You are consulting with a patient that has bruising from a fall. Her male companion answers questions for her, and she barely gives eye contact. What do you do in this situation to get the patient to answer independently?

"I would need to separate the potential abuse victim from the abuser, though I understand that it may be difficult. I would first ask him to leave the room for the assessment and if he balked, I would probably ask a nurse to take her to the bathroom for a urine sample to ask her questions. I would be careful not to judge or prejudge the situation, but I would do what I needed to do to assess the potential abuse victim thoroughly. I definitely would seek guidance from a faculty member in this situation and I wouldn't hesitate to get security involved if needed."

Sometimes a domestic abuse victim's only connection to help might be a trip to the ER, urgent care, or any other type of appointment with a physician. All patients should be screened for abuse whether man, woman, or child. As the physician in charge as a resident, you need to know the warning signs and learn how to assess and ask effective questions. As you answer this question, it is vital that you reiterate the need for separating the couple during your examination so you can ask the right questions of the patient and give her the opportunity to speak openly. From there, talk about any reporting protocols that you are familiar with from your medical training.