Recognizing the hidden nature of domestic violence, Kaiser Permanente National California, a national health maintenance organization, has instigated a more comprehensive approach to screening patients for domestic abuse. In November of 2001, Cassandra Floyd, an OB/Gyn at a Kaiser Permanente hospital was shot and killed by her former husband. The tragic death of the prominent doctor shocked the medical community and reinforced Kaiser’s determination to lead the way in diagnosing patients with domestic violence.
Kaiser Permanete hospitals screen for domestic violence not only in the emergency room but also during routine exams. This approach involves questioning patients about their home-life, and takes note of a patient’s health. People in abusive relationships are 60% more likely to suffer from neurological, gynecological and stress-related problems. Symptoms characteristic of domestic violence include headaches, anxiety, depression, and chronic abdominal pain. Other symptoms include failing to get children vaccinated on time or missing appointments. “We’re identifying the situation before people come in with a broken bone or a black eye,” said Dr. Brigid McCaw, a leader of the Family Violence Prevention Program at Kaiser Permanente. One Kaiser Psychologist, a domestic violence survivor herself, recalls, "I became very ill during my marriage, with chronic insomnia, night sweats, arrhythmia and I developed positive markers for lupus." Her physician urged her to seek help, worried that either her husband, or the stress, would eventually kill her.
As a health plan, medical center, pharmacy and outpatient clinic, Kaiser can connect patients diagnosed with domestic violence with a network of services. Heavily involved in the community, Kaiser routinely refers patients to mental health counselors, shelters and food banks. Hoping to raise awareness, Kaiser has also created a traveling exhibit called “Silent Witness” which relates the stories of employees who are survivors of domestic violence.
According to the Family Violence Prevention Fund, thirty-seven percent of women who sought treatment in emergency rooms for violence-related injuries in 1994 were injured by a current or former spouse/intimate partner. One-in-three women are assaulted by a domestic partner at some point in their life.
This year, in renewing the Violence Against Women Act, (VAWA 2), the United States Congress has introduced a bipartisan bill to improve domestic abuse screening by health professionals. Following Kaiser’s example, this bill would fund training and education, while encouraging partnerships between health care providers and community services.
Compiled from: “Hospital Program Identifies More Domestic Violence,” Rebecca Vesely, WeNews, 13 June 2005;