Tensions between policy makers and general practitioners in implementing new genetics: grounded theory interview...

Area of Science:

• Genetics in primary care
• General practice and emerging technologies
• Healthcare policy and implementation

Background:

• Genetic technology is rapidly advancing, necessitating its integration into various healthcare settings.
• The role of general practitioners (GPs) in implementing new genetic services remains a critical area of exploration.
• Understanding GP perspectives is crucial for successful technology adoption in primary care.

Purpose of the Study:

• To explore general practitioners' perceptions of their role in implementing genetic technology within primary care.
• To identify discrepancies between policymakers' and GPs' views on the integration of genetic services.
• To examine the implications of genetic technology for the identity and practice of generalism.

Main Methods:

• Grounded theory interview study design.
• Purposive and theoretical sampling of 44 general practitioners.
• Primary care setting.

Main Results:

• Identified inconsistencies between policymakers and GPs regarding the role of general practice in genetic technology implementation.
• GPs emphasized building on existing practices, contrasting with policymakers' focus on transforming practice for specialized roles.
• Key themes included genetics in a generalist context, ethical dilemmas (e.g., "therapeutic gap"), familial-hereditary distinctions, and potential marginalization of generalism.

Conclusions:

• Genetic technologies should be integrated into primary care by leveraging existing generalist frameworks.
• Addressing the identified discrepancies is essential for effective implementation of genetic services in general practice.
• Preserving the core identity of generalism is important when introducing new specialized roles and skills.