Johns Hopkins University School of Medicine conducted a pilot study of non-geneticist physicians. It explored, through in-depth interviews, the barriers and incentives to appropriate diffusion of genetic services into mainstream medicine and providers' willingness to participate in clinical studies that would assess the safety and effectiveness of emerging genetic technologies.
These interviews were designed to complement a survey of 3,000 physicians, conducted concurrently by the project director with a grant from the National Human Genome Research Institute. The goal of the survey was to establish the actual use of two genetic tests in adults: cystic-fibrosis-carrier screening and testing for genetic susceptibility to breast cancer.
Researchers selected a random sample of 998 obstetricians, pediatricians, family practitioners, and general internists in Maryland, Virginia, and Washington, D.C., from the American Medical Association Masterfile of Physicians.
The interviews revealed that:
Insufficient data on clinical validity and clinical utility were foremost among the aspects of genetic testing that caused physicians to hesitate in using predictive genetic testing.
Concerns about insurance discrimination in the absence of treatments for patients with positive test results also discouraged use.
High cost and perceptions of inconvenience associated with obtaining genetic testing were also barriers to use of genetic testing.
The primary inducement to testing—among physicians who had adopted testing—was interest on the part of the patient.
92 percent of the primary care physicians (PCPs) interviewed were willing to participate in practice-based research to assess the safety and effectiveness of new genetic tests, as were 30 percent of the PCPs who declined to be interviewed.