A Call to Family Physicians: Your Notes Can Help Protect Victims of Domestic Abuse
For more than four decades, I have asked countless women living with abuse a simple question:
“Have you told anyone?”
“Have you even told your doctor?”
“Have you ever gone to your doctor with the bruises?”
Far too often, the answer is “no.”
Many women experiencing abuse feel too ashamed to speak out. Others fear retaliation or lack confidence that they will be believed. While law enforcement agencies have made significant progress in their response to domestic violence-through sensitivity training, specialized domestic assault units, and coordinated prosecutions—family doctors remain one of the most trusted and potentially powerful early points of intervention.
In Toronto, the Integrated Domestic Violence Court ( 4 7 Sheppard A venue East) is an example of a coordinated approach to domestic violence, allowing one judge to address both criminal and family law matters, often in partnership with organizations such as the Barbara Schlifer Commemorative Clinic. Evidence collected early in the cycle of abuse can make a critical difference in ensuring a victim’s safety and access to legal remedies.
And this is where physicians can play a pivotal role.
Why Medical Documentation Matters
We ask family physicians: Please keep notes.
Not only on what your patient reports, but on what your professional experience tells you. If bruising, injuries, or other signs appear inconsistent with the explanation provided—or if there is no explanation at all—document your observations carefully.
Abusers often target areas of the body that are not visible when clothed. Patients may minimize, deny, or remain silent about the cause of their injuries. Even when they do not disclose abuse, your clinical observations can later become critical evidence in family and criminal proceedings.
Far too often, when survivors later seek legal protection, their medical records contain little or no documentation. In these cases, a woman’s story is easier for an abuser to deny. But even a brief marginal note can provide credible, contemporaneous evidence that supports her account and helps secure legal remedies such as:
- Exclusive possession of the matrimonial home
- Restraining or protection orders
- Custody and access decisions that protect children’s safety
- Support orders and related relief
A Case That Changed Everything
Years ago, a client came forward after years of physical and emotional abuse. For a time, she had turned to alcohol to cope—something her abuser later used against her, insisting that no one would believe her claims. When she sought legal help, he denied the abuse entirely.
But there was one crucial difference in her case: her ophthalmologist had meticulously documented injuries around her eyes. His notes made it clear that the injuries were consistent with assault—not an accident. Those records, created years earlier, provided powerful evidence in court.
They validated her experience when she couldn’t speak.
They discredited the abuser’s denials.
They helped secure her protection and legal remedies.
That physician’s careful documentation quite literally changed the outcome of her case.
A Simple Act with a Lasting Impact
As a family physician, you may never know the full story behind a patient’s injuries. But your notes may one day become a lifeline—the key piece of evidence that allows a survivor to be heard and believed.
Please:
- Document inconsistencies and injuries, even when there is no disclosure.
- Record your clinical impressions with care and precision.
- Understand that these records may play a decisive role in legal proceedings long after the fact.
It may seem like a small act in the moment. But to a woman escaping violence, your words could mean the difference between fear and freedom.
