MAIN RESULTS:
Of the 853 respondent physicians (adjusted
response rate, 57%), 88% usually or always ask new outpa-
tients about alcohol use. When evaluating patients who
drink, 47% regularly inquire about maximum amounts on an
occasion, and 13% use formal alcohol screening tools. Only
82% routinely offer intervention to diagnosed problem drink-
ers. Psychiatrists had the most optimal practices; more con-
sistent screening and intervention was also associated with
greater confidence in alcohol history taking, familiarity with
expert guidelines, and less concern that patients will object.
CONCLUSIONS:
Most primary care physicians and psychia-
trists ask patients about alcohol use, but fewer use recom-
mended screening protocols or offer formal treatment. A sub-
stantial minority of physicians miss the opportunity to
intervene in alcohol problems. Efforts to improve physicians’
screening and intervention for alcohol problems should ad-
dress their confidence in their skills, familiarity with expert
recommendations, and beliefs that patients object to their
involvement