I cannot agree more that every patient should be screened for ongoing violence during routine primary care and should also be queried directly in other appropriate circumstances, such as during the work-up of such chronic conditions as the irritable bowel syndrome. Although partner violence appears to be more prevalent in young, poor, and unmarried women who present for ambulatory care [1], it is regularly seen in women of all ethnic and economic backgrounds who present in primary care settings [2, 3]. Indeed, routine screening should extend to a venue of care in which screening issues are not often considered-the emergency department. In this setting, one in nine women present for treatment of conditions related to acute, ongoing partner abuse but are not treated for the primary problem. The lifetime prevalence of partner abuse in women who present for emergency care is a staggering 54% [4].

As physicians, we should be more than the experts at diagnosing and treating diseases and conditions that have already occurred, whether or not they are outwardly manifest. Medical educators need to teach about the important role that primary, specialty, and emergency care physicians can have in helping victims of violence through their terror and toward recovery and safety. This should be a central component of medical education. Equally important, however, is that physicians can have an important role in promoting public health and primary prevention by sending a clear message to patients and the public at large that they are vigilant and zealous advocates for the maintenance and promotion of the health and well-being of every member of society.

There is no quick fix for intimate partner violence, but we do have a clear task. We can communicate care, compassion, and consistency to our patients. We can let our abused patients know they are not to blame and that they need not feel alone in their fear. We can offer solace and a place of trust and confidentiality. We can make sure that every at-risk patient can develop an individualized safety plan with an advocate or other expert who can spend the time that we do not realistically have. Most important, we can say to our patients and society that we are prepared and united as a profession to stand and be heard among the many influential voices making clear that violence is not only unacceptable but also ultimately preventable.