Family and Community Approaches to Intimate Partner Violence: Restorative Programs in the United States.

Now is the time to rethink reliance on legal intervention to end intimate partner violence (IPV). Arrest, incarceration, and family separation have fallen disproportionately on people who are Black or Brown, impoverished, or immigrant, lesbian, gay, bisexual, transgender and queer (LGBTQ). Restorative approaches bring together the persons harmed, persons causing harm, their family or community networks, or combinations of these stakeholders. Based on a U.S. national study, this article examines: What influences programs to adopt a restorative approach to ending IPV? How do programs safeguard their original vision for social change? What principles guide the programs in carrying out their work in safe and productive ways?

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic.

BACKGROUND: Burnout is high among resident physicians and may be associated with suboptimal patient care and reduced empathy. OBJECTIVE: To investigate the relationship between patient perceptions of empathy and enablement and physician burnout in internal medicine residents. DESIGN: Cross-sectional, survey-based observational study between December 2012 and March 2013 in a resident continuity clinic located within a large urban academic primary care practice in Baltimore, Maryland. PARTICIPANTS: Study participants were 44 PGY1-3 residents and a convenience sample of their English-speaking adult primary care patients (N = 244). MAIN MEASURES: Patients rated their resident physicians using the Consultation and Relational Empathy Measure (CARE) and the Patient Enablement Instrument (PEI). Residents completed the Maslach Burnout Inventory (MBI). We tested for associations between resident burnout and patients' perceptions of resident empathy (CARE) and enablement (PEI) using multilevel regression analysis. KEY RESULTS: Multilevel regression analyses indicated significant positive associations between physician depersonalization scores on the MBI and patient ratings of empathy (B = 0.28, SE = 0.17, p < 0.001) and enablement (B = 0.11, SE = 0.11, p = 0.02). Emotional exhaustion scores on the MBI were not significantly related to either patient outcome. CONCLUSIONS: Patients perceived residents who reported higher levels of depersonalization as more empathic and enabling during their patient care encounters. The relationship between physician distress and patient perceptions of care has important implications for medical education and requires further study.