Assessment of primary care provider presence and its impact on patient-centered clinical care during genetic consultations

Background. The relative scarcity of genetic service providers and the rapid increase in genetic information in the provision of health care have created a situation in which many primary care physicians (PCPs) and specialists are faced with difficulties in determining which of their patients would be well served by evaluation in the genetics clinic what the implications of genetic testing might mean for those patients. Purpose. This paper aims to review literature and propose a conceptual framework predicting how participation of PCPs in genetic consultation sessions affects the quality of health care and addresses information and knowledge gaps in genetics specialty areas both for patients and PCPs. Method. Major databases containing health communication and promotion literature (PubMed, PsycINFO, SSCI and ERIC) were searched to identify previous theoretical and empirical studies. Results. The framework is based on the social learning theory and Devin's sensemaking model, and explains the affect of PCP's particiaption in specialty consults on individual's experience of and coping with the cognitive gap. Discussion. Research propositions are presented and future research questions are discussed. The model also provides a foundation for practical evaluation of efficiency and effectiveness of PCP's partipation in specialty consults and its impact on the quality and continuity of primary care.