Silent Pain of Spousal Abuse : Many battered women don’t know who to turn to. Although the AMA is attempting to change that, doctors find that quizzing the victims can be invasive.

Beverly never told anyone her husband beat her. For much of their three-year marriage, he choked her, kicked her, knocked her to the ground and hurled her across the room. She endured each violent outburst, never calling the police, never seeking help from family, never revealing the source of her bruises and broken bones.

“The only person I would have confided in,” she says, “was my gynecologist. I would have broken down and told my doctor.”

If only he had asked.

But he never did.

While most battered women never report their abusive mates to police, they are likely to call a doctor. The American Medical Assn. estimates that one out of three women seeking emergency hospital treatment and one out of four pregnant women seeking prenatal care have been abused.

To help doctors identify and support them, the association recently published guidelines recommending that all female patients routinely be asked about violence in their homes.

“The woman needs acknowledgment that this is a serious problem,” says Dr. Marie Kuffner, president of the Los Angeles County Medical Assn. “It is important to let her know it is a serious health care issue that could be life threatening, and the doctor does care.”

About 1.8 million wives are beaten by their husbands every year, and an estimated 3 million to 4 million more attacks go unreported, according to a 1991 Senate Judiciary Committee report. In Los Angeles, police investigated more than 73,000 calls on domestic violence in 1992 and arrested more than 8,000 men on charges of spousal abuse. American women are more likely to be injured or killed by a husband or boyfriend than by all other assailants combined. More than half of all women slain nationwide are killed by a current or former male partner, according to FBI statistics.

But despite the epidemic nature of the problem, many doctors say quizzing every woman about domestic violence is awkward, embarrassing and invasive.

“Doctors are not the police of the world,” says Dr. David Frankle, an emergency physician at Holy Cross Medical Center in Mission Hills. “I can do a lot of patching and comforting and reassuring, but I don’t have the ability to put the fire out. I try to be supportive, but I don’t turn the bright light on someone like a prosecuting attorney.”

Dr. Jonathon Serebrin, medical director of the emergency department at the Medical Center of North Hollywood, agrees. “If a patient comes in with a cold, it is inappropriate and bad medicine to start discussing abuse,” he says. “It is an extremely personal area that people don’t want to broadcast.”

Since Jan. 1, 1992, the Joint Commission on Accreditation of Healthcare Organizations, a national organization that sets standards for hospitals and accredits facilities meeting its criteria, has required hospitals to develop policies to identify and treat battered women, document their injuries and refer them to hot lines and shelters.

“Our objective is to let them know that it is not OK to be beaten up and there is help available,” says Bonnie Lipton, who heads the social services department at Kaiser Permanente in Panorama City and sees several cases of domestic violence every week. “We let them know we care about them and they are not alone. We help many women out of very bad situations.”

“I sit down and talk with the woman while I examine her. About 50% of the time, she will admit what happened,” says Dr. Julia Cameron, an emergency physician at Verdugo Hills Hospital in Glendale. “Even if she won’t admit, we give her the numbers and hope she gets in contact with resources.”

Cameron reports all suspected cases of abuse to police--even if the woman begs her not to. “I have had boyfriends and husbands arrested while they were sitting in the waiting room,” she says.

Unlike Cameron, most emergency doctors do not notify the police unless the woman asks them to--even though they are legally required to report all assaults.

“If the woman is unwilling to talk, the police blow it off,” Serebrin says. “Then the patient gets mad because she feels her safety is jeopardized all the more.”

Serebrin’s viewpoint was repeated by emergency doctors and nurses at several Valley hospitals.

But Los Angeles Police Sgt. Bob Medkeff disagrees. “Domestic violence is a crime, and it is treated like a crime,” he says. “Even with minor injuries, we make the arrest, and he gets the message: Don’t hit your wife or girlfriend. Then the courts intervene, we get into a batterers’ treatment program, and she gets the protection she needs.”

Where to call for help

For information and referrals to emergency shelters, counseling, legal assistance and social services, call:

* Center for the Prevention of Domestic Violence, Van Nuys, (818) 786-2079.

* Domestic Abuse Center, Northridge, (818) 705-5030.

* Family Service Agency, Burbank, (818) 845-7671.

* Family Violence Project, Jewish Family Service, Van Nuys, (818) 908-5007.

* Haven Hills Hotline, San Fernando Valley, (818) 887-6589.

* Las Mujeres (Spanish-speaking), Van Nuys, (818) 786-2079.

* Los Angeles Commission on Assaults Against Women, (310) 392-8381.

* Los Angeles Commission on the Status of Women, (213) 485-6533.

* Los Angeles County Domestic Violence Council, (310) 393-6676.

* Los Angeles County Infoline, (818) 501-4447.

* Southern California Coalition on Battered Women, (213) 655-6098.

* Valley Oasis, Lancaster, (805) 945-6736.