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

政策制定者与全科医生在实施新遗传学技术过程中的紧张关系:扎根理论访谈研究

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Abstract

OBJECTIVE: To explore general practitioners' perceptions of their role in implementing genetic technology. DESIGN: Grounded theory interview study. SETTING: Primary care. SUBJECTS: Purposive sample of 30 general practitioners with a further theoretical sample of 14. RESULTS: Inconsistencies were identified between policy makers' and general practitioners' definitions of general practitioners' role in implementing the new genetics. General practitioners emphasised the need to build on current practice, whereas policy makers focused on transforming practice to include the new specialised roles and skills. Two core themes were identified: genetics in a generalist context, which included appropriate generalist intervention, the ethical dilemmas implicit in the "therapeutic gap," the familial-hereditary distinction in primary care, and the implications for generalist identity, including the potential marginalisation of generalism. CONCLUSION: New technologies such as genetics that require implementation in general practice should be integrated within existing generalist frameworks.

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