Spotlight on domestic abuse

Dr Emily Donovan explains how doctors are affected

Dr Emily Donavan is a GP Partner in Whitchurch, and has carried out academic research on domestic abuse and its impact on doctors who are single mothers. We spoke to Emily about her findings, which reveal that doctors face unique barriers in seeking help.

Here at the RMBF, we have seen a significant increase in doctors coming to us for support as a result of domestic abuse. Does that surprise you?

No, not at all. There is some evidence that certain factors may make doctors more likely to experience domestic abuse than the general population.

Can you tell us about your research?

I did a qualitative study interviewing female doctors who were all single mums and had experienced domestic abuse.

What were the key themes coming out of your research?

We found that the culture in medicine can have an impact. The women cited how it perhaps made them used to being bullied. When they experienced a partner being horrible to them when they got home, it mirrored how they had been treated at work all day by patients, nurses, and other doctors – being criticised, dumped on, told to work harder, do more, work long hours. It just carried on in their home life. It made it seem normal to be in a relationship which is like how you are treated at work.

You move around a lot when you are in medical training. Moving every few years can leave doctors isolated from friends, family and their support network. It makes someone much more dependent on an abusive partner, because they might not know anyone else where they are training.

Doctors tend to be people that haven’t failed at anything before – they’ve typically been top of their class, haven’t given up, and had the mentality in their studies to keep going and keep working hard. Many of the participants I spoke to felt that this mentality probably kept them going in a relationship much longer than they should have.

What are some of the barriers doctors face in getting help with domestic abuse?

Internalised stigma is a major one. Doctors spoke about the shame and embarrassment of being in an abusive relationship. It impacted their sense of identity and belonging as a doctor, causing social and professional isolation. The women were often disbelieved, and there was a sense of “you are a clever doctor, why the hell would you have got into such a mess?”

I spoke to women who went to access domestic abuse support, and bumped into their patients while there. Or sometimes, the people giving the support just assumed they were there in a professional capacity, and not there as a victim themselves.

Lack of confidentiality was an issue too, especially where the abusive partner was also a doctor (accusing the victim of mental illness or threatening to report them to the GMC).

Domestic abuse can have a huge financial impact on a doctor. Can you tell us more about that?

The women in my research were all single mums because they had left an abusive relationship. Many were struggling financially with the costs of childcare. It is often so much more expensive for working doctors who do long hours or evening, weekend and on call shifts. Night-time child care can be astronomical. The conventional nursery just isn’t an option. Single mums find themselves forced to reduce their hours, or having to change to a job they don’t want just so they can manage childcare.

It all has a big impact. It’s best highlighted by one woman I interviewed, who said: “I was literally providing for three kids on my own with no support, and paying for three lots of child care. I didn’t have any money, I was at the point of using food banks, and it was like – how can I be a doctor and be in this sort of financial situation?”

If the abusive partner has control over the money, that has a financial impact. If they are a high earner, they will often force expensive legal proceedings on the victim to deny financial support. Legally contesting custody of the children can cause great financial strain too, quickly depleting any savings they may have.

Tell us why the RMBF’s support for doctors who have experienced domestic abuse is so important.

It is one of the very few places that women in this situation can access funds. On paper it looks like they are earning well, but they are struggling and desperately need help.

Domestic abuse impacts negatively on a doctor’s sense of identity and wellbeing. Doctors face unique barriers to seeking help for domestic abuse, and the medical culture they work in can leave little space for self-care and support. Specialised, confidential support services are absolutely vital.

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