Primary care physicians' experience with family history: an exploratory qualitative study

Family history can guide patient care but is underused. Physician experience with family history has been inadequately characterized. The study's purpose was to assess primary care physicians' experiences with family history.

A qualitative study using an existential-phenomenological approach. Primary care physicians using an electronic health record to enter family history participated in semistructured interviews. Themes were developed relating to physicians' experiences with collection and documentation of family history. A summary describing each physician's experience was developed and analyzed. The themes and experiences from each primary care physician were synthesized across all participants.

Positive and negative experiences were identified. Positive experience was associated with the perceived usefulness of family history to guide patient care, confidence using family history, practice efficiency, and enhancing the physician-patient relationship. Negative experience was primarily associated with perception that family history had to be collected and process problems, although confusion about the use of family history, perceived inaccuracies and incompleteness of the information provided, time, and potential liability contributed to negative experience. Most primary care physicians had an overall positive experience with family history, although the balance of the positive and negative experiences did not seem related to the degree the electronic health record was used to enter family history.

The primary care physicians' experience with family history represents the synthesis of tensions between positive and negative experiences relating to collection and use. Understanding the components of the experience could inform redesign of systems to enhance the positive and reduce the negative elements.