Domestic violence is a national public health concern.  All around the country, programs are acting to address this issue, including the state of Nebraska.  Having given lectures to thousands of people, I compiled a survey of the frequently asked questions from the audiences.

I surveyed survivors at local shelters in Omaha, 58 in total.  Their comments are stunning.  In the medical community, we do some things well while others show a distinct opportunity for improvement.

By sharing their experience, survivors have been able to shed some light on what it is like to be treated for their abuse.  It is clear that some patients have had a good experience while others have not.  One victim commented, "The doctor was professional, showed compassion and treated my wounds but did not know what to do with me next."

Others stated "my doctor was rushed, didn't seem to care and just sent me home with pills."  A trend in the answers showed the need for: more education of our physicians in reporting issues; available resources; and a reminder that a compassionate hand, even in these frustrating situations, can go a long way.

It was amazing to see how many survivors didn't realize what they were experiencing was abuse until someone told them.  "I thought this was normal until my doctor said I didn't deserve to live this way."  That survivor goes on to state "my doctor saved my life."

Patients that were seen in the Emergency Department were concerned about being treated for fear of being reported to the police.  "I thought it would make the abuse worse."  Patients seen by their primary care doctors noted more often that they would have shared more if they felt the doctor would listen and "dig deeper". 

In both primary care and emergency settings, some patients noted that their abusers were in the room when asked key questions and requested that we "talk to them (us) alone".

Overall, comments were more often positive than negative but continual education is needed to keep our doctors, and the medical community, up to date.

I am thankful to the survivors for their candidness, and willingness to share.  We have made sure to address their numerous concerns in the education of our medical community.

On a closing note, I have heard from many colleagues about how hopeless they feel when treating patients who are being abused, comments such as, "I have helped victims so many times and they keep going back" and "it takes a lot of time."  I understand your frustration.  Perhaps it would help to think of abuse as a cancer.  Cancer is difficult to treat. Cancer takes a lot of your time in diagnostic procedures, coordination of resources and care.  Sometimes you can rejoice in a successful case.  Sometimes you do everything you possibly can, provide the best care, line up all of the appropriate referrals and the patient dies.  Would you stop screening and treating cancer?