A Qualitative Assessment of Primary Care Physicians' Perceptions about the Ethical and Social Implications of Offering Genetic Testing

Abstract

Due to the increasing likelihood that new genetic tests will be incorporated into primary care, we investigated the preparedness of primary care physicians to offer such tests. As a follow-up to a national survey of physicians' knowledge and attitudes regarding genetics, we conducted five focus groups with a total of 39 survey respondents from 5 specialties and 4 states. Semi-structured questions were used to generate and guide discussion about participants' perceptions of (a) ethical obligations regarding genetic decision making and (b) barriers to widespread genetic testing. This article describes those perceptions. Participants believed that the goals of full disclosure and non-directiveness in genetic counseling were neither possible to achieve nor desirable in primary care. There were consistent gender differences, with female physicians reportedly deferring to patients in decision making more often than males. Participants seemed aware of the costs of genetic tests and the social risks to patients of disclosing confidential genetic information to insurance companies. Results have implications for the training of primary care providers.