High-Risk Encounters: Primary Care Experiences of Women Living with Intimate Partner Violence, and Implications for the Patient Centered Medical Home

Women experiencing intimate partner violence (IPV) often face stigma, uncertainty, and complex emotions when deciding to disclose IPV to primary care providers. As the Patient Centered Medical Home (PCMH) model’s general assumptions and value have been more widely accepted, interest has grown in understanding how well it serves different populations. We interviewed 50 women who had experienced prior-year IPV and received care from 2 Veterans Health Administration (VA) facilities, to explore their health care needs Disclosure of IPV status was revealed as a high-risk moment in medical care for many participants, yet nearly all supported clinical screening and described or envisioned patient-centered screening practices. The PCMH’s interprofessional team-based care model offers strengths for connecting women to services and support. However, if women do not experience trust, genuine care, and respect for their autonomy, they are unlikely to disclose IPV or access extended services. The PCMH model holds intrinsic promise but may fall short in delivering on relational aspects of patient-centered care desired by women experiencing IPV (and possibly others facing similar complex, stigmatized challenges). IPV screening practices should aim to empower the entire care team to be able to build the trusting relationships that open the door to discussions of IPV.