Parental screening for intimate partner violence by pediatricians and family physicians.

Objective: To ascertain and compare the knowledge, practices, and training needs of pediatricians and family physicians regarding intimate partner violence screening and intervention.

Methods: Surveys were mailed to national random samples of 1350 pediatricians and 650 family physicians evenly divided between senior residents, practitioners completing their residency training within the last 5 years, and practitioners completing their training >5 years ago.

Results: The overall response rate was 37% (41% for pediatricians, 30% for family physicians). Among practicing physicians, only 8% of family physicians and 5% of pediatricians routinely screened a parent for intimate partner violence during well-child and teen visits. Family medicine residents were significantly more likely to routinely screen for intimate partner violence (18%), whereas pediatric residents were not (7%). All groups demonstrated deficits in knowledge of appropriate management of situations of domestic abuse; for example, over 60% of family medicine and 75% of pediatric residents and practitioners agreed with the inappropriate response of always urging a woman to leave her abusive partner immediately. Many physicians indicated a need for more information about domestic violence, ranging from 40% of family medicine residents to 72% of pediatric residents. Residency training and continuing medical education in the prevention of child/adolescent violence and having an office protocol for managing cases involving domestic violence increased the likelihood of parental screening for intimate partner violence.

Conclusions: Few child and adolescent primary care physicians routinely screen parents for intimate partner violence and most need more information on this topic. Residency training and continuing medical education on violence prevention, including screening and intervention skills in intimate partner violence, and office protocols for managing cases of domestic violence could increase screening rates.