MEASURING PHYSICIANS TOLERANCE FOR AMBIGUITY AND ITS RELATIONSHIP TO THEIR REPORTED PRACTICES REGARDING GENETIC TESTING

Despite uncertainties in medicine, attempts to study physicians tolera nce for uncertainty have been few, and limited by the measurement inst ruments available. This paper describes development of a modified tole rance for ambiguity (TFA) scale, and correlates it with several physic ian characteristics and reported behaviors. Eighteen TFA items were in cluded in a national survey of physicians' knowledge and attitudes abo ut genetic testing. Sixty-five percent (n = 1,140) of 1,759 obstetrici ans, pediatricians, internists, family practitioners, and psychiatrist s responded. After psychometric analyses, the scale was reduced to 7 i tems, demonstrating an acceptable reliability (Cronbach's alpha = .75) . TFA was higher among psychiatrists than other specialties, among tho se who were older when they graduated from medical school, and among t hose willing to offer a new low-cost, accurate predictive test when no ne of their colleagues do. TFA was lower among those who indicated tha t attendance at religious services was important, among those who woul d make a recommendation to their patients regarding pregnancy terminat ion after prenatal diagnosis, and among those who would withhold negat ive genetic test results. Future research is needed on the scale itsel f, and to assess factors affecting TFA, such as its susceptibility to modification, and its potential association with clinical practice in other areas of medicine that are characterized by ambiguity.