A 91-page report from the Task Force on the Health Effects of Woman Abuse (www.healthunit.com/reportsresearch.htm), released in September, contains 29 recommendations for identifying and preventing such abuse. The task force members included physicians and representatives from London hospitals, community agencies, the University of Western Ontario and the judicial system.

"Screening works," says Dr. Graham Pollett, medical officer of health with the Middlesex–London Health Unit. "We do it for breast cancer, diabetes and high blood pressure, and we must begin doing it for woman abuse."

Because of the potential health impact of such screening, adds Pollett, "woman abuse is an area where a public health approach — that is, a community response — is long overdue."

A key recommendation is that females older than 12 be routinely screened by health care professionals for any form of physical, sexual or emotional abuse occurring in childhood, adolescence or adulthood. Family physicians in London will take part in a pilot project to test a routine protocol for universal screening.

"We're not asking health care professionals to fix this problem, because there is no quick fix," says task force Chairperson Marion Boyd, a former attorney general in Ontario. "We're asking them to play a pivotal role in the early identification and prevention of woman abuse."

Because of the time constraints that physicians face, referral to community agencies — considered the "specialists" in dealing with this type of abuse — is suggested. This, says Pollett, would mean that "the woman is connected to the support services she needs. What we ask is that physicians document and undertake the health care assessments so that doesn't get lost."

The task force organizers say London's excellent network of services, its reputation as a leader in research of woman abuse, along with its lobbying for criminalization of intimate partner abuse, makes the city the ideal setting for the pilot project.

"We think that as physicians do this, they will see the immediate benefits," says Boyd. "All those puzzling [symptoms] become clearer. The [physician–patient] relationship grows with this — it isn't destroyed by this."