to be really worried - doc asked if DD had brother re abuse

[tetleymel]

or is it standard that GPs ask this sort of question and I shouldn't give it another thought?

DD aged 4 may have a vaginal infection (awaiting swab results). Doc asked if there's an older brother in the house, which there is. He's 15.

As DD didn't flinch when he took a look at her vulva, the doc wondered if there is any risk of abuse. :-(

it can really fuck up a real investigation when someone who has only done basic manditory safeguarding starts questioning the wrong way by themselves!

I don't know what training you have had jingle but that certainly isn't what I have been told on any of the courses I have been on.

Tetley, I have name changed for this. Do not dismiss the doctor's questions lightly, just see them as an opportunity to find out if there is anything else going on.

I was sexually abused by a close family member when I was 4 and he was 12. To the date, his mum and the rest of the family can't contemplate the idea he did it. My mother followed the thrush theories even when I had never had a thrush infection before then and never had another one for years.

I thought it was normal so was not fussed by it. It hit me when I became a teenager. To this date nobody believes he did it much less so his own mother, but I still have some very clear recollections on how he asked me to do things.

It took years to put all this trauma behind me, I'm ok now, but still can't forgive my mother who had all the clues in front of her and my words and decided to brush it off because those things didn't happen in families like ours.

I'm sorry to add some misery to this thread but keep your eyes open. Just in case.

Jingle are you meaning directly questioning a possible child victim of abuse?

If so then you are correct parents ect shouldn't but that does not mean a doctor can not ask the mother of that child?

Don't be so ridiculous all of you. The dr was doing his job, which means having a duty of care. Blaming him, acting as though he is being unreasonable and other such denial does not take the possibility away.

IIWY I would ask very casually what games she plays with older bro, in slightly different and non-threatening ways over a period of weeks, just to make sure.

also just to be aware when they are alone together. This isn't being paranoid, it is just being alert, watchful and letting them know you are alert and watchful (boundaries). I did beyond a certain age. It is just keeping your radar up, not being pathological or paranoid.

This is the most common form of sexual abuse (sibling exploration), don't kid yourselves for a second.

If all is well, make sure she knows to wipe front to back, every time. Give her lots of yoghourt, and cut down on sugary things.

tetleymel - are you reading this?

If this is genuine, I really would urge you to concentrate on the good sense from some posters - such as Abitwobblynow. This is about your child. You have a responsibility to her - it isn't about your feelings or just listening to the views you want to hear.

So many times, I hear adult survivors ask the same question over and over - why did no one notice?

You have a duty to her - everyone has a duty to notice what is happening to children, everyone has a duty to make sure that they are safe. This isn't about you, don't close your eyes. Maybe everything's fine - you need to make sure.

BalthierBunansa, I am really sorry everyone has ignored you after you took the trouble to share a horrendous experience. I'd like you to know that I read and agree that child protection is more important than a parent's potentially hurt feelings.

This reminds me of what happened to me and my then seven year old daughter a few years ago. My dd1 was taken to hospital complaining of a painful hip and groin. She was examined by the doctors in a and e and because she moved her underwear aside and showed the doctor exactly where it hurt (like she was asked to do) they said it showed sexualised behaviour and I was reported to social services there and then and I was not allowed to accompany my dd to the toilet alone. They told me her pain was due to abuse and trauma to the area.

I was horrified but absolutely furious as a few days later her test results came back after a three day stay in hospital. She had fluid on her hip joint and the pain in her groin was referred pain and nothing to do with any abuse whatsoever.

I am so wary of taking my dc to hospital again. Dd broke her arm last year falling of a space hopper but I was half expecting the abuse questions to pop up again

I've just read the whole thread through and I do see that doctors and gps are just doing their job but its awful when you are reported to social services for something you didn't do and prevented from leaving a ward and watched.
Btw social services didn't contact us afterwards so they obviously were not bothered.

Imo absolutely fine when doctors are doing their job by asking questions that might reveal abuse.

Not fine at all (and in fact dangerous) when they omit doing standard tests for physical conditions because they have already decided in their heads that the answer is abuse.

And certainly not fine when they tell the child that the pain is all in their head/has no physical cause. Dd at 16 still struggles with medical investigations because the paed kept telling her so very forcefully that the pain she felt wasn't real; his questions were very clearly informed by the "trauma from abuse" scenario long before other avenues had been explored.

Which is why I think jingle is making such an important point: questioning should be done very carefully according to strict guidelines and a person who hasn't had the requisite training shouldn't be doing it. The paed who questioned dd did her harm. Because her painful condition was real and is incurable she has to live with that every time she needs another hospital visit.

I quite like it when they do the family tree as part of a standard questionnaire at the beginning of every hospital visit: it gives the medic the relevant information without putting ideas in the child's head.

Problem is - I'm being hypothetical here so please don't think I'm talking about you op - the mother may be complicit in the abuse. So asking straight out 'is there abuse' gives the family the heads up and can hamper an investigation. This I think is what jingle is getting at.

But the other alternative is the gp sits on his hands and refers every third patient he sees to child protection.

However I'd have thought more normal to ask who all was at home, are there any probs at home, how is she emotionally etc. if other red flags raised you are building up a case to refer to social work. Perhaps this is how the conversation did go though.

"But the other alternative is the gp sits on his hands and refers every third patient he sees to child protection"

but if there are a number of very separate issues, and each time the front line person questions it themselves and is satisfied with the answers, noone sees the quantity of the flags that are being seen IYKWIM, whereas if concern is registered, then the authorities can see if there are a number of different people being concerned by a variety of things, even if there seems to be a good explanation for each

Good point jingle

It's not the frontline person's(in this case,the doc) responsibility to investigate whether abuse is going on,it is their responsibility to report any concerns to social services and to allow their trained staff to deal with it properly.

For all he knows,the mother is abusing the child,and he just alerted her.That's why all,and any,concerns about a child should be reported to the appropriate authorities,so that a full picture can quickly be revealed.

All he as done is either A) alerted someone who may be abusing a child that he has suspicions (I'm really not for one minute suggesting you are abusing her,Op) and B) frightened the life out of a mother who was only trying to help a child with thrush.

Badly handled by the doctor,I think.

I am wondering what level of training people have had to make such damning comments on the doctor....?

Healthcare professionals are required to discuss with the family any concerns before making a referral unless this will put the child at more risk

With the way the world is these days, sadly i can see why a doctor may ask this.
If it saves another child from abuse then surely it's worth it.
But i wonder why he didn't ask of other men in the home first.

All he as done is either A) alerted someone who may be abusing a child that he has suspicions (I'm really not for one minute suggesting you are abusing her,Op) and B) frightened the life out of a mother who was only trying to help a child with thrush.

So informing the SS and having them knock on the door would not have alerted the mother if she was abusing the child or frightened the life out of the mother who was only trying to help. I can see horrible ongoing issues for the family if the SS arrived on the doorstep. That might be fine if there was abuse but not fine if there wasn't. And could even lead to some perhaps unconcious exclusion of the victim for 'causing' all the stress and humiliating invasion of family life for the rest of the family - oh, and ruining Xmas.

I would say the Doc has alterted the mother to the most probably cause of abuse if there is any. Were the mother the abuser I'm not sure she would toddle off to the doc's with the child with any probs 'down there' if she had been the perpretator.

The doc was being pragmatic and suggesting the possiblity of abuse from most likely perpetrator, a male family member, without the horror of SS enquiry, and allowing for the likelihood that there was none.

I understand that Doctors are trained to ask these questions, and why. Here, the doc asked if there were an older brother, and there is. Then what? The doc had his answer (positive), so what does he do with this information? If nothing, then what was the point of the question? Or is it to alert the Mum to be on the look out?

It's hard to draw a line on duty of care in cases where it gets so blurred around the edges, Hoppingforsun. There is a legal duty here to the child, responses will have been noted. But where does the duty to delve end? Well we can't go imposing legal duties to delve into every patient's life, can we? If there is actual cause for concern for this little girl then this will be revisited but at this stage the GP's actions were totally appropriate and OP should be alerted to all potential causes of her DD's problem.

Yes, cafecito I am 100pc convinced that the doctor was following the correct protocol. I am merely questioning the point of that protocol if it leads nowhere: it smacks a little bit of tokenism to ask about whether there is a brother, find that there is, and then do nothing. If that was to be the outcome, then why ask (other than for the GP to cover him/herself by being able to say they asked)?

As DD didn't flinch when he took a look at her vulva

Why should she have flinched? She is four.

I'd expect a four-year-old to kick off if she's in pain or is frightened of the doctor, but I wouldn't expect her reaction to be any different if it was her arm or whatever other body part that hurt. Are people seriously suggesting that a normal four-year-old should feel some sort of shame when undressing in front of a doctor?