Genomic medicine in primary care: Texas physicians' adoption of an innovation
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New applications of genomic medicine stemming from the Human Genome Project are predicted to become routine components of primary care. Primary care physicians (PCPs) will increasingly become responsible for screening patients for inherited diseases, recommending genetic testing, and making referrals to genetic services. Clinical applications of genomic medicine will occur at a variable pace. Characteristics of an innovation such as genomic medicine are strong indicators of its potential for adoption. The purpose of this study is to assess whether (and to what extent) physicians' perceptions of genomic medicine as an innovation influence their likelihood of adopting this innovation into primary care. The study's sample consists of 400 primary care physicians in Texas and employs a survey design. Based on Rogers' Diffusion of Innovations Theory, the perceived characteristics of genomic medicine - Relative Advantage, Compatibility, Complexity, Trialability, and Observability - are the study's independent/predictor variables. Likelihood of PCPs Adopting Genomic Medicine is the dependent variable. The nature of the social system (private or group practice) is examined as a possible moderator variable. The study suggests that Texas PCPs who are likely to adopt genomic medicine strongly perceive its clinical uses (such as genetic testing for carrier status or susceptibility to common diseases, testing an embryo for genetic disorders before it is implanted, and supplementing a family history) to be highly advantageous. For half of the PCPs, genetic services such as genetic counseling and genetic testing are not compatible with current practice. Perceived complexity of the innovation is the strongest predictor of likelihood of PCPs adopting genomic medicine. Many PCPs find it difficult to stay updated on genomic medicine and locate genetic services. Although Texas PCPs feel genomic medicine can be gradually incorporated into primary care practice, most are not presently observing their colleagues adopting genomic medicine or assisting their patients to make decisions regarding genetic services. Future efforts to advance the use of genomic medicine in primary care will require more emphasis on genetics in medical school curriculum and continuing education programs. Links with specialists trained in genetic counseling and health education will be essential to translate relevant information to patients and families.
Suther, Sandra Gayle (2003). Genomic medicine in primary care: Texas physicians' adoption of an innovation. Doctoral dissertation, Texas A&M University. Texas A&M University. Available electronically from