Catherine Gutfreund, MD, is a family practitioner at Kaiser Permanente Santa Rosa who represents the organization on the California Medical Association board, is a Kaiser Permanente Physician Ambassador in her community, and serves as the facility’s chief of Complimentary and Alternative Medicine, among other roles. But it’s Dr. Gutfreund’s six years as the Domestic Violence Champion at Kaiser Permanente Santa Rosa she most wants to discuss during October’s annual national Domestic Violence Awareness Month.
Why do you work on behalf of domestic violence prevention?
As I became more immersed in my role as Domestic Violence Champion, I realized that the topic of family violence impacts every aspect of our patients’ health and lives. My career has been dedicated to helping families from birth to death, and I saw that domestic violence prevention is a fundamental part of that.
Here’s another take on it: The Adverse Childhood Experiences (ACE) study looked at childhood adverse events such as child abuse and neglect, witnessing domestic violence, or other serious family dysfunction and found that if a child experiences any ACE events, he or she will have a higher incidence of major health problems later — even if the events are over and done with. And the more ACE events a child experiences, the higher the risk. If we can prevent violence in children’s lives, it will significantly improve their health for the rest of their lives.
What have you learned as you’ve helped your own patients?
This past year I asked a patient I’ve treated for 12 years if she was OK. She told me something I had never known, that her mother sent her to live with a 35-year-old man when she was 12 who abused her until she left him at age 18. This still weighs on her, even though she is a senior and happily remarried. The psychological and social issues continue. So it’s not enough to ask once. You have to keep asking because sometimes the person is just not ready to talk — but will be one day.
How do you help raise awareness?
I work closely with a diverse set of community partners, including the Family Justice Center, the YWCA, and the assistant district attorney in charge of sexual assault. I spend 45 minutes talking about the topic during the orientation of our new Kaiser Permanente physicians and medical students. Whether I’m at a women’s chamber of commerce meeting or giving a talk on alternative medicine, I mention the taboo — domestic violence — and what Kaiser Permanente is doing through its integrated care delivery model to help stop it.
Tell us more about Kaiser Permanente’s efforts.
Our commitment is far and deep, led by Brigid McCaw, MD. Examples include tools and resources for our clinicians, the traveling Silent Witness Display, and our Kaiser Permanente Northern California “Rooming Alone” program, in which family medicine, ob-gyn, and emergency room patients meet with a nurse alone, without friends or family, to be asked if there is domestic violence. At the moment, Kaiser Permanente is the national sponsor of a brand-new campaign called “No More,” in which celebrities are raising public awareness of the topic by bringing it out in the open as a conversation, using morning TV talk shows and social media.
Have you seen the perception of domestic violence change over the years?
There is still a stigma about it. I feel like it is considered some sort of lower-income issue, but it is not. It happens at every socio-economic level, to gay and straight, old and young. I recently read a book called Half the Sky: Turning Oppression into Opportunity for Women Worldwide. It covers domestic violence, sexual assault and human trafficking all over the world. It reconfirmed that terrible things are happening worldwide. And it’s not just a women’s issue; it’s a human rights issue.
This topic seems personal to you. Is it?
At 43 I had just joined Kaiser Permanente’s domestic violence prevention team and was up at Tahoe researching and writing an article on emotional abuse for our physician in chief newsletter. It suddenly came to me that my stepfather’s rages, the yelling, and how he would punch his fist through the wall, was emotional abuse. I lived with that from age 7 until I was 16, when my mother nailed the divorce papers to the door and took me and my five siblings into hiding. We restarted our lives in a two-bedroom trailer, and I got where I am today by sheer determination. I had been a victim, and yet had never realized it. Today I’m married to a wonderful man and have two beautiful boys. But I am telling you that this can happen to anyone right next to you.
Last reflections as a physician?
If we don’t ask our patients, they won’t tell us. So let’s ask.
Learn more about Kaiser Permanente’s Family Violence Prevention Program.