RT Journal Article
SR Electronic
T1 A Qualitative Study of Primary Care Physicians’ Approaches to Caring for Adult Adopted Patients
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 24
OP 34
DO 10.1370/afm.240146
VO 23
IS 1
A1 Wexler, Jade H.
A1 Toll, Elizabeth
A1 Goldman, Roberta E.
YR 2025
UL http://www.annfammed.org/content/23/1/24.abstract
AB PURPOSE Adoption has lifelong health implications for 7.8 million adopted people and their families in the United States. The majority of adoptees have limited family medical history (LFMH). Primary care physicians (PCPs) rarely receive training about adoptees including their mental health needs and increased suicide risk. The growing availability and popularity of direct-to-consumer genetic testing kits amplifies the need for PCPs to be prepared to address genetic testing for adoptees with LFMH. This study explores PCP training and approaches to adult adopted patients with LFMH.METHODS We used critical adoption studies as a theoretical framework for this study to understand how adoptive identity might shape clinical experiences. We recruited PCPs from Minnesota and Rhode Island via purposive, criteria-based, reputational sampling. We conducted hour-long semistructured qualitative interviews incorporating hypothetical clinical vignettes. Transcripts were coded via template organizing method and analyzed via Immersion-Crystallization.RESULTS We interviewed 23 PCPs. They reported receiving little training or resources on adult adoptees with LFMH and showed substantial knowledge gaps regarding mental health and genetic testing for this population. Many failed to adjust history-taking and primary care approaches, which they recognized as potentially resulting in inaccuracies, inappropriate clinical care, and microaggressions while inadvertently triggering anxiety, shame, and distrust among patients. A mismatch between adopted patients’ and physicians’ understandings of family medical history could strain the therapeutic relationship. Nearly all interviewees viewed additional training to care for adult adoptees with LFMH as beneficial.CONCLUSION Future research should expand education and training for PCPs on adult adoptees with LFMH.