Improving Primary Care by Addressing Trauma



“Understanding the link between trauma and health is an epiphany for clinicians. Many of us have spent years struggling to help our patients improve their health but did not realize that there was a missing ingredient in our model of care. Trauma affects health not only through psychological and behavioral factors, but also biologically, through neuroendocrine and inflammatory changes in response to trauma. By understanding the central role that trauma plays in illness, we can use this new model to reengineer clinical practice around trauma-informed principles to better serve our patients and save lives,” said Machtinger.

” ‘In our clinic where we treat women with HIV, we are able to deliver lifesaving anti-HIV medications, but we still lose patients far too often. Looking back over the last ten years, only 16 percent of our patient deaths were due to HIV/AIDS. Most deaths were due to events such as depression, suicide, murder, drug overdoses and lung diseases that are directly related to adult and childhood experiences of trauma. We also realized that trauma is having a devastating impact on the health of a broad spectrum of the U.S. population, regardless of someone’s HIV status. We need a new model of care that addresses this key social determinate of health,’ said the paper’s lead author, Edward L. Machtinger, MD, director of the Women’s HIV Program at UCSF.”

“In the trauma-informed primary care model, the healthcare team routinely inquires about trauma, ideally in the context of an ongoing provider-patient relationship. Patients are educated about the ways that trauma affects health. Screening includes assessment for recent trauma including intimate partner violence, lifetime trauma, and/or the emotional and physical consequences of trauma such as depression, post-traumatic stress disorder (PTSD), substance use and chronic pain.”

Read the full article here:

University of California, San Francisco. “Improving primary care by addressing trauma.” Medical Express, May 6, 2015

Photo Credit: Mimozaveliu. “The children of Kosovo-Sorrow and hope 3.” Wikimedia Commons, 14 February 2013

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