This study examined physicians' attitude, involvement, and perceived barriers with the health care proxy. A cross sectional, correlational design was used to survey practicing physicians (N = 70). Physicians had positive attitudes toward the health care proxy and indicated that the most significant barriers to health care proxy completion were patient discomfort in discussing the topic, patient knowledge about the health care proxy, and timing of discussions. Physician involvement with the health care proxy included supporting patients' wishes on the health care proxy, initiating discussions with patients about the New York State (NYS) health care proxy, and advocating for patients' rights about the health care proxy. A multiple regression analysis was conducted to understand the factors that predicted overall physician involvement. End-of-life training was a significant predictor. Implications for training and education of physicians and multidisciplinary work with health care professionals, including social workers and nurses, are discussed. (Contains 3 tables.)