A recent study from Mass General Brigham suggests that orthopedic surgeons could play a significant role in identifying patients who have experienced intimate partner violence (IPV). The research, published in JB&JS Open Access, found that while orthopedic surgeons frequently treat musculoskeletal injuries, they rarely refer patients for IPV intervention. According to the study, only 0.3% of referrals for IPV came from orthopedic surgeons, compared to 29% from emergency departments.
Lead author Ophelie Lavoie-Gagne, MD, a resident physician in the Department of Orthopaedic Surgery at Mass General Brigham, stated: "This study challenges the assumption that orthopedic encounters are not the right place for IPV screening."
Lavoie-Gagne emphasized the importance of all members of the orthopedic care team in recognizing signs of IPV. She said: "We have a unique opportunity to educate and empower our patients who otherwise are not presenting for care in other medical sites. This study underscores the urgent need for tools that combine our clinical expertise with support to provide timely, life-saving referrals. Identifying risk early could alleviate suffering and could also prevent a patient's death."
The researchers analyzed data from Massachusetts General Hospital (MGH) and Brigham and Women's Hospital (BWH) Domestic Abuse Intervention Programs (DAIP) registry between 2000 and 2024. They categorized referrals by department and specialty and reviewed electronic health records for those referred by orthopedics. Out of 11,227 patients referred to DAIPs at MGH and BWH, 29.3% were referred from emergency departments, 18.2% from behavioral health services, 8.4% from obstetrics and gynecology departments, but just 0.3% came from orthopedic surgery.
Many patients referred by orthopedics had not seen any other specialists within six months before their disclosure of abuse. This suggests that orthopedic teams were often the only clinical providers able to make these critical referrals. Over half of these patients sought elective care through orthopedics rather than emergency treatment.
The investigators highlighted several strengths that position orthopedic surgeons well for IPV screening: knowledge about injury patterns linked to abuse, ongoing relationships with patients due to follow-up visits, and experience managing pain symptoms common among IPV survivors.
Artificial intelligence may also assist clinicians in this area by detecting subtle signs across imaging or clinical data during routine visits.
Senior author Bharti Khurana, MD, MBA—founding director of the Trauma Imaging Research and Innovation Center—said: "This study reinforces why tools like the Automated Intimate Partner Violence Risk Support System are urgently needed. Orthopedic encounters often represent missed opportunities to identify patients experiencing IPV. By combining clinicians' expertise with AI models that detect subtle patterns across imaging and clinical data, we can support surgeons in making timely, life-saving referrals."
