The numbers of patients who receive diabetes education are disappointingly small. Access to education has been proposed as a barrier, particularly in communities in which the closest DSMT program may be miles away. Another potential problem may be the traditional way in which education is prescribed and delivered. Currently, physicians are expected to refer diabetes
patients to a hospital-based DSMT program. This process is consistent with the current system of health care delivery as it applies to acute care where services are provided at a hospital. Although more than 90% of patients with diabetes are cared for by primary care physicians (PCPs), education is rarely available in the primary care office.