Joslyn Fisher-clinical-s

Primary Care, Emergency Centers on Front Lines of Domestic Violence Cases

Primary Care, Emergency Centers on Front Lines of Domestic Violence Cases

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Health care providers in primary care clinics and hospital emergency centers at Harris Health System offer front-line assistance to domestic violence victims. While most laws don’t compel physicians or nurses to report cases of domestic abuse, staff is trained to identify victims, directing them to resources and care for their physical and mental health.

Dr. Joslyn Fisher, medical director, Harris Heath’s VIVA (Volunteer Initiative against Violence Acts) Clinic, and associate professor, Medicine, Baylor College of Medicine, says the health system’s exam rooms play the added role of being “safe” settings for victims.

“Women can see their physicians and feel it’s a safe place to talk about abuse they’re experiencing at the hands of their intimate partner,” she says.

October is Domestic Violence Awareness Month and Oct. 8 is Health Cares about Domestic Violence Awareness Day, a national day of focus for raising awareness of the issue among healthcare providers. In 2013, the U.S. Preventive Services Task Force published its recommendation that physicians screen all child-bearing aged women for domestic violence, the most at-risk group for intimate partner violence.

The task force is an independent, volunteer panel of national experts in the fields of preventive medicine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics/gynecology and nursing, working to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services and preventive medications.

“Identifying domestic violence should be like screening for breast cancer or doing a Pap smear exam,” Fisher says. “Many studies show the important link between intimate partner violence and poor health outcomes. Providing resources to prevent and intervene in domestic violence can improve our patients’ well-being.”

According to a 2008 report by the U.S. Centers for Disease Control and Prevention, women who have experienced domestic violence are 80 percent more likely to have a stroke, 70 percent more likely to have heart disease, 60 percent more likely to have asthma and 70 percent more likely to drink heavily than women who have not experienced intimate partner violence.

“Screening for domestic violence is so important that it’s quickly becoming the standard of care in emergency and primary care settings,” she adds.

Legally, Texas physicians and healthcare providers are required to report suspected abuse cases to law enforcement involving minors under the age of 18, seniors over the age of 65 or cases affecting persons with physical or mental disabilities.

With a national spotlight on the topic because of high-profile cases like that of suspended professional football player Ray Rice, Fisher cautions people from applying levels or degrees of severity to domestic violence cases. To some, using repeated demeaning language against a partner might be seen as less abusive than the occasional slap or punch to the face.

“It doesn’t matter if violence was verbal or psychological, or if it was physical abuse, that abuse and its consequences to someone’s health are very similar,” she says.

Domestic violence can affect a person’s ability to perform daily life tasks like working, going to school, raising a family or feeling happy. The abuse can lead to poor self-esteem, anxiety, insomnia, chronic pain and substance abuse.

For more information on domestic violence (intimate partner abuse) and the awareness of healthcare providers, visit

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