Why GPs Hesitate to Refer Patients to a Diabetes Education Program

Important lessons regarding the implementation of an education program in primary care have been learned and can contribute to a better understanding of the reasons why GPs hesitate to refer patients to a self-management education program. Reasons included: the role of GPs and other health care providers in diabetes care needs to be clarified before introducing new functions; feelings of security and a basic trust of providers in the health system are a prerequisite for participation in care innovation; from a sample of 20 GP’s, one of the most striking reasons was the limited readiness for innovation among GPs; feelings of fear of further fragmentation of diabetes care, and frustration and insecurity regarding their own role in diabetes care prevented them from engaging in the innovation process; they needed time to be reassured that the program respects their role and has an added value to usual care; once GPs considered referring patients, it was not clear enough which of their patients would benefit from the program; some GPs expressed the need for training in motivational skills, so that they could better motivate their patients to participate; distance to the center where the program was delivered; and uncertainty about continuity. BMC Family Practice, 09/19/2011