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Challenges for providing genetic counselling in Colombian genetic clinics: the viewpoint of the physicians providing genetic consultations

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Abstract

This study explores the provision of clinical genetic services in Colombia, in order to promote improvements in these services. We carried out semi-structured interviews with 20 doctors working in genetic clinics, and we report the challenges in providing genetic counselling that they have identified. Education and training in genetics in Colombian medical schools were described as inadequate, and interviewees found that many of their medical colleagues knew too little to be able to refer appropriately to a genetics service. The doctors interviewed recognised their own limitations, including lack of knowledge, absence of training in communication skills and the strong influence of religious beliefs on the consultations of some colleagues. There may also be communication problems during the consultation: patients may fail to understand the explanations given or to accept the incurable nature of genetic conditions. There are also problems with access, because genetic services are not covered by the health insurance system in Colombia. More training in genetics is required at medical schools in Colombia, at the undergraduate and postgraduate level. There was a consensus that most medical specialities are limited in their knowledge, awareness and understanding of genetics. Furthermore, many medical geneticists did not believe that other health professionals should work as genetic counsellors. These findings may assist in the development of improved genetic counselling services in Colombia and in the establishment of an enhanced academic curriculum of basic and clinical genetics at Colombian universities.

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Acknowledgments

We want to thank all participants in this study: doctors and colleagues and the people who directly or indirectly helped us during our fieldwork in Colombia.

Conflict of interest

All authors declare that they have no conflict of interest.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. University of Warwick, Gibbet Hill Road, Coventry, UK, CV4 7AL

    Clemencia Rodas-Pérez & Margaret Thorogood

  2. Cardiff University, Cardiff, UK

    Angus Clarke

  3. University of Oxford, Oxford, UK

    John Powell

Authors
  1. Clemencia Rodas-Pérez
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  2. Angus Clarke
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  3. John Powell
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  4. Margaret Thorogood
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Corresponding author

Correspondence to Clemencia Rodas-Pérez.

Additional information

This article is part of the special issue on “Genetics and Ethics in Latin America”

Appendix 1 Topic guide of interviews with doctors

Appendix 1 Topic guide of interviews with doctors

Job of physicians in respect to clinical genetics

Background/first contact with genetic topics

Workplace/clinical/universities/other institutions

Professional status

Education and training of physicians in clinical genetics and genetic counselling

Personal learning experiences in clinical genetics and counselling

Voids on training and education in genetics at medical schools

Genetic knowledge and training of GPs and other health professionals

Importance and status of genetic counselling in Colombia

Risk assessment and delivering risk information in Colombian genetic clinics

Approaches for delivering genetic and risk information

Patients understanding of doctors’ explanations

Communication of genetic information among families

Physicians’ level of knowledge and training in clinical genetics and counselling

Differences of doctors training depending of the universities

Awareness of the meaning and importance of genetic counselling

Views of training and education in genetics of other colleagues doing genetic consultation

How difficult is it to give genetic counselling in Colombia?

Universities’ and health institutions’ perception of genetics

Challenges faced during consultation

Problems of knowledge and comprehension (doctors and patients)

Doctor–patient relationship

Resources (budget, time, professionals)

Health insurance cover of genetic conditions

Lay beliefs and public knowledge of genetics

General understanding of the importance of genetic counselling

Genetic counselling and the new legislation on abortion in Colombia

Opinions and views

How this law affects clinical genetics

Abortion and the Catholic Church

Differences between genetic consultation and genetic counselling

Influence of Colombian physicians’ own beliefs during counselling

Personal and religious beliefs

Enabling other health professionals to give genetic counselling in Colombia

Opinions and views

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Rodas-Pérez, C., Clarke, A., Powell, J. et al. Challenges for providing genetic counselling in Colombian genetic clinics: the viewpoint of the physicians providing genetic consultations. J Community Genet 6, 301–311 (2015). https://doi.org/10.1007/s12687-015-0237-1

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  • DOI: https://doi.org/10.1007/s12687-015-0237-1

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