Smets Ellen, van Zwieten Myra, Michie Susan
Department of Medical Psychology and Clinical Genetics, Academic Medical Center/University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
Patient Educ Couns. 2007 Nov;68(3):225-34. doi: 10.1016/j.pec.2007.05.015. Epub 2007 Jul 2.
Increasingly clinicians other than genetic counselors will advise people with genetic risks. Although some express concerns about this development because of the need for non-genetic clinicians to have additional training, we argue that genetic counseling has more in common with other health care interactions than is generally assumed.
In this narrative review we investigate the health communication literature taking the perspective that all provider-patient/client interactions share the following goals: forming a relationship, the exchange of information, decision making, promoting health-related behavior and providing support.
We found that both non-genetic and genetic 'disciplines' endorse an egalitarian relationship, based on a patient-centered approach and both have difficulties with attuning to the patients' agendas and enhancing patient understanding. Shared decision making is increasingly the preferred model for geneticists and non-geneticists alike, and both need skills to constructively discuss patients' risk-reducing behavior and provide emotional support.
Rather than developing separate vocabularies and research traditions, the discipline of genetic counseling may benefit by drawing on non-genetic patient-provider interaction research.
Since geneticists face the same challenges as non-geneticists, medical training should continue to improve basic consultation skills, regardless of whether the consultation involves genetic information.