title: The views of Pakistani doctors regarding genetic counseling services - is there a future?
abstract: Pakistan is a densely populated country in South Asia with a high burden of genetic disease. A dearth of medical genetic services exists and master's level trained genetic counselors (GCs) are currently not a part of the healthcare system. This study is the first to determine the views of Pakistani medical doctors (MDs) towards genetic counseling services in Pakistan, including what manner a master's level genetic counselor might be incorporated into the healthcare system. Fifty-one MDs practicing in the city of Karachi completed a self-administered survey of twenty questions. Of the 49 respondents who answered a specific question, 100 % (49/49) felt that they would refer at least some, if not all, of their relevant patients to a genetic's clinic if one existed in Karachi. Overall, the respondents showed a positive attitude towards the provision of genetic counseling services as a part of the healthcare system of Pakistan. Some of the proposed roles identified specifically for GCs included: explaining how Down syndrome occurs (66.1 %), discussing genes associated with breast cancer (77.4 %), and explaining the inheritance pattern of β-thalassemia (65.5 %). In contrast, the review of medical and family history and discussion of medical procedures such as ultrasound and amniocentesis were typically seen as the role of a physician. A majority of the respondents (98 %) were in favor of premarital carrier screening for thalassemia and would refer patients to a GC to describe the importance of carrier screening (84.3 %) and to help explain carrier screening results (94.1 %). Many respondents selected GCs as the ideal provider of education and support for people with inherited conditions (43.8 %), followed by specialist MDs (26 %) and general physicians (22.9 %). Considering the high burden of genetic disease in the country, we encourage the development of genetic counseling services in Pakistan.
authors.affiliation: Department of Pediatrics Division of Medical Genetics, The University of Texas Health Science Center at Houston, 6431 Fannin Street MSB 3.146B, Houston, TX, 77030, USA.
authors.forename: Myla
authors.initials: M
authors.lastname: Ashfaq
authors.forename: Farhana
authors.initials: F
authors.lastname: Amanullah
authors.forename: Ayesha
authors.initials: A
authors.lastname: Ashfaq
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Ormond
mesh_terms: D001291:Attitude of Health Personnel; D006580:Genetic Carrier Screening; D005817:Genetic Counseling; D006801:Humans; D010154:Pakistan; D010820:Physicians / Q000523:psychology*
references.citation: Prenat Diagn. 2006 Mar;26(3):248-57
references.pmid: 16475227
references.citation: Int J Cancer. 2006 Dec 15;119(12):2832-9
references.pmid: 16998791
references.citation: BMC Nurs. 2006 Sep 19;5:6
references.pmid: 16984630
references.citation: Am J Med Genet. 1992 Jul 15;43(5):769-75
references.pmid: 1642259
references.citation: Acta Paediatr. 2005 Jun;94(6):769-74
references.pmid: 16188785
references.citation: N Engl J Med. 2002 Oct 10;347(15):1162-8
references.pmid: 12374877
references.citation: Soc Sci Med. 2011 Apr;72(8):1393-9
references.pmid: 21470731
references.citation: J Genet Couns. 2010 Feb;19(1):7-8
references.pmid: 19816760
references.citation: J Pak Med Assoc. 2010 Jun;60(6):418-9
references.pmid: 20527633
references.citation: J Pediatr Hematol Oncol. 2012 Mar;34(2):90-2
references.pmid: 22258353
references.citation: Prenat Diagn. 2006 Oct;26(10):903-5
references.pmid: 16821247
references.citation: Arch Phys Med Rehabil. 2011 Jan;92(1):161-6
references.pmid: 21187218
references.citation: J Oncol. 2011;2011:632870
references.pmid: 21559243
references.citation: J Genet Couns. 2006 Apr;15(2):77-83
references.pmid: 16761103
references.citation: J Biosoc Sci. 1999 Oct;31(4):449-61
references.pmid: 10581876
references.citation: J Genet Couns. 2009 Jun;18(3):205-16
references.pmid: 19277852