Domestic violence: an approach to identification and intervention.

DV encompasses a wide variety of actions that coerce, control, or demean the victim. Victims of DV suffer many physical and mental health consequences that cause emergency physicians to encounter them knowingly or unknowingly in the medical setting. Physicians who are aware of the prevalent problem of DV are able to help victims the most. A physician should be educated to recognize the physical and emotional presentations of victims, but, more importantly, the physician should be knowledgeable about the need for screening of all patients to reach the greatest number of victims. Victims often are not ready or able to disclose DV because of patient and physician barriers. Clinicians should work to overcome these barriers by initiating screening, ensuring patient comfort and safety, and understanding the many stages involved in behavioral change that a victim must traverse. The emergency physician would experience less frustration and more success if he or she would change their role from problem solver to listener and empowerer. This approach allows the survivor to make informed choices. Patients who are ready to make changes must be provided with protection,treatment, resources, and support. Informed, active physicians have great potential for improving DV victims' lives, reducing the effects of violence,and facilitating the patient's progression from victim to survivor.