category. Often enough, you get a negative response during routine screening questions, but once a patient trusts you, they open up.
Once you get past the barrier of patient disclosure, you run directly into the “what to do” problem. It’s safe to say that most of my patients who have confided to me about domestic violence do not have the resources to pick up and leave. Also, domestic violence takes place on a very long contiuum of different kinds of abusive situations. And the patient isn’t always the only victim…sometimes the violence is reciprocal.
Resources are out there, but I’ve found that with some of the patients I serve, fear is only one of the barriers to seeking help. Escaping domestic violence requires an entire system, and what we really have is a hodgepodge of volunteer groups.
Hence, the public health angle. Just like any other widespread medical problems, a single doctor-patient relationship is not a panacea. For instance, I can identify measles, but I can’t create a widespread system of surveillance and vaccination. I feel a bit hopeless with my patients suffering from domestic violence. I can give them a list of phone numbers, but after that, they are pretty much on their own.
Despite an excellent network of advocacy groups, domestic violence has not been adopted as a serious public health concern the same way that infectious diseases have. It’s time.
I’m a father of 3 little (but growing too fast) girls. Couldn’t agree more. The problems of sexual and physical violence keep me up at night.
As a domestic violence advocate, I couldn’t agree more that it should be a health concern just as much or more than the infectious diseases talked about each and every day….
Thank you for all that you have done, do, and will do for the domestic violence awareness.
The grammar police are gonna getcha, as in “The panda bear eats, shoots, and leaves.”
I’m gonna assume you meant advocate for survivors/victims, or some such. Not meant as a snark, but I have the grammarians patrolling regularly, and they can be harsh.
Thanks for stopping by!
I can offer an article I wrote to offer a little insight: http://www.bigmedicine.ca/angeladevlen.htm#Battered
Keep offering a safe place to talk, information for those ready to accept it, and recommendations on where to put together a plan to leave when they are ready to take that step goes a long way.
This of course addresses the impact of the problem. Dealing with the root of it is another issue-simply stated public education on the issue and a culture of respect would be a start.