THE CHILD-ABUSE LOTTERY - WILL THE DOCTOR SUSPECT AND REPORT - PHYSICIAN ATTITUDES TOWARDS AND REPORTING OF SUSPECTED CHILD-ABUSE AND NEGLECT

Objective: To assess the responsiveness and attitudes of medical pract itioners to the reporting of suspected child abuse or neglect. To dete rmine whether characteristics of the medical practitioner (specialist or generalist, rural or urban based, age since graduation, gender, hav ing children of their own) influenced the responsiveness to reporting. Method: A survey of all members of the Australian College of Pediatri cs in Queensland (Australia) and pediatric registrars at a tertiary tr aining hospital in Brisbane (n = 124) and a random sample of Queenslan d general practitioners (n = 100). The survey requested demographic de tails, responses to three case vignettes suggestive of possible physic al abuse or neglect, and details of suspected child abuse or neglect r eporting behavior. Results: There were a wide range of responses to th e case vignettes, bur responses did not vary between specialties. Fort y-three percent of all doctors had at some stage considered a case as suspected child abuse or neglect and decided nor to report despite a l egal mandate to do so. General practitioners were more cautious toward s reporting. The reasons for not reporting were multiple but highlight ed perceived problems in the services available for the child and fami ly once a report was made. Conclusions: There is need for continuing e ducation of medical practitioners regarding symptoms and signs of phys ical abuse and the role of doctors in the multidisciplinary management of child abuse. To some extent children's outcome when presenting to medical practitioners as a result of child abuse or neglect is no bett er than a lottery, dependent on which doctor they happen to see. (C) 1 998 Elsevier Science Ltd.