🔹 Episode Overview
This episode explores intimate partner violence (IPV) in the orthopedic/surgical patient population — an issue surgeons encounter frequently but often fail to recognize or feel unprepared to address.
The discussion focuses on:
- Awareness
- Identification
- Surgeon responsibility
- Practical next steps
Key message:
👉 Surgeons see IPV regularly — whether they realize it or not.
👩⚕️ Guest Introductions
Dr. Lisa Canada
- Orthopedic trauma surgeon
- University of North Carolina School of Medicine – Charlotte Campus
-
25 years in practice
- Professional pillars:
- Education
- Mentorship
- Clinical excellence
- Co-author of paper on IPV in orthopedic patients
Motivation: Bridging clinical care and education to help surgeons recognize hidden violence affecting patients.
Dr. Marissa Ullrich
- Third-year orthopedic surgery resident
- Mayo Clinic, Rochester
- Medical school: Ohio State University
- Passionate about whole-patient care
Key realization:
Medical training teaches mandatory reporting for:
- Children
- Elderly
- Vulnerable adults
➡️ But no standardized system exists for adult IPV screening.
🔹 What Is Intimate Partner Violence?
IPV is broader than many physicians assume.
Common Misconceptions
❌ Only married couples
❌ Only male-on-female violence
❌ Only long-term relationships
Reality
IPV can involve:
- Spouses
- Boyfriends/girlfriends
- Dating partners
- Roommates
- Caregivers
- Any gender combination
- Any age group
🔹 Why Surgeons Must Care
Surgeons often encounter IPV first because injuries bring patients to medical attention.
Examples include:
- Fractures
- Recurrent injuries
- Injuries inconsistent with reported mechanism
- Multiple prior visits
Orthopedic and trauma surgeons are uniquely positioned to identify abuse patterns.
🔹 The Hidden Gap in Medicine
Training emphasizes:
- Child abuse reporting
- Elder abuse reporting
But lacks:
- Standardized adult IPV detection
- Education on resources
- Clear clinical pathways
Result:
➡️ Physicians suspect abuse but don’t know what to do next.
🔹 Clinical Red Flags
Surgeons should consider IPV when they notice:
- Multiple injuries over time
- Vague or inconsistent injury history
- Injuries inconsistent with mechanism described
- Frequent “falls”
- Delayed presentation for care
- Partner answering questions for patient
- Patient reluctance or anxiety
Especially important in:
- Fragility fracture patients
- Elderly individuals with caregivers
- Repeat trauma presentations
🔹 Core Takeaways for Surgeons
1. You Are Already Seeing IPV
Statistically, surgeons encounter affected patients weekly.
2. Recognition Is the First Step
You don’t need to solve everything — awareness matters.
3. Think Beyond the Injury
Treat the whole patient, not just the fracture or operation.
4. Pattern Recognition Saves Lives
Connecting repeated injuries can reveal abuse.
🔹 Cultural Shift Needed in Surgery
The episode highlights a broader shift:
- Moving from purely technical care → holistic patient care
- Expanding surgeon identity beyond operator
- Embracing advocacy and safety as part of surgical responsibility
