Breast cancer risk communication: Assessment of primary care physicians by standardized patients

Julie O. Culver, Deborah J. Bowen, Susan E. Reynolds, Linda E. Pinsky, Nancy Press, Wylie Burke

    Research output: Contribution to journalArticle

    18 Scopus citations

    Abstract

    PURPOSE: To assess primary care providers' communication about breast cancer risk. METHODS: We evaluated 86 primary care providers' communication of risk using unannounced standardized (simulated) patients. Physicians were randomly assigned to receive one of three cases: (1) moderate risk case (n = 25), presenting with a breast lump and mother with postmenopausal breast cancer; (2) high-risk (maternal side) case (n = 28), presenting with concern about breast cancer risk; and (3) high-risk (paternal side) case (n = 33), presenting with an unrelated problem. After the appointment, three qualitative parameters were assessed by standardized patients on a 3-point scale (3 = highest satisfaction, 1 = lowest): whether the physician took adequate time; acknowledged her concerns; and offered reassurance. RESULTS: Mean satisfaction with physician communication was higher for the moderate risk case (2.92) than for the high-risk paternal case (2.25) or high-risk maternal case (2.42) (P < 0.0001). The score was not influenced by session length, medical specialty, or physician gender. CONCLUSION: Physicians more consistently provided a moderate risk standardized patients with reassurance and support compared with the high-risk cases. Primary care physicians may be more unprepared or uneasy addressing the issues raised by more complex scenarios and may benefit from training in the assessment and communication of breast cancer risk.

    Original languageEnglish (US)
    Pages (from-to)735-741
    Number of pages7
    JournalGenetics in Medicine
    Volume11
    Issue number10
    DOIs
    StatePublished - Oct 1 2009

    Keywords

    • Breast cancer
    • Counseling skills
    • Primary care
    • Risk communication
    • Standardized patients

    ASJC Scopus subject areas

    • Genetics(clinical)

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