Maternal serum alpha-fetoprotein testing: physician experience and attitudes and their influence on patient
D J Madlon-Kay1, C Reif, D J Mersy
1Department of Family Medicine, St Paul-Ramsey Medical Center, MN 55101-2595.
Background:
Maternal serum alpha-fetoprotein (MSAFP) testing is complex and controversial. Although patient response to testing has been studied extensively, physician experience with and attitudes toward the test have not been investigated. The purpose of this study was to describe family physician experience with MSAFP testing and determine if physician characteristics and attitudes influence whether the test is offered and whether patients accept it.
Methods:
Eight hundred forty-nine Minnesota members of the American Academy of Family Physicians who provide prenatal care were surveyed by mail. Statistical analyses were performed, comparing physician characteristics, their offering of the test, and patient acceptance of the test.
Results:
The survey response rate was 84%. Eighty-seven percent of the physicians offered MSAFP testing, most of them routinely. However, relatively few patients chose to have the test done. Physicians had concerns about the cost of the test and its effect on maternal anxiety. The strongest predictor of offering the test was whether the physician agreed it was "medically-legally necessary."
Conclusions:
Although most Minnesota family physicians offer MSAFP testing they have concerns about the test and its limitations and appear to convey these concerns to their patients.
