CHOP doctor wins Lutheran Settlement House’s first Male Ally Award

“It was wonderfully surprising,” Fein said of winning the award. “I was extremely honored and excited.”

On Wednesday, May 8, Philadelphia City Councilwoman Helen Gym will host Lutheran Settlement House’s 14th annual Women of Courage Awards at the DoubleTree by Hilton Hotel in Center City. But for the first time in those 14 years, one of those awards will be made to be specifically given to a man. It’s called the Male Ally Award, and it will go to a man Lutheran Settlement House feels has displayed a keen and strong desire to help combat domestic violence in the community. This year, that man’s name is Dr. Joel Fein.

Fein wears many hats. He’s an attending physician in the Emergency Department at the Children’s Hospital of Philadelphia, the co-director of the CHOP Violence Prevention Initiative and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. But above all, he’s a soldier on the frontlines against domestic violence, or as he prefers to call it, “intimate partner violence.”

“It was wonderfully surprising,” Fein said of winning the award. “I was extremely honored and excited.”

Fein, who called Lutheran Settlement House “an organization that I truly love to work with and have been working with for so many years,” earned the award primarily because of his work with screening parents for intimate partner violence. Fein, being a pediatrician, isn’t somebody you would expect to be dealing with such an issue. But he’s hoping to change that, in part, due to the negative effects such violence has on the development of children.

“For pediatrics, this is a particularly unique issue because we know that intimate partner violence has one of the greatest impacts on childhood development and health and wellness, yet the parent is not our patient per se, so we have to be very — I would say careful, but also creative in how we screen.”

The screening program at CHOP, which Fein was instrumental in starting, is universal. This is how they work: a child and his or her parent will come in for a doctor’s visit. If only one parent comes with the child, Fein will conduct the screening. To begin the screening, he’ll hand the parent a laminated card with a list of questions pertaining to potential physical abuse in the household. The parent is asked simply to read the questions with the child in the room and simply say either yes or no in response to each question without divulging in detail when answering as a way to keep the child from getting suspicious.

“If a 5-year-old tells an abuser that, ‘Hey, [the doctor] asked mommy about whether you hit her,’ that’s not a good thing,” Fein explained. For this reason, any information obtained about potential intimate partner violence won’t go into the child’s medical record. This is because both parents have access to the record, which means the potential abuser could discover the screening, putting his or her partner in danger.

Sometimes, Fein and other CHOP doctors will still conduct the screening if the parent comes in along with a “trusted support person that we feel is safe,” despite the fact that the parent isn’t alone. But these situations, he says, are judgment calls.

If a CHOP doctor comes to the conclusion that intimate partner violence is indeed happening within the child’s household, the doctor can refer the parent to Lutheran Settlement House with the parent’s permission. According to Fein, Lutheran Settlement House keeps a staff member onsite at CHOP during the day during most weekdays whom they can speak with. In the event that the appointment is during a time in which the staff member is not there, Fein said that CHOP has a “very robust” referral system through an outside database that allows the Lutheran Settlement House folks to see the referral in real time.

“Occasionally, they’ll call [the parent] even before I’m finished with the visit,” Fein said.

Buy what if the parent doesn’t give permission?

“We just let the person know that we’re always here in case they need help,” he said. “We really do want the medical institutions in the city to be a place where people know that when they don’t have any other place to turn, they can come here and get what they need.”

Fein believes that oftentimes, medical institutions “don’t build a strong enough net to catch people when they need it,” he said. “Most of my professional goals have been around creating that net and making sure that it logistically works without destroying the flow of care, which is important not to do.”

After all, Fein said, doctors screen patients for diabetes and hypertension, but not until recently did they screen for “social determinants of health that can have as much if not more impact on the lives of our kids and their families,” like intimate partner violence.

Fein prefers the term ‘intimate partner violence’ because he feels it’s a better label since the people involved may not technically live together. Also, the term domestic violence can refer to any two people living in a domestic situation, which technically could be siblings, parents, aunts, uncles, cousins or anybody living within the same household.

But back to the award — why create the award in the first place? According to Lutheran Settlement House’s director of development, Erica Zaveloff, the organization noticed that an increasing number of its clients were men, and the awards should be more inclusive to reflect that (Zaveloff said that about 85 percent of the organization’s clients are still women, however).

“It felt mission-aligned to also recognize the work of male-identified community partners,” she said, “especially given the #metoo movement and realizing that if we’re going to find a solution to any of these social programs or reduce their occurrence, we have to be engaging everyone in this work.”

Zaveloff spoke highly of Fein, who had been involved with Lutheran Settlement House since the days he served as the board chair of the Institute for Safe Families, a now defunct organization and think tank that brought experts in the city together on these important issues, including intimate partner violence and adverse child experiences, to establish proper practices for addressing such issues.

“If you’re a parent of a child and you’re being abused yourself, you may not go seek medical attention,” Zaveloff said, “but if your kid is hurt, you will almost always bring your kid in for help. It’s a way to reach people who may not typically report abuse.”

According to Lutheran Settlement House staff worker Toby Fraser, countries that have less income equality typically have less violence, so advocating for increased equality can be potentially helpful in combating this type of violence. Additionally, he encourages people to get involved in campaigns for different avenues for justice and that men should do their part to change the stereotypes of masculinity, which can sometimes portray men negatively as “controlling” figures.

“One stereotype is that people who are raised to be men are raised to be in control all the time,” Fraser said. But, “We don’t want to be people who are controlling all the time.” Changing the stereotypes of masculinity, according to Fraser, includes doing things like not laughing at rape jokes or not joining in when men get laughed at for not conforming to negative masculine stereotypes.

Above all, Fein said it was important to recognize that it is “all of our responsibility to address the issue of intimate partner violence,” he said. “It is not a purely female or male issue. It is on my end a child issue if they’re exposed to it. So I am thrilled that there’s a recognition that not just women but men as well have a part in that process.”