Genetic counseling by the primary care physician.

This paper has presented, in a rather concise and limited form, an outline of basic genetic principles which are necessary for the primary physician to provide good genetic counseling and good patient care. The assistance of a genetic center with prenatal diagnostic facilities allows consultation to proceed in a logical and constructive manner. The primary physician is in an excellent position to determine the pedigree, especially if he has the opportunity to examine the proband's immediate family and close relatives. The diagnosis may be easily made by the primary physician or it may require the combined efforts of the genetics clinic and the primary physician. In either case, the decision to terminate future pregnancies or to limit future offspring is made by the proband and his family, not the physician. The decision-making process may be affected by the primary physician who provides a sufficient amount of relevant information to his patients and allows them to reach a rational decision. Whether the decision appears rational to the physician or not, he must help his patients deal with it.