The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints.
Environmental factors, such as lack of time, lack of resources, lack of reimbursement and organizational constraints, may also preclude adoption of guidelines.
Other barriers include lack of training, lack of accurate and easily accessible information, lack of subsidies or reimbursement, legal concerns, time constraints, and the fact that other staff in a pharmacy may recommend these products [ 4, 14, 16, 18, 20].
This survey identified a number of barriers for health professionals in completing developmental monitoring, including time constraints, inadequate reimbursement, lack of non-physician support staff, lack of further diagnostic and treatment services, insufficient training, and lack of familiarity with assessment tools.
Various reasons given by primary care physicians for not utilizing spirometry include: limited access to spirometry, uncertainty about the impact of the test, inadequate or lack of reproducibility of patient effort, lack of provider training, difficulty in interpreting results, reimbursement issues, and time constraints in busy practice settings [ 13, 14].
Being able to see perfection required being freed from the mental constraints of regulations, reimbursement systems, and existing staff training programs so that visionary thinking was possible.
"Internal" barriers include time constraints, possibly inadequate reimbursement and disagreement with innovative programs.
This is especially important when budget constraints allow the reimbursement of only a limited number of new pharmaceuticals.
Although the reasons why screening has not been widely implemented are unclear, they include time constraints, lack of reimbursement, stigma (on the part of both the patient and the physician), and financial barriers to effective treatments (e.g., psychotherapy and antidepressant agents).
In another vein, factors linked to administrative requirements of funding agencies related to reimbursement for physiotherapy and financial constraints of the patients also appear as newly identified context-specific factors influencing the interprofessional practices of physiotherapists working in the private sector.
