Specific strategies are offered to address these obstacles: (1) framing the problem medically; (2) developing a credible knowledge base visible to clinicians; (3) entering mainstream medical education; and (4) emphasizing elder abuse policy efforts that address the concerns of physicians. The concept of the "geriatric syndrome" provides a familiar and useful framework for physicians to systematically evaluate suspected elder abuse and neglect. The author believes that physicians can make a difference in family violence, that the prevailing culture can be influenced positively, and that the proper management of elder abuse can produce improvements in the quality of life rivaling or exceeding gains made when physicians aggressively diagnosis and treat other organic illnesses. 7 references