Elder abuse and neglect represents an extensive medical and social problem in the United States with an estimated prevalence of 4-10% of older persons. Physicians are mandated to report suspected abuse, but <2% of Adult Protective Service reports are filed by physicians. A knowledge or attitude survey was mailed to all adult primary care physicians in the study community. The intent was to explore possible knowledge deficits and perceived barriers to physician reporting. Regarding the attitude measure, physicians expressed that a lack of understanding of reporting mechanisms represented the most significant obstacle. Regarding the knowledge measure, a majority of the responding physicians were unable to recognize key risk factors for abuse. Study findings will be used to develop local educational programs to enhance physician understanding of elder abuse.