Spending time outdoors is associated with numerous physical and mental health benefits in children, including improved motor skills, reduced ADHD symptoms, increased creativity, and lower obesity rates. Nature Deficit Disorder (NDD) is an informal diagnosis that remains poorly defined and underrecognized among physicians, highlighting a gap in clinical awareness and counseling practices. We hypothesized that physicians caring for pediatric patients have limited knowledge of NDD and face barriers to effectively counseling families on outdoor activity. To test this, we distributed a 29-question survey to primary care physicians who see pediatric patients to assess NDD awareness, counseling practices, and perceived barriers. Among 44 physicians across diverse practice settings and experience levels, 70.5% had never heard of NDD and 88.6% reported no prior training on discussing outdoor time, despite 88.6% rating it as highly important. Outdoor activity was also the least frequently discussed counseling topic, with screen time, unsafe environments, and lack of motivation identified as key barriers. Study limitations included selection bias, and multiple responses may have been recorded from a group dedicated to nature with a greater awareness of NDD than other physicians. These findings demonstrate a significant gap in physician education and counseling regarding NDD and outdoor activity. Future research should include additional data collection, analysis of counseling methods, and strategies to overcome barriers.
