April 2002 Bulletin

Identifying family violence: the role of the orthopaedist

Identify: Familiarize yourself with the scope of the problem. Have a high index of suspicion.

Interview: Talk to the patient outside the presence of others, using a direct gentle inquiry. Ask the question "Did someone hurt you?" Few patients will disclose a history of family violence without direct inquiry.

Document findings: Carefully document the history, using the patient’s own words in quotes. Use a body map or photographs taken of injuries.

Evaluate for safety: At a minimum, ask victims/patients if they think it is safe to return home.

Refer/Report: If possible, refer to persons/agencies specifically trained in abuse counseling. Disclosure of the diagnosis of abuse in a competent adult to any third party should not be done without the patient’s knowledge and consent. Bottom line: Follow individual state statute. Check AAOS web site for reporting details per state (www.aaos.org).

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