title: Barriers to identification and treatment of hazardous drinkers as assessed by urban/rural primary care doctors.
abstract: This pilot study analyzed three types of barriers encountered by forty family physicians when identifying and treating patients with hazardous drinking and alcohol dependence. The Patient Centered category included patient denial and lack of motivation to change. The Physician Centered category included lack of physician time and lack of addiction medicine training. The System Centered category included lack of community resources and distance to treatment programs. The Patient Centered barriers were rated significantly greater (p < .001) than the Physician Centered or the System Centered barriers. There was also a significant negative correlation (r = -0.49, p < .001) between the Physician Centered and the Patient Centered categories, meaning that the more problematic the patients were rated, the less problematic the physicians rated their time or training. The types of barriers that were rated as most problematic varied depending on rural/urban practice location and how current the physician's training was.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Ferguson
authors.forename: Richard
authors.initials: R
authors.lastname: Ries
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
mesh_terms: D000437:Alcoholism / Q000191:economics / Q000453:epidemiology* / Q000534:rehabilitation*; D003717:Denial, Psychological; D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008403:Mass Screening; D009042:Motivation; D010865:Pilot Projects; D011320:Primary Health Care / Q000191:economics; D012423:Rural Health; D011795:Surveys and Questionnaires; D014504:Urban Health