We use this forum to regularly report on findings from patient safety organizations, expert review
committees of the Office of the Chief Coroner, and inquests.
a Sensitive Topic
very family physician – knowingly or un-
knowingly – has patients in his or her practice
who are experiencing abuse at home. As such,
FPs have a crucial opportunity to be a sup-
port, perhaps even a lifeline, to such patients.
About 7% of Canadian women, some 650,000, are es-
timated to be victims of Intimate Partner Violence (IPV).
That’s considered to be a conservative figure, due to
underreporting. In fact, IPV is documented as the most
common form of violence experienced by women, and
is seen as a major underlying cause of poor health, and a
significant public health issue. (Men can also be subjected
to abuse but are much less likely to experience physical
injuries than are women.)
And yet large population-based surveys have shown
that fewer than 10% of family physicians ask their pa-
tients about violence in the home.
There is no shortage of reasons why a family physician
may be reluctant to broach such a sensitive subject – a
lack of time, a lack of comfort with the issue, or a lack
of knowledge about available supports. Some physicians
may worry that they will offend the patient or it won’t
make a difference if they do ask.
Dr. Lopita Banerjee, a regional coroner and Brampton
family physician, agrees that physicians may feel over-
whelmed at the prospect of opening what they perceive
will be a Pandora’s Box in the course of a 15-minute visit.
But she suggests that physicians may be overestimating
the load they will be expected to carry in the event of a
A patient’s disclosure of being abused does not tag the
physician with the responsibility of solving the problem,
she said. Physicians, she said, should be prepared to play
a supportive role, not a curative role.
“Clinicians have the sense that they must manage it
alone. But this is not the case. We just need to open the
door. Once we do that, there are resources and a commu-
nity to help,” said Dr. Banerjee, who sits on the Domestic
Violence Death Review Committee, an expert committee
of the Chief Coroner of Toronto.
Family physicians are uniquely positioned to ask, iden-
tify and assist their patients, she said. “So many health
conditions that women present with may be related to
intimate partner violence effects, if not directly, then in-
ISSUE 3, 2019 DIALOGUE