Thank you, Jane. I have printed out that post, and will read the Port Townsend info as well.
Yes, I said "nurse" in the post above, but in fact it would either be a nurse practitioner or a social worker do the follow-up after the doctor has addressed the issue in the appointment. In Vermont, most practices are enrolled in the state-wide Blueprint for Health, which provides the practice a team of care coordinators. There are always nurses and usually social workers on these teams. In drafting the screening guidelines, we consider these teams a critical piece to get past the screening barrier of "I don't have time for that."
BTW, we have Dr. Felitti coming to Vermont in October for a state-wide conference on ACE, aimed at primary care physicians, their teams, and community service providers. We're designing the conference using Dialogue Education, which is based on adult learning research, so that everyone will engage with the information at the conference, and have breakout sections with their community service partners. We are hopeful this will help with that very tough issue of implementation. We'll see!
Best,
Kathy