A QUALITATIVE ASSESSMENT OF PRIMARY-CARE PHYSICIANS PERCEPTIONS ABOUTTHE ETHICAL AND SOCIAL IMPLICATIONS OF OFFERING GENETIC TESTING

Due to the increasing likelihood that new genetic tests will be incorp orated into primary care, we investigated the preparedness of primary care physicians to offer such tests. As a follow-up to a national surv ey of physicians' knowledge and attitudes regarding genetics, we condu cted five focus groups with a total of 39 survey respondents from 5 sp ecialties and 4 states. Semistructured questions were used to generate and guide discussion about participants' perceptions of (a) ethical o bligations regarding genetic decision making and (b) barriers to wides pread genetic testing. This article describes those perceptions. Parti cipants believed that the goals of full discolsure and non-directivene ss in genetic counseling were neither possible to achieve nor desirabl e in primary care. There were consistent gender diferences, with femal e physicians reportedly deferring to patients in decision making more often than males. Participants seemed aware of the costs of genetic te sts and the social risks to patients of disclosing confidential geneti c information to insurance companies. Results have implications for th e training of primary care providers.