Barriers Limiting Clinician Recognition of Intimate Partner Violence

Abstract

One in three ever-married women in Nova Scotia faces assault from an intimate partner in her lifetime, making woman abuse a major public health concern.  The role of physicians and medical students in the health care system allows them to address this epidemic, yet a number of barriers diminish their ability to deal with domestic violence, also referred to as intimate partner violence (IPV).  Using case-reports, personal correspondence, consensus statements, conference proceedings and clinician publications, this article uniquely presents a systematic review of most known barriers which clinicians face in dealing with intimate partner violence.  This study examines personal factors, dissonance between clinician views of private versus public spheres, and structural constraints (such as remuneration and work schedules) as reasons mitigating limited clinician attention to intimate partner violence.  Barriers related to medical education and traditional medical curricula, as well as problems facing reform of medical education are presented.  Lastly, clinician misconceptions and misinformation and professional circumstances are examined as barriers to IPV recognition.  This study shows that there are still numerous personal, educational and structural barriers limiting clinician ability, motivation and support to deal with one of the most prevalent health and social problems facing women.  This paper concludes that greater attention needs to be focused within medical education, resident education, and continuing medical education on issues surrounding IPV.  Whereas this study identifies numerous barriers facing the recognition of IPV, it remains an important corollary to identify the means to address the removal of such barriers.  Increasing knowledge of these barriers is the first step in heightening awareness of this public health and medical problem.