Ep. 231 Intimate partner violence in our surgical patients with Dr. Lisa Cannada & Dr. Marissa Ullrich

🔹 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