Background: Race in the USA has an enduring connection to health and well-being. It is often used as a proxy for ancestry and genetic variation, although self-identified race does not establish genetic risk of disease for an individual patient. How physicians reconcile these seemingly paradoxical facts as they make clinical decisions is unknown. Objective: To examine physicians’ genetic knowledge and beliefs about race with their use of race in clinical decision-making Design: Cross-sectional survey of a national sample of clinically active general internists Results: Seven hundred eighty-seven physicians completed the survey. Regression models indicate that genetic knowledge was not significantly associated with use of race. However, physicians who agreed with notions of race as a biological phenomenon and those who agreed that race has clinical importance were more likely to report using race in their decision-making. Conclusions: Genomic and precision medicine holds considerable promise for narrowing the gap in health among racial groups in the USA. For this promise to be realized, our findings suggest that future research and education efforts related to race, genomics, and health must go beyond educating health care providers about common genetic conditions to delving into assumptions about race and genetics.
Bibliographical noteFunding Information:
The BHealth Professionals Genetics Education Needs Exploration^ (HP GENE) survey was developed through focus groups, cognitive interviews, and pilot testing. HP GENE study received institutional review board approval from the National Human Genome Research Institute, National Institutes of Health. From April to December 2010, the HP GENE survey was administered via the web and mail to a national sample of clinically active general internists. The sample was drawn from the SK&A Company AMA Masterfile database. Physicians who were not currently practicing general internists according to their office staff or did not have a current US mail address were excluded for an identified sample size of 1738 eligible physicians. Informed consent was obtained from all participants included in this study. Of the 787 total completed surveys, 108 (13.76%) were completed and returned using the paper questionnaire. Analysis indicated no significant differences between mail and web respondents. The overall response rate for the survey was 45.35%.
© 2018, W. Montague Cobb-NMA Health Institute.
- Clinical decision-making