UofL pediatrician joins elite group of board-certified child abuse specialists
University of Louisville pediatrician Lisa Pfitzer, MD, recently passed the 2011 child abuse pediatrics certifying exam, making her one of just 264 physicians nationwide who are certified in this recently designated medical specialty. Pfitzer is Kentucky’s second board-certified child abuse specialist.
Kosair Charities gave a $300,000 grant to establish UofL Pediatrics-Forensic Medicine in 2007 and has provided ongoing support totaling $1.1 million. The team includes two board-certified child abuse specialists.
Child abuse medicine is a specialty within the field of pediatrics. These specialists assess suspected victims of neglect and physical and sexual abuse to determine the reason for the child’s condition or injuries. They work closely with child protection professionals and law enforcement and testify under subpoena in child abuse cases.
Although she has just recently been board certified, Pfitzer has worked with abused children for many years, first as a nurse practitioner in West Virginia. After medical school and pediatric residency, she arranged an extra year of training with a practicing child abuse expert—an unofficial fellowship since the specialty didn’t yet exist.
“As a nurse practitioner, I worked with lots of cases of neglect and seemed to be drawn to those situations. I worked at a teen clinic and became especially interested in sexual abuse as I realized how many kids had been in sexual assault situations,” she explained.
Pfitzer joined UofL Pediatrics in 2005. As director of outpatient services for UofL Pediatrics-Forensics, she spends half her time as lead physician at Family & Children’s Place Child Advocacy Center assisting child victims of sexual abuse. The rest is spent on physical abuse cases.
“Sexual abuse and physical abuse are different. For most physical abuse cases, there is some kind of injury. With sexual abuse, the exams are often normal. Sometimes, the child can give explicit details about what happened to them but that doesn’t mean there will be physical findings,” she said.
Certification strengthens credibility
In court, Pfitzer often spends time helping judges and juries understand that there is not always physical evidence of sexual abuse. Adding board certification to her years of forensic experience makes her testimony in court cases even more valuable.
“It’s helpful to have credentials to back up my findings. It shows that what I say isn’t coming off the top of my head,” she said.
Having a second board-certified child abuse specialist on staff also makes possible a child abuse medicine fellowship training program at UofL Pediatrics. There are only 25 accredited child abuse fellowships in the nation.
“We’ve applied for the fellowship and we’re waiting for our application to be reviewed,” explained Pfitzer, who will be fellowship program director if it’s approved.
The forensics team has proposed a comprehensive three-year training program that would include clinical time spent with forensic pediatricians as well as subspecialists such as orthopedists and radiologists who are often called on to evaluate injured children. Fellows will be required to produce a research project.
“Fellows also increase our manpower, which makes us better able to help abused children across the state,” Pfitzer said.
Thanks to Kosair Charities
The UofL Pediatrics-Forensic Medicine staff, which includes two child abuse physicians, five forensic nurses, a social worker, a psychologist and two administrative assistants, has been working full tilt since the team was formally created in 2007 with a $300,000 grant from Kosair Charities. That year a national child advocacy group announced that Kentucky had the highest rate of child deaths from abuse and neglect in the country. Statistically, Kentucky’s ranking has improved nationwide, but the need is still great.
“I don’t believe we’ve plateaued on our abuse numbers,” Pfitzer said. “We still have near fatalities where babies are hurt so badly they’re not going to have any quality of life. I’m concerned there’s more work to do. Luckily, our team continues to grow in number and expertise and other organizations are now following Kosair Charities’ example, standing up against child abuse.”