SAN ANTONIO – Doctors are often the first people to come in contact with domestic violence victims after they are abused. Yet there's still no standard in the medical field for how to best help those patients. A diverse group in Bexar County is now trying to change that.
Two women involved believe the first step is educating incoming medical professionals.
Anu Kapadia is in her final year of medical school and she's practicing doctor-patient scenarios with fellow students.
"I'll be asking you some questions I ask all my patients, OK?" she said to her friend from school who responded, pretending to be a patient.
However, the series of questions they practiced in front of the KSAT crew isn't taught at school.
"Do you feel safe at home?" Kapadia asked the pretend patient.
The question is meant to screen for domestic violence victims, but right now in the medical field there's no standard for this.
"A standard on how to address the very basics that a healthcare provider needs to know when you encounter a victim of domestic violence," said Bexar County Battered Women and Children's Shelter CEO Marta Pelaez.
Pelaez believes all health care providers need to be uniformly educated on domestic violence.
"So that everybody works with the same knowledge, to provide the assistance to the victims," she said.
She's part of a statewide task force that is working to create those standards.
"Screening, for example," Pelaez said. "That question or questions need to be asked properly. For example, never in front of the perpetrator or the person that is accompanying the victim."
The screening questions haven't been chosen yet, but they'd be similar to these: Do you feel safe in your home? Has anyone in your home hurt you? Have you been threatened recently? These questions would be asked at every medical appointment.
"I think it would be very beneficial to practice this even first and second year of medical school when you are already learning how to take a history and do a physical exam," Kapadia said.
However, she thinks it has to be far more than simply learning a series of questions. She said understanding the background and stimuli of domestic violence, and how to react when a patient gives a certain answer, are key in being able to help them.
"If you don't have a basic understanding of the issue, even if you're given a standard set of questions you don't know what to do with that information," Kapadia said.
Pelaez believes these changes need to start with students like Kapadia, who is now part of the statewide task force. Both women want domestic violence training to be part of the curriculum at all medical, nursing and even dental schools.
"The first part is teaching students about the fundamentals. The second part would be having a survivor come in and share their story to explain why does someone do what they do or not take a certain step.The third piece would be incorporating standardized patient encounters," she said, which are the pretend doctor-patient scenarios she is already practicing with her medical school friends.
In addition, the training would also make sure medical professionals knew about all the resources available to domestic violence survivors so when necessary, they could intervene and offer the often life-saving information earlier.
They also believe these standards would normalize the conversation about domestic abuse.
"That's one of the biggest barriers to addressing domestic violence, feeling that no one wants to talk about it and feeling ashamed about it," Kapadia said. "I think this makes it normal and knowing you're not being singled out."
Although Kapadia spoke on the subject on her own terms and not on behalf of her school, she mentioned her medical program at the UT Health Science Center has already started incorporating a training session on domestic violence. A mandatory session on domestic violence is part of the students' medicine, behavior and society curriculum. Pelaez has come to the school to offer the training and said she has done the same with some doctors in the field as well.
The positive response Pelaez has already received from the local medical community makes her hopeful these standards will someday become a norm. The Harris County members of the statewide task force are already putting some pilot programs in place. Bexar County members hope to do that here soon.
"In Bexar County, per capita we are second after Harris County in incidents of domestic violence," Pelaez said, expressing concern.
She said once recommendations for standards are created, she hopes they will one day become state law. Though she knows it will be a while until that may happen, she said it is the only way she believes the standards will be implemented equally across the state.
Texas Sen. Jose Menendez told KSAT he fully supports any standard that will help cut down on domestic violence. He said he will be following the task force's work in the future to see what it comes up with.