Family history in primary care: understanding GPs' resistance to clinical genetics - qualitative study

MATHERS, J, GREENFIELD, S, METCALFE, Alison, COLE, T, FLANANGAN, S and WILSON, S (2010). Family history in primary care: understanding GPs' resistance to clinical genetics - qualitative study. British Journal of General Practice (BJGP), 60 (574), 221-230.

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Official URL: http://bjgp.org/content/60/574/e221
Link to published version:: https://doi.org/10.3399/bjgp10X501868
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    Abstract

    Background National and local evaluations of clinical genetics service pilots have experienced difficulty in engaging with GPs. Aim To understand GPs' reluctance to engage with clinical genetics service developments, via an examination of the role of family history in general practice. Design of study Qualitative study using semi-structured one-to-one interviews. Setting The West Midlands, UK. Method Interviews with 21 GPs working in 15 practices, based on a stratified random sample from the Midlands Research Practices Consortium database. Thematic analysis proceeded alongside data generation. Framework grids were constructed for comparative analytical questioning. Interpretation was framed by two explanatory models: a knowledge deficit model, and practice and professional identity model. Results There is a clear distinction between the routine use and function of family history in GPs' clinical decision making, and contrasting conceptualisations of genetics and ‘genetic conditions’. Although genetics is clearly a part of current GP practice, with acknowledgement of genetic components to multifactorial disease, this is distinguished from ‘genetic conditions’ which are seen as rare, complex single-gene disorders. Importantly, family history takes its place within a broader notion of the ‘family doctor’ that interviewees identified as a key aspect of their role. In contrast, clinical genetics was not identified as a core component of generalist practice. Conclusion The likely effectiveness of educational policy interventions aimed at GPs that focus solely on knowledge deficit models, is questionable. There is a need to acknowledge how appropriate practice is constructed by GPs, within the context of accepted generalist roles and related identities

    Item Type: Article
    Research Institute, Centre or Group - Does NOT include content added after October 2018: Centre for Health and Social Care Research
    Identification Number: https://doi.org/10.3399/bjgp10X501868
    Page Range: 221-230
    Depositing User: Justine Gavin
    Date Deposited: 17 Jul 2018 15:35
    Last Modified: 01 Oct 2018 16:16
    URI: http://shura.shu.ac.uk/id/eprint/22016

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