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A Survey of Patient Preferences and Physician Practices

Lawrence S. Friedman, MD; Jeffrey H. Samet, MD; Mark S. Roberts, MD; Margaret Hudlin, MD; Paul Hans, MD

Arch Intern Med. 1992;152(6):1186-1190.

Abstract
• Background.—
It is unknown whether patients want primary care physicians to inquire about physical abuse (PA) or sexual abuse (SA) or how frequently physicans make such inquiries.

Methods.—
To determine patient preferences and physician practices, we surveyed 164 patients and 27 physicians at private and public primary care sites. Data were collected using confidential, anonymous, written, multiple-choice questionnaires and were evaluated using univariate analysis.

Results.—
Among patients, routine PA inquiry was favored by 78% and routine SA inquiry was favored by 68%. Only 7% were ever asked about PA and 6% about SA. A history of PA was reported by 16% and a history of SA by 17%. Ninety percent believed physicians could help with problems from PA and 89% felt physicians could help with problems from SA. Among physicians, one third believed that PA and SA questions should be asked routinely. However, SA inquiries were never made by 89% at initial vi its or by 85% at annual visits. Physical abuse inquiries were never made by 67% at initial visits, or by 60% at annual visits. Eighty-one percent believed they could help with problems associated with PA and 74% with SA.

Conclusions.—
Most patients favor inquiries about physical and sexual abuse and believe physicians can help with these problems. Physicians believe they can help with these problems though they frequently do not inquire.

(Arch Intern Med. 1992;152:1186-1190)

Author Affiliations
From the Departments of Medicine, New England Deaconess Hospital (Drs Friedman, Roberts, and Hans), Boston, Mass, and Harvard Medical School (Drs Friedman, Roberts, Hudlin, and Hans), Boston, and the Department of Medicine, Section of General Internal Medicine, Thorndike Memorial Laboratory, Boston City Hospital and Boston University School of Medicine (Dr Samet).

Footnotes
Accepted for publication March 13, 1992.

Reprint requests to Division of General Internal Medicine, Kennedy Ambulatory Care Building, New England Deaconess Hospital, 1N Autumn St, Boston, MA 02215 (Dr Friedman).

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