This study examines the extent and characteristics of primary care physicians' response to their patients' drinking problems and several factors which might impede or facilitate their response. The data were collected in an anonymous questionnaire survey of primary care practitioners in the greater Boston area. Although most had been exposed to some type of alcohol education, few physicians were very confident in their patient management skills and few felt professionally responsible for long-term alcohol treatment. The data suggest that physicians may be reluctant to become involved in treatment they are not prepared to carry out or which they feel is not appropriate to their role. If physicians are to be encouraged to take an active role in the diagnosis and treatment of alcoholism, the emphasis of educational programs should go beyond increasing knowledge and changing attitudes, and focus instead on providing the necessary clinical skills.