A qualitative study with the general practitioners in southwestern France

Introduction. Child maltreatment is a public health issue which has serious consequences on child development and health, but it remains underdiagnosed. The general practitioner (GP) has a central position in the medical follow up of children. However, less than 3% of the abuse reporting come from the medical profession. Objectives. To bring out strategies for tracking child maltreatment, replicable in general medicine practice. Method. A qualitative study has been conducted by semi-directed interviews with fourteen GPs who reported at least one abuse reporting in the department of Les Landes in France. Results. This study suggested ways of improvement of the medical practices for tracking child maltreatment as soon as possible. Different themes arised: using prevention messages, creating shelter for children upstream any violence, recognizing the warning signs, positioning oneself as a support for families, adopting a benevolent neutrality, becoming systematic, and most of all, not remaining alone facing uncertainties. Conclusion. The GP must be a key actor in the child protection system. Thus, it would be interesting to work towards a new paradigm: reconsidering the role of the GP who could provide support for parenting, and redesign the paediatric consultation, by going out to a systematic screening of intrafamilial and scholar violence.