Time limitations affect decisions: Comfort level dictates referral patterns

Violence often is so far-reaching that effectively responding to it sometimes can extend beyond the primary care pediatrician's grasp.

When that happens, physicians need to refer patients to a specialist.

But determining whether a referral is appropriate or choosing the appropriate specialist requires skill.

Psychiatrists, psychologists, social workers, child protective services, even clergy represent the array of resources that might be necessary to help a child who has suffered or witnessed violence.