Limitations

Several limitations should be considered when interpreting these findings. First, there is a potential for selection bias, as physicians who chose to participate may have had stronger opinions about acute pain management or greater professional interest in the topic than those who did not participate. Although purposive sampling across multiple recruitment channels was used to support diversity in the sample, more than two-thirds of participants were from the Northeastern US. This geographic concentration may limit transferability to other regions or practice settings. In addition, because purposive rather than probabilistic sampling was used, the findings are not statistically generalizable, although they may be transferable to similar contexts. Second, all findings were based on self-reported data and may therefore be influenced by social desirability bias. To reduce this risk, interview questions were framed neutrally and open-ended, and participants were assured their responses would remain anonymous and confidential.