RESULTS: 81 VA and 129 non-VA physicians participated. Regarding diagnosis, 85% of VA versus 95% of non-VA physicians listed depression as a possible diagnosis (p = .02), and 47% versus 62% assigned depression a probability of greater than 50% (p = .04). Regarding management recommendations, 15% of VA physicians versus 2% of non-VA physicians said they would recommend a mental health referral (p = .001), and 9% versus 13% would recommend an antidepressant (p = NS). 35% of VA physicians versus 53% of non-VA physicians would see the patient portrayed in the videotape for a return visit within 2 weeks (p = .01). CONCLUSION: Non-VA physicians were more likely to recognize depression, although many VA physicians also considered it. Neither group followed Agency for Healthcare Research and Quality guidelines for follow-up and for initiation of pharmaco-or psychotherapy, although non-VA physicians were more likely to see the patient back within 2 weeks and VA physicians were more likely to refer to mental health. Differences in management by VA versus non-VA physicians may point to systems issues underlying non-adherence to depression management guidelines.