Violence in intimate relationships and the practicing internist: new "disease" or new agenda?

Domestic violence is endemic in U.S. society and is seen in nearly every venue of medical care. A history of abuse should be considered and routinely queried in all women who present for emergency care, should be suspected in any woman who presents with an injury, and should be routinely screened for in primary care settings. Clinical manifestations, suggested diagnostic strategies, obstacles to leaving the abusive relationship, and the barriers that patients face in obtaining and that physicians face in providing optimal care in situations of domestic violence are discussed. Physicians can play a pivotal role in primary prevention, early intervention, and follow-up care during and after an episode of intimate partner violence. Clinical competence in the treatment and prevention of family violence is an important component of the new agenda for health care, particularly in generalist fields such as general internal medicine.