Primary care doctors need help talking to patients about genetic tests

While the number of genetic tests is only going to grow, a new study found that many primary care doctors feel ill-equipped to talk to patients about them.

The study, published in Health Affairs, found primary care doctors are optimistic about the benefits of genetic tests but aren’t confident about their ability to work with patients at high risk for genetic conditions or about interpreting test results.

The study makes it clear that primary care doctors need help in order for patients to benefit from genetic discoveries, two of the study’s authors, Diane Hauser and Carol R. Horowitz, M.D., told FierceHealthcare. Both authors are from the Center for Health Equity and Community-Engaged Research at the Icahn School of Medicine at Mount Sinai in New York City.

Diane Hauser
Diane Hauser (Icahn School of Medicine)

Researchers surveyed 488 primary care providers in community and academic practice in New York City about their views on genetic testing for chronic diseases. The majority, of whom most were current or recent physicians in training who had formal genetics education, were positive about the use of genetic testing. Yet, despite their education, they indicated they felt unprepared to help their patients.

“We were not surprised,” Hauser says about the survey results. She said she was talking about the study with a friend who had sent her DNA in for testing by 23and Me, the personal genomics company, and found she was at risk for a disease. The friend said she went straight to her primary care doctor for advice and was told, “I don’t know. I’ll have to do some research and get back to you.”

“That’s the situation we want to be able to address,” said Hauser.

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Horowitz agreed. “I’m a primary care provider. I need help. I need information at my fingertips. To say, ‘I’ll get back to you,’ that doesn’t serve our patients,” she said.

Many of the doctors surveyed were also concerned that genetic testing might lead to insurance discrimination, and they lacked trust in the companies that offer genetic tests.

Carol R. Horowitz
Carol R. Horowitz, M.D.
(Icahn School of Medicine)

The study researchers concluded it is going to take a variety of sources—enhanced training, guidelines, clinical tools and awareness of patient protections—to help support the effective adoption of genomic medicine by primary care providers.

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For instance, tools within the electronic health record at the point of care will help, Horowitz said. Materials to help educate both providers and patients about the various genetic tests also need to be developed. Both women said they would like to see professional societies and associations offer more guidance for doctors.

With all the discoveries coming down the pike when it comes to genomic medicine, doctors will need support to keep up with the rapidly emerging knowledge, said Horowitz.

It is often primary care providers who help patients with the kinds of chronic conditions that genetic tests can reveal risks for, Horowitz explained. Those doctors need to know about genetics and how to talk to their patients, said Hauser.