A study of California physicians shows the majority has mixed feelings about a state law requiring suspected cases of domestic violence to be reported to authorities.
While some believe legislation improves a physician's response to providing care, many also note that mandatory reporting requires physicians to violate patient confidentiality, which could deter many patients from seeking care or could jeopardize patient safety.
"We conducted this study because intimate partner violence is a problem of high priority in the health care and legal communities. However, the California reporting law, enacted in 1994, has remained controversial," said study director Michael Rodriguez, M.D., M.P.H., a UC San Francisco assistant professor of family and community medicine who treats patients at San Francisco General Hospital Medical Center.
California is one of six states--including Colorado, Kentucky, New Hampshire, New Mexico, and Rhode Island--with specific laws on reporting suspected cases of intimate partner violence.
While most of these states have provisions for protecting victim identity, obtaining informed consent, or reporting to social service agencies, the California law requires that identification information be reported to police regardless of patient consent.
There has been no evaluation of the impact of the California mandatory reporting law on domestic violence victims, and these study results are not encouraging, according to Rodriguez. "The findings support the concern that this law violates basic tenets of medical ethics and may create barriers to health care for victims. There is a serious need for research into how the law impacts abuse victims in their daily lives. When dealing with people's lives, we need to avoid circumstances where well-intentioned laws do more harm than good," he said.
Research results are published in the April issue of the American Journal of Public Health.
The UCSF study randomly surveyed 508 California physicians from four specialties: emergency medicine, family medicine, internal medicine, and obstetrics/gynecology. All were members of the California Medical Association. The age range was 29-83 years.
Study results showed:
Study co-investigators are Heidi Bauer, M.D., M.P.H.; Kevin Grumbach, M.D.; and Valentine Parades, M.D., M.P.H., of the UCSF Department of Family and Community Medicine at SFGHMC; and Elizabeth McLoughlin, ScD, Pacific Center for Violence Prevention.
Rodriguez also serves as research director for the Pacific Center for Violence Prevention, an organization that develops and promotes public policies to reduce youth violence using a public health approach.
The study was funded by the Trauma Foundation, the UCSF's San Francisco Injury Center, the California Academy of Family Physicians, UCSF Center for the Health Professions, and Picker-Commonwealth Scholars Program.
NOTE TO THE MEDIA: Reporters who would like to interview Michael Rodriguez, M.D., M.P.H., study principal investigator, can reach him directly at 415-206-4989.
American Journal of Public Health