Wednesday, 17 March 2010

If They Suspect Domestic Abuse, Should They Waterboard Them..?

New GP surgery layout:
"Take a seat and tell me what the problem is. And if you lie, I'll know!"

I took a call last night from my GP, who I haven't seen for years (in fact, I think the last time I visited was for jabs for my Hong Kong/Bali/Singapore holiday, and that's easily 15 years ago). She'd obviously got a report from A&E about my arm fracture, and told me I 'needed to make an appointment to see her'.

A bit miffed that she'd ring me at 7:30 at night, I pointed out that the hospital had already made me a follow up appointment to check the fracture next week. She told me this was for a different reason and I 'needed' to come to her. I pointed out if I needed anything, I would, but didn't see the point in making an appointment otherwise, whereupon she clearly realised I wasn't going to meekly acquiesce, so rang off. I wondered at the time, on Twitter, whether she was in line for some sort of payout for a followup visit, no matter how unnecessary.

Now, I wonder if she isn't a Guardian reader who wants to get ahead of the curve:
The NHS hasn't taken violence against women seriously enough and must now do better, claims a government report published last week.
Oh, really? What seems to be the problem, then?
The women report their injuries, which are often horribly obvious, but they usually don't volunteer that they have been abused. I interviewed a woman who had been savagely abused over 20 years and regularly consulted her GP. She never reported the abuse because she saw it as her fault and hoped that she could recreate a loving relationship with her partner. And the GP never asked.
Umm, I always thought it took two to tango. What was he supposed to do, shine a light in her eyes until she confessed? She does have some responsibility to herself, doesn't she?
The report includes an account from a mother: "My daughter … not very long ago had her two front teeth knocked out by her partner who headbutted her. She was taken to A&E and was treated really carelessly by the medical staff there. It was all very rushed, they were brusque and didn't ask her about domestic violence at all. They referred her to a dentist, who didn't ask her about domestic violence either."
Just a thought here, but maybe they were too busy dealing with the actual injury -you know, doing their jobs - to do something that shouldn't be their job?
Why are clinicians so poor at identifying domestic violence?
Because if they'd wanted to be detectives or interrogators, they'd have joined the police or the Army instead of spending all those years at medical school. Next question?
...perhaps they don't recognise its signs, although you might think that it would be reasonable to ask any women who present with any injury.
Actually, I wouldn't. And note that it seems that in Guardianworld, only women ever suffer domestic abuse...
General practitioners are wholly familiar with the idea that the reasons people say they have come to see them are often not the real reasons. They know to ask questions about family, relationships, work, financial and social problems when patients complain of symptoms like backache, vague abdominal pain or being "tired all the time". But for some reason they don't ask about domestic violence.
Great! Now the poor bloody GP has another list of questions that his patients will probably lie about...
The new report has 23 recommendations on how the NHS could do better, aimed mainly at NHS organisations, local authorities, the Department of Health and the government. But many of these recommendations will be of little use if abused women can't be identified. One option might be to routinely ask all women.
And men? Nah, they can suffer in silence, right?
...most abused women are currently being failed by the NHS.
Actually, if they are putting up with abuse and not telling anyone about it, they are failing themselves. It's no good expecting to have the truth prised out of you by a professional; you have a tongue in your head. Use it.

I can't wait to see NHS Blog Doctor's take on this...


Chris Gilmour said...

Surely the mother with the abused daughter should have done something about it, rather than moan about the NHS. Or is her daughter's welfare none of her responsibility.

NickM said...

This is a serious problem.

When I see a doctor I want to see a doctor and not a lifestyle coach, social worker, guru or goddamn Quincy thinking of the children. The last time I was at A&E I saw a doctor who basically had a brief look at the wound said the nurse would stitch it and then got out a clipboard to conduct a survey!

The nurse was fine. But a highly paid professional carrying out surveys!

PS Hope your arm gets better soon Julia.

Angry Exile said...

You didn't by any chance break your arm by shoulder charging some time wasting, box ticking fucktard into an inviting stairwell or something, did you? Just that we'd all understand if you did.

Anonymous said...

The NHS have been doing this for years.
At least 15 years ago my sister stayed the night at her boyfriends, needed the toilet in the night and taking a wrong turn in the dark fell down the stairs, tearing off half of an ear.
She said that she had quite a job convincing the nurses that it was only an accident and that they were all for calling the police and having her boyfriend arrested.

As for only women can be victims of domestic violence, try telling that to my neighbour whose wife stabbed him in the heart during an argument. Oh no, that's right, you can't!

JuliaM said...

"Or is her daughter's welfare none of her responsibility."

It seems that years ago, it would be. But now, we are all too keen to surrender our will to the stste and it's minions.

The conditioning has worked!

"PS Hope your arm gets better soon Julia."

Cheers! ;)

"You didn't by any chance break your arm by shoulder charging some time wasting, box ticking fucktard into an inviting stairwell or something, did you?"

Heh, not yet! I still have one good shoulder though, and a form to take on my referral that asks for data (work telephone numer, religion, race) that I'm not going to give on principle.

Should be interesting!

"She said that she had quite a job convincing the nurses that it was only an accident and that they were all for calling the police and having her boyfriend arrested."

From nothing to overkill! Why am I not surprised?