Fitting a square peg into a round hole: Perceptions of Appalachian physicians on the incorporation of chronic disease prevention into their practice

In the end, the study revealed that a request for physicians to identify and refer at risk patients to a diabetes prevention program is problematic due to conceptual and structural issues. Based on the findings it does not appear at this time that private physicians in rural settings can incorporate diabetes prevention into their existing practice. To address conceptual and structural barriers the invitation to rural physicians must: 1) present evidence on how physicians may be effective in a diabetes management team; 2) include a model that demonstrates a limited, specific role and duties for the physician within a team setting; and last, 3) integrate physicians into an existing community-based network of social and human service providers set up to provide diabetes prevention services.