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Barriers to Providing Nutrition Counseling by Physicians: A Survey of Primary Care Practitioners
Abstract
Background Previous surveys have shown that there is a disparity between physicians' beliefs about the importance of diet and nutrition in health maintenance and disease prevention and the actual delivery of nutrition counseling. The primary objective of this study was to assess the current attitudes, practice behavior, and barriers to the delivery of nutrition counseling by primary care physicians.Methods A random-sample-mailed questionnaire was sent to 2,250 primary care physicians selected from the AMA masterfile from general practice, internal medicine, and pediatrics, representing self-employed, group, hospital, and HMO practices. Participants were stratified by age, gender, geographical region, and present employment. The main outcome measures were to determine time spent by physicians providing and percentage of patients receiving dietary counseling and to identify barriers to the delivery of nutrition counseling.Results A 49% response rate (n = 1,103) was obtained. Results are presented for the 1,030 physicians (70% private practice) with complete data. Over two-thirds of physicians provide dietary counseling to 40% or less of patients and spend 5 or fewer min discussing dietary changes. Despite this pattern, nearly three-quarters of respondents feel that dietary counseling is important and is the responsibility of the physician. Ranking of perceived barriers to delivery of dietary counseling were lack of time, patient noncompliance, inadequate teaching materials, lack of counseling, training, lack of knowledge, inadequate reimbursement, and low physician confidence.Conclusions This survey suggests that multiple barriers exist that prevent the primary care practitioner from providing dietary counseling. A multifaceted approach will be needed to change physician counseling behavior.
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“Given the demands on providers’ time, an increase in the frequency of PCP counseling does not appear to be feasible.8”
From A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice (2011) · cites this paper as [8]
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Treatment of the Obese Child or Adolescent
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Metadata
- Authors
- Kushner, R. F.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Kushner, R.F.
- ORCID
- Kushner, R.F.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 1995-11
- Volume
- 24
- Issue
- 6
- Pages
- 546-552
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2007745104
- Cited by
- 604
- References
- 0
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 17 · 2023: 19 · 2022: 18 · 2021: 21 · 2020: 15 · 2019: 29 · 2018: 25 · 2017: 27 · 2016: 34 · 2015: 33 · 2014: 27 · 2013: 28 · 2012: 29
- FWCI
- 7.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30dk026678-20)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-26678)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Dietetics, Nutrition, and Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Keywords
- nutrition counseling, primary care physicians, barriers to counseling, physician attitudes, physician practice behavior, time constraints, patient noncompliance, physician confidence, physician training, reimbursement, diet and health
- MeSH terms
- Adult, Counseling, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Physicians, Family, Surveys and Questionnaires, Time Factors, United States, Treatment Refusal, Workload, Nutritional Sciences
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