Generalist docs admit to ignorance of genetics

April 28, 2002

--- In @y...:

By Merritt McKinney

NEW YORK, Apr 02 (Reuters Health) - Don't feel bad if reading a news

story about the most recent genetic breakthrough makes your head

spin. A

new study from Australia suggests that many doctors feel equally

overwhelmed by the latest genetic information.

" General practitioners are expected to know so much these days, and

they

already feel overwhelmed, " Dr. Sylvia Metcalfe, of the University of

Melbourne, told Reuters Health.

Since there are not enough specialists to deal with the growing demand

for genetic services, the job of explaining genetic information will

fall primarily on general practitioners, Metcalfe and her colleagues

note in a report in the March/April issue of the journal Genetics in

Medicine.

" It is important that education programs deal with what is relevant to

them in their daily practice, " Metcalfe said.

Now that the human genome--the genetic road map of human development

and

function--has been almost completely decoded, there has been an

explosion of genetic information. Little is known about how prepared

general practitioners--who are often a patient's first contact with

the

healthcare system--are to deal with this genetic information.

To find out what general practitioners know about genetics, Metcalfe's

team conducted focus groups, interviews and surveys of generalist

physicians and focus groups with genetics experts. They also held a

discussion with patients with genetic diseases and their family

members.

Overall, doctors rated their genetics knowledge as " extremely poor. "

In

fact, physicians often felt that their patients were more

knowledgeable

about genetic conditions.

" They've searched the Net and seen all the specialists so I feel a bit

like a fish out of water there, " said one doctor.

The investigators also found that doctors rarely ordered genetic

testing

for their patients. More than 60% said they never or almost never

ordered such tests. And when they did order genetic testing, they

often

did not feel prepared to interpret the results. Many doctors also had

little experience in referring patients to genetics experts.

" General practitioners need to have access to simple and relevant

information with up-to-date referral contacts, " Metcalfe said.

" They need to be able to recognize when a condition has a genetic

component, how to take a thorough family history and how to refer to

genetics services, " she noted. Metcalfe pointed out that general

practitioners expressed interest in getting better at counseling

patients and explaining the results of genetic tests.

Communication about genetic information was also important to patients

and families.

" They would like to see general practitioners listen more to families,

with greater emphasis on communication skills, and to know where to

refer families, " Metcalfe added.

According to Drs. J. Hayflick and M. Patrice Eiff at Oregon

Health

and Science University in Portland, the focus of physician education

should be on how to " consider genetics in every patient encounter "

rather than on specific genetic information. In a related editorial,

they call for genetic education that encourages doctors to " think

genetically " with every patient.

SOURCE: Genetics in Medicine 2002;4:71-77.

--- End forwarded message ---

April 28, 2002

Generalist docs admit to ignorance of genetics

By Merritt McKinney

NEW YORK, Apr 02 (Reuters Health) - Don't feel bad if reading a news

story about the most recent genetic breakthrough makes your head spin. A

new study from Australia suggests that many doctors feel equally

overwhelmed by the latest genetic information.

" General practitioners are expected to know so much these days, and they

already feel overwhelmed, " Dr. Sylvia Metcalfe, of the University of

Melbourne, told Reuters Health.

Since there are not enough specialists to deal with the growing demand

for genetic services, the job of explaining genetic information will

fall primarily on general practitioners, Metcalfe and her colleagues

note in a report in the March/April issue of the journal Genetics in

Medicine.

" It is important that education programs deal with what is relevant to

them in their daily practice, " Metcalfe said.

Now that the human genome--the genetic road map of human development and

function--has been almost completely decoded, there has been an

explosion of genetic information. Little is known about how prepared

general practitioners--who are often a patient's first contact with the

healthcare system--are to deal with this genetic information.

To find out what general practitioners know about genetics, Metcalfe's

team conducted focus groups, interviews and surveys of generalist

physicians and focus groups with genetics experts. They also held a

discussion with patients with genetic diseases and their family members.

Overall, doctors rated their genetics knowledge as " extremely poor. " In

fact, physicians often felt that their patients were more knowledgeable

about genetic conditions.

" They've searched the Net and seen all the specialists so I feel a bit

like a fish out of water there, " said one doctor.

The investigators also found that doctors rarely ordered genetic testing

for their patients. More than 60% said they never or almost never

ordered such tests. And when they did order genetic testing, they often