Objectives: We sought to examine primary care providers’ gout knowledge and reported treatment patterns in comparison to current treatment recommendations.

Methods: We conducted a national survey of a random sample of primary care physicians (internists and family practitioners) to assess their treatment of acute, intercritical, and tophaceous gout in comparison to published European and American gout treatment recommendations and guidelines.

Results: There were 838 respondents (response rate of 41%) most of whom worked in private practice (63%) with >16 years experience (52%). For acute podagra, 16% reported care consistent with the recommendations including avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤ 1.8mg a day, and no initiation of a urate-lowering drug (ULD) during an acute attack (internists 21% vs. family practitioners 11%, p

Conclusion: While internists were more likely than family practitioners to suggest recommended care, the majority of physicians did not report optimal treatment practices, suggesting further education is needed.