Attitudes of Internal Medicine Physicians
Background. This study was designed to identify differences among internists in their attitudes about diabetes and how those attitudes influence practice behavior.
Methods. A cross-sectional study of 55 internists in an academic medical center was done using the Diabetes Attitude Scale (DAS-3), a valid and reliable measure of attitudes toward diabetes.
Results. Most respondents were white (89%), male (65%), and ≤40 years old (85%). On the need for special training, internists were significantly different from the standardized norm for the DAS-3. Similar differences were observed on the seriousness of type 2 diabetes, the value attached to "tight control," and patient autonomy. Differences by age, sex, and level of training were not significant.
Conclusion. Regardless of age, sex, or level of training, internal medicine physicians have negative attitudes toward type 2 diabetes that require future educational interventions.

In the United States, approximately 15.7 million people have diabetes, representing 5.9% of the population. Type 2 diabetes is a chronic, debilitating illness with significant morbidity and mortality and accounts for 90% to 95% of all cases of diabetes in the United States. Most of the complications of diabetes can be delayed or prevented by "tight glucose control."

Routine care for patients with type 2 diabetes is provided mainly by primary care physicians such as internists and family physicians. However, data from several studies indicate that the quality of diabetes care in primary care settings is less than optimal. Suggested reasons include deficiencies in physician knowledge, lack of belief in the value of aggressive treatment of diabetes, and problems with patient compliance, including the lack of fostering patient autonomy. Other suggested factors include the complicated nature of diabetes care and the substantial time requirements of high-quality diabetes care.

Negative attitudes toward diabetes among primary care physicians is thought to be a more significant barrier to improving outcomes than a deficit in diabetes-specific knowledge. Data suggest that negative beliefs and attitudes impede guideline adherence and aggressive treatment of type 2 diabetes. To identify the attitudes of internal medicine physicians toward type 2 diabetes and the differences between attending physicians and physicians-in-training, a survey of internal medicine physicians was conducted in an academic medical center.