Taiwanese primary care physicians’ experience and confidence in genetic service delivery: A pilot survey study

Abstract

BackgroundWith the rapid advancement of genetic testing technologies and their increasing application in preventive care, the role of primary care physicians (PCPs) in genetic service delivery is gaining importance. In Taiwan, where direct-to-consumer genetic testing is prohibited and the certified genetics workforce is limited and unevenly distributed, PCPs may serve as crucial entry points for patient access to genetic services. However, little is known about Taiwanese PCPs’ current experience, confidence, and attitudes toward delivering these services. Objectives This study aims to explore the experiences, perceived barriers, and training needs of Taiwanese PCPs in the context of ordering genetic tests and referring patients for genetic counseling. Findings are intended to inform policy and workforce development strategies to improve the integration of genetic services into primary care in Taiwan. Methods An anonymous online survey was conducted between November 2024 and March 2025 among Taiwanese PCPs. The 58-item survey included questions on physician characteristics, experience with genetic services, attitudes toward genetic testing, confidence in genetic knowledge, and views on genetic education and certification. Descriptive statistics and Fisher’s exact tests were used to analyze the data. Results A total of 96 PCPs completed the survey. More than half (57.3%) had ordered genetic tests, and 79% had referred patients to genetic specialists. Common barriers to ordering tests included patients’ financial concerns (69.8%) and uncertainty about test selection (64.6%), while referral barriers included unclear pathways (57.3%), uncertainty about referral options (57.3%), and patients’ financial concerns (52.0%). Only a small proportion of respondents reported confidence in interpreting genetic reports (23.9.0%) or understanding legal (14.6%) and insurance-related (11.5%) issues. Although most respondents agreed that current genetic knowledge among PCPs is insufficient and that enhanced genetic education during medical school can be beneficial, opinions were divided on the effectiveness of continuing education and the necessity of board certification. Conclusion Taiwanese PCPs encounter multiple barriers in delivering genetic services, particularly related to knowledge gaps, referral infrastructure, and policy ambiguity. Addressing these challenges through tailored education, clear service models, and health system support is essential for enabling PCPs to meet the growing demand for genetic services in Taiwan’s primary care settings.