Non-therapeutic attitude among family medicine physicians

A public health concern, not a clinical problem

A concern that questioning about alcohol use will lead to patient resistance, discomfort, and exiting from the practice

Other health problems are more urgent or important

Denial that drinking is a problem

Feeling that treatment isn’t effective

Inadequate knowledge and clinical skills

Limited training in medical school and residency

Feel ill-prepared to deal with the realities of screening and assessment

Lack of provider self-efficacy, feeling you can’t make a difference

Provider reference material lacks information and consistent recommendation to abstain

Lack of time

Inadequate reimbursement

System barriers

Lack of intervention tools

Lack of a system strategy or protocol

Lack of treatment and referral resources

Lack of office staff involvement

Legal barriers