Statewide survey of physician attitudes to controversies about child abuse

To assess physician attitudes and practices in controversial areas of child abuse and neglect, anonymous questionnaires were mailed to pediatricians, family practitioners, and emergency medicine physicians in Pima County (Tucson) and Arizona (statewide). The effects of respondent characteristics on responses to each item were analyzed. Three hundred and ninety-three questionnaires (49.3%) were returned. Responses differed according to gender, age, specialty, and practice or training status. Females estimated a higher percentage of adult women had been sexually abused as children (26.6 vs. 21.6, p < .01) and a lower incidence of false accusations, when sexual abuse was alleged in custody disputes (48.1 vs. 56.1, p < .005) than did males. Older physicians were more likely to refer cases of sexual abuse to a specialist, were more concerned about false reports of child abuse, and gave higher estimates of the percentage of adolescent child sexual abuse offenders who could be rehabilitated (54.4 vs. 43.4, p < .05). Pediatricians expected a lower percentage of sexual abuse exams to be positive than did family practitioners (32.6 vs. 40.7, p < .05). Pediatricians were less likely to agree to involvement of Child Protective Services (CPS) in failure to thrive cases or to criminal prosecution of maternal drug use in pregnancy than either family practitioners or emergency physicians. Respondents were uncertain that reporting to CPS would lead to an improvement in the child's welfare. Exposition and explanation of physician attitudes may benefit medical education about child abuse.