No patient would want their physician to act on their behalf without their consent. Ignoring the abuse. Asking nothing when there are obvious signs of abuse can be harmful. Providing empty reassurance. Talking about the reality of a difficult situation is often more valuable than suggesting ideas that may sound nice but are unlikely to happen.
Some women cite previous bad experiences with physicians when the issue of abuse was raised.
Direct and indirect signals that the physician does not want to discuss abuse may also affect women's willingness to discuss it. High on the list is time pressure, which can affect the time spent with patients as well as the time to learn about partner violence and resources available in the community. Ignoring partner violence may not only be harmful to patients, but it may also be costly, especially under capitation. Most of the suggestions made by abused women focused on time-limited measures physicians can take to help, e.g., acknowledge that the problem is real and not the victim's fault, and provide information about partner violence and community resources. Developing positive, compassionate methods to end encounters when time pressures loom may reduce provider anxiety about opening Pandora's box.