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Physicians Launch New Effort to Treat ’Overserviced, Underserved’ Patients Exposed to Violence and Abuse


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MINNEAPOLIS, Sept. 9 -- In an effort to more effectively treat millions of patients whose health has been adversely affected by lifetime exposure to violence and abuse, some of the country’s leading physicians and researchers have launched the Academy on Violence and Abuse (AVA).

Dr. David Schneider, professor of family and community medicine at the University of Texas Health Science Center, San Antonio, and president of the AVA, announced the formation of the new academy at a gathering today in Minneapolis. The event included featured speaker, Dr. Ed Hill, president of the American Medical Association and a founding member of the AVA.

According to Schneider, the academy is a grassroots effort that grew out of work by the American Medical Association National Advisory Council on Violence and Abuse. The AVA will address many of the concerns articulated in the 2002 Institute of Medicine Report, “Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence.”

“Preliminary research-most of it published outside the medical literature-indicates that a significant number of our patients have experienced some form of violence and abuse during their lifetime, including elder abuse, child abuse, gang-related violence, sexual abuse, and domestic violence,” said Schneider.

"These patients can present with numerous complaints, diagnoses, and health risk behaviors influenced by their lifetime exposure to violence and abuse. These conditions can range from high blood pressure, heart disease, diabetes, and severe mental illness such as post-traumatic stress disorder to risky health behaviors such as smoking and substance abuse.

“Although these patients access the healthcare system 2-2 1/2 times more often than patients who have never suffered from abuse, their underlying problems seldom are properly identified and addressed,” he added.

The result is patients who are overserviced and underserved, adding billions of dollars of excess costs to the healthcare system, according to Dr. David McCollum, an emergency physician at Ridgeview Medical Center in Waconia, Minn. McCollum is chair of the AMA National Advisory Council on Violence and Abuse, and a founding member of AVA.

He said AVA will promote health education and research on the medical impact of violence and abuse on patients. It will facilitate development of faculty who are experts in the field and pursue an integrative approach to education of all patient care providers. Post-doctoral fellowships are planned to establish this as a new medical discipline.

“If it’s not in the medical literature, it’s hard to expect instructors to teach it,” said McCollum. “It only makes sense, when you realize the impact violence and abuse has on healthcare, that we take an academic approach to understanding the issues of violence and abuse.”

The newly formed AVA will be headquartered in the Twin Cities. For more information, visit the AVA Web site at http://www.avahealth.org .



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