Guidelines for Managing Domestic Abuse When Male and Female Partners Are Patients of the Same Physician

OBJECTIVE: To provide clinical guidelines for primary care physicians are dealing with domestic abuse and who have both the abused woman and her as patients. PARTICIPANTS: A 15-member expert panel with members experience in family practice, gynecology, emergency medicine, medical, nursing, psychology, law, and social work; an 11-member consulting with members representing medicine, consumers, police, psychology, work, and nursing; and participants from focus groups including 48 abused women and 10 previously abusive men. Members of the expert and the consulting group were recruited by the research team. Focus members were recruited through the agencies from which they were services. EVIDENCE: Available research information, and opinions of expert panel, the consulting group, and the focus group participants. PROCESS: Scoring of 144 clinical scenarios was performed by the panel using a modified Delphi technique involving 4 iterations. were rated in terms of best practice for primary care physicians with suspected and confirmed cases of physical abuse. Consulting group and focus group participants then commented on the panel's results. guidelines were approved by the panel and the consulting group, with reserved in the guidelines for information from focus group. CONCLUSIONS: It is not a conflict of interest for the physician deal with abuse of the female partner when both partners are patients. Both have a right to autonomy, confidentiality, honesty, and quality care. should be dealt with independently, thereby facilitating assessment the magnitude and severity of the victim's injuries. Physicians should not the possibility of domestic abuse with the male partner without the consent of the abused female partner. Joint counseling is generally and should be attempted only when the violence has ended, provided partners give independent consent and the physician has adequate training skills to deal with the situation without escalating the violence. If the feels unable to deal effectively with either patient because of the relationship, referral to another qualified physician is preferred.