Genetic testing issues land in primary care practices

With more patients asking about such tests, experts say primary care doctors will lead the genomic medicine revolution.

By Victoria Stagg Elliott, AMNews staff. Nov. 8, 2004.

In the past year, Rebecca T. Cherry, MD, a family physician from Kettering, Ohio, has struggled with counseling a patient with breast cancer.

The challenge stems from a combination of complexities Dr. Cherry has not encountered before. First, the patient has a family history of breast cancer. Second, testing for the genetic mutation that makes her more susceptible to this cancer as well as ovarian cancer is more available than ever.

It has led the patient to wonder if she should be tested. Dr. Cherry wonders, too. "Mostly, what I've been telling her so far is, I don't know."

Dr. Cherry was one of the many family physicians at the American Academy of Family Physicians scientific sessions last month in Orlando, Fla., who attended lectures about genetic issues. Both genetic testing and the difficult patient decisions surrounding it are increasingly becoming a part of their practices.

"It's not a big part of my practice right now, but it's becoming bigger as more patients realize certain diseases are hereditary," said Eric Schertzer, MD, a family physician from Plantation, Fla.

The issue has long been the subject of AMA policy, which states that genetic susceptibility testing should be performed only with comprehensive pre- and posttest counseling and that physicians should refer to specialized centers as needed. Any such counseling should include information about the implications for relatives and the fact that, in some situations, information would need to be shared.