• Lorrie Elliott, Michael Nerney, Theresa Jones, and Peter D Friedmann.
• Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 3051, Chicago, IL 60637, USA. lelliott@medicine.bsd.uchicago.edu
• J Gen Intern Med. 2002 Feb 1; 17 (2): 112-6.

ContextDomestic violence has an estimated 30% lifetime prevalence among women, yet physicians detect as few as 1 in 20 victims of abuse.ObjectiveTo identify factors associated with physicians' low screening rates for domestic violence and perceived barriers to screening.DesignCross-sectional postal survey.ParticipantsA national systematic sample of 2,400 physicians in 4 specialties likely to initially encounter abused women. The overall response rate was 53%.Main Outcome MeasureSelf-reported percentage of female patients screened for domestic violence; logistic models identified factors associated with screening less than 10%.ResultsRespondent physicians screened a median of only 10% (interquartile range, 2 to 25) of female patients. Ten percent reported they never screen for domestic violence; only 6% screen all their patients. Higher screening rates were associated with obstetrics-gynecology specialty (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.31 to 0.78), female gender (OR, 0.51; CI, 0.35 to 0.73), estimated prevalence of domestic violence in the physician's practice (per 10%, OR, 0.72; CI, 0.65 to 0.80), domestic violence training in the last 12 months (OR, 0.46; CI, 0.29 to 0.74) or previously (OR, 0.54; CI, 0.34 to 0.85), and confidence in one's ability to recognize victims (per Likert-scale point, OR, 0.71; CI, 0.58 to 0.87). Lower screening rates were associated with emergency medicine specialty (OR, 1.72; CI, 1.13 to 2.63), agreement that patients would volunteer a history of abuse (per Likert-scale point, OR, 1.60; CI, 1.25 to 2.05), and forgetting to ask about domestic violence (OR, 1.69; CI, 1.42 to 2.02).ConclusionsPhysicians screen few female patients for domestic violence. Further study should address whether domestic violence training can correct misperceptions and improve physician self-confidence in caring for victims and whether the use of specific intervention strategies can enhance screening rates.

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