Routine screening of medical patients for alcohol-related problems has been suggested, but this would be costly and might reveal only a few people with alcohol use disorders. The U.S. Department of Veterans Affairs (VA) calls for annual alcohol screening. Desai et al. (p. 1521) collected data on 15,580 VA patients without identified alcohol use disorders. Screening was performed for 74.2% of these patients, 4.2% had positive screening results, and 1.7% ultimately were diagnosed with alcohol use disorders. Several risk factors for alcohol use disorders—lower age, unmarried status, disability, psychiatric disorder, multiple medical conditions—were related to a lower frequency of alcohol screening. The likelihood of screening was also lower at academically affiliated medical centers, and follow-up of a positive result was less likely at the largest facilities. Although this screening identified relatively few people with alcohol use disorders, targeting high-risk patients and removing barriers to follow-up might increase this number.