 |
|
Incorporation of Genetics in Primary Care PracticeWill Physicians Do the Counseling and Will They Be Directive?
Gail Geller, ScD;
Ellen S. Tambor, MA;
Gary A. Chase, PhD;
Karen J. Hofman, MD;
Ruth R. Faden, PhD, MPH;
Neil A. Holtzman, MD, MPH
Arch Fam Med. 1993;2(11):1119-1125.
Abstract
| |
Objective
To determine, by response to a scenario, how willing primary care physicians would be to counsel a couple about prenatal diagnosis of cystic fibrosis and how directive they would be about whether the couple should undergo prenatal diagnosis and whether the couple should terminate the pregnancy if the fetus is affected.
Design
Survey of a random sample of primary care physicians, psychiatrists, and genetics professionals in 10 geographically representative states.
Respondents
Sixty-five percent (N=1140) of 1759 obstetricians, pediatricians, internists, family practitioners, and psychiatrists, and 79% (N=280) of medical geneticists and genetic counselors.
Outcomes and Results
Respondents were evenly divided on whether they would counsel about prenatal diagnosis or refer to a genetic counselor (49.4% and 50.6%, respectively). Those who indicated that they would counsel were likely to have greater knowledge about genetics, greater confidence in communicating about genetics, and higher tolerance for ambiguity and were more likely to have completed their medical training since 1971 and to practice in a rural area. Forty-four percent of physicians would give an opinion about prenatal diagnosis. Men would be more likely to give an opinion than women (P<.005). Only 9.6% of respondents would give an opinion regarding abortion. These respondents were more likely to come from specialties with less exposure to genetics and to value attendance at religious services. Primary care physicians were more likely to give their opinions about prenatal diagnosis and abortion than genetics professionals.
Conclusions
To the extent that attitudes are reflected in practice, genetic counseling may be more directive when provided by primary care physicians than by genetics professionals, unless primary care physicians' growing involvement in genetics changes their attitudes.
Author Affiliations
From the Department of Pediatrics, School of Medicine (Drs Geller, Hofman, and Holtzman and Ms Tambor), and the Departments of Health Policy and Management (Drs Geller, Faden, and Holtzman) and Mental Hygiene (Dr Chase), School of Public Health, Johns Hopkins University, Baltimore, Md.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Do Differences in the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists Positions on the Ethics of Maternal-Fetal Interventions Reflect Subtly Divergent Professional Sensitivities to Pregnant Women and Fetuses?
Brown et al.
Pediatrics 2006;117:1382-1387.
ABSTRACT
| FULL TEXT
GPs' opinions of their role in prenatal genetic services: a cross-sectional survey
Qureshi et al.
Fam Pract 2006;23:106-110.
ABSTRACT
| FULL TEXT
Effect of a Computer-Based Decision Aid on Knowledge, Perceptions, and Intentions About Genetic Testing for Breast Cancer Susceptibility: A Randomized Controlled Trial
Green et al.
JAMA 2004;292:442-452.
ABSTRACT
| FULL TEXT
American Thoracic Society/European Respiratory Society Statement: Standards for the Diagnosis and Management of Individuals with Alpha-1 Antitrypsin Deficiency
Am. J. Respir. Crit. Care Med. 2003;168:818-900.
FULL TEXT
"Genetic Exceptionalism" in Medicine: Clarifying the Differences between Genetic and Nongenetic Tests
Green and Botkin
ANN INTERN MED 2003;138:571-575.
ABSTRACT
| FULL TEXT
The genetics liaison nurse role as a means of educating and supporting primary care professionals
Shickle et al.
Fam Pract 2002;19:193-196.
ABSTRACT
| FULL TEXT
Ethical Aspects of Genetic Testing
Carter
Biol Res Nurs 2001;3:24-32.
ABSTRACT
GPs' views on their role in cancer genetics services and current practice
Fry et al.
Fam Pract 1999;16:468-474.
ABSTRACT
| FULL TEXT
A systematic review of the literature exploring the role of primary care in genetic services
Emery et al.
Fam Pract 1999;16:426-445.
ABSTRACT
| FULL TEXT
The new genetics: Implications for clinical services in Britain and the United States
Kinmonth et al.
BMJ 1998;316:767-770.
FULL TEXT
Genetic Testing for Susceptibility to Adult-Onset Cancer: The Process and Content of Informed Consent
Geller et al.
JAMA 1997;277:1467-1474.
ABSTRACT
A Qualitative Assessment of Primary Care Physicians' Perceptions about the Ethical and Social Implications of Offering Genetic Testing
Geller and Holtzman
Qual Health Res 1995;5:97-116.
ABSTRACT
Incorporation of Genetics in Primary Care Practice-Reply
Geller
Arch Fam Med 1994;3:218-218.
ABSTRACT
Incorporation of Genetics in Primary Care Practice
Revels
Arch Fam Med 1994;3:217-218.
ABSTRACT
|
