Kaiser Permanente

Dr. Rob Schreiner Says NO MORE

Rob_Schreiner Dr. Rob Schreiner is the Executive Medical Director for The Southeast Permanente Medical Group, Inc. Dr. Schreiner represented Kaiser Permanente at the NO MORE Day launch event on Capitol Hill in March 2013. He spoke about his personal commitment, and the commitment of Kaiser Permanente, to preventing domestic violence and sexual assault and helping survivors. Here are some highlights from his presentation:

I have the privilege of addressing you today as a physician in Atlanta, as a leader of healthcare in Georgia, and as a representative of Kaiser Permanente nationally.

In my 28 years as a Physician, I’ve helped restore peace of mind and sense of dignity to victims of domestic violence and sexual assault. I have treated physical conditions that had their genesis in the psychological trauma and PTSD of violence against women. I have cared for women badly injured by domestic violence. And yet, I’m certain that I failed to reach every woman who needed my help...perhaps I missed a subtle clue while performing the History and Physical Exam, failed to ask a follow-up question that would have clued me in, didn’t create enough safety and comfort to empower my patient to ask for my help.

The NO MORE Campaign will raise the awareness of domestic violence and sexual assault in a manner that can lead to earlier and more effective conversations between medical personnel and their patients, among teens, between teens and parents, all for the purpose of prevention and earlier treatment.

In my 12 years as a leader of healthcare in Georgia, I’ve seen how focusing the public’s attention on selected prevention activities (mammograms, colonoscopies, vaccinations) has led to more cancer cures and prevented illnesses – and that’s great. At the same time, I am aware that Domestic Violence impacts millions of women, men and children in the US each year, so it’s time we directed more awareness and prevention strategies to this healthcare scourge.

The NO MORE Campaign will help remove the shame and stigma that surround domestic violence and sexual assault, making it easier for all Americans to discuss, prevent and intervene. We were successful in doing so for breast cancer in the 1980s, HIV in the 1990’s, and colon cancer during the last decade. We should do the same for domestic violence and sexual assault in this decade.

As a National Representative of Kaiser Permanente, I’m proud of our leadership in better identifying and treating victims of domestic violence; we created

  1. patient information and a supportive environment that encourages disclosure, including advice and call-center protocols
  2. routine clinician screening and referral, embedded in our electronic health record, powered by multidisciplinary teams with on-site support services
  3. community linkages to additional domestic violence support services

Since implementing the program over 10 years ago in Northern California, identification has increased six-fold, the majority of which occurs in ambulatory care, rather than the emergency department, identifying members earlier, intervening earlier. Clinicians are more skilled in inquiry and documentation, and patients are more comfortable disclosing abuse. Our very own Dr. Brigid McCaw has earned local and national recognition for her excellent work in the field.

All of us, working together, can help prevent domestic violence and sexual assault through a more coordinated approach to awareness, communication, assessment, and intervention. As the largest non-profit healthcare system in the US, we are proud to be part of the NO MORE campaign.

Dr. Schreiner has also blogged about the NO MORE campaign. Read his posts “NO MORE...It's time men lead” and “Symbols Can Change the World” for additional thoughts about this ground-breaking campaign.