['To ascertain the variation in strategies for managing delirium of physicians with expertise in geriatrics.', 'Cross-sectional mail survey.', 'United States.', 'A probability sample of physician members of the American Geriatrics Society.', 'Management choices presented in a two-part case vignette of an older woman hospitalized with a hip fracture who develops mild and then severe delirium.', 'One hundred twenty-two respondents (43%) selected the three answers constituting current "best practice," 50 (18%) selected an unnecessary diagnostic test (brain imaging, lumbar puncture, or electroencephalogram), and 47 (17%) selected unnecessary pharmacologic therapy for mild delirium. For severe delirium, 270 (96%) selected pharmacological therapy, of whom 180 chose haloperidol alone, 55 chose lorazepam alone, 23 chose lorazepam in combination with haloperidol, and 12 wrote in another drug. Thirty percent of the respondents made any selection of lorazepam, alone or in combination with haloperidol, for mild or severe delirium. Sixty-one percent of those selecting haloperidol for severe delirium chose a dose greater than that recommended for geriatric patients. Sex, date of graduation from medical school, clinical specialty, completion of a geriatric fellowship, or certification in geriatrics had no significant effect on responses.'] Do physicians vary in approaches to the clinical management of delirium?