To report or not to report. Physicians' attitudes toward discipline and child abuse

Interviews were conducted with 58 physicians to ascertain what factors influenced their reporting of child abuse. When physicians were presented with sample cases of injured children, factors that influenced their decision to report suspected abuse included their attitudes toward physical discipline, seriousness of the injury, presence of other injuries, their familiarity with the family, appropriate parental concern, compatibility of the history and physical examination findings, and the child's behavior. Results indicated that inappropriate discipline was usually not equated with reportable child abuse. Physicians believed that abuse is not often reported because of its low incidence in the private practice setting, the fear of losing patients, the need for certainty, and the lack of confidence in community agencies. These beliefs may conflict with the welfare of young patients.