Sexual Abuse and the Primary Care Doctor

General practitioners and nurses working in a variety of settings have no control over the type of problems that patients present. Whether they want to deal with sexual abuse or not is irrelevant: sooner or later they will be presented with the problem by a patient who will assume that both their physical problems and their distress may be discussed with a practitioner of medicine or nursing. It is only recently that doctors have become familiar with the concept that sexual abuse may be an important factor in almost any complaint. Dr Wakley has written sensitively about the problems of those confused and distressed by sexual abuse and of the responses of those who pick up the unspoken and spoken clues. Some patients may need to be referred to ther specialists but others can be successfully treated over a short period of time in their own general practice. This is not comfortable reading. Dr Wakley discusses problems that evoke an uneasy response. At the same time, the practitioner is helped to acquire knowledge and develop new skills to extend the scope of medical care.