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. 2020 Jan;22(1):227-231.
doi: 10.1038/s41436-019-0628-5. Epub 2019 Aug 16.

Genetics workforce: distribution of genetics services and challenges to health care in California

Monica Penon-Portmann  1 , Jiyoo Chang  2 , Mira Cheng  2 , Joseph T Shieh  3   4
Affiliations

Genetics workforce: distribution of genetics services and challenges to health care in California

Monica Penon-Portmann et al. Genet Med. 2020 Jan.

Abstract

Purpose: Access to genetics health-care services is often complicated by the distance to hospitals, workforce shortages, and insurance coverage. Despite technological advances and decreasing costs of genetic sequencing, the benefits of personalized medicine may be inaccessible to many patients. To assess potential disparities in care, we examined the genetics workforce in California and geographical issues that people encounter in seeking care.

Methods: Data on all board-certified genetics providers were analyzed including medical geneticists (MGs) and genetic counselors (GCs) in California. To assess distance traveled for care, we computed the distance patients traveled for n = 288 visits to University of California-San Francisco (UCSF) Medical Genetics. We performed geographic optimization to minimize the distance to genetics providers.

Results: The provider-to-patient ratio in California is 1:330,000 for MGs, 1:100,000 for GCs, and 1:1,520,000 for biochemical MGs. Genetics providers are concentrated in major metropolitan areas in California. People travel up to 386 miles for genetics care within the state (mean = 76.6 miles).

Conclusion: There are substantial geographic barriers to genetics care that could increase disparities. Our findings highlight a challenging genetics workforce shortage. The shortage may be even greater due to care subspecialization or lack of full-time equivalency and staffing. We are currently promoting efforts to increase remote health-care options, training, and modified models of care.

Keywords: disparities; provider shortage; telegenetics; telehealth; workforce.

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Conflict of interest statement

Penon et al. GIM

Conflict of interest statement:

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.. Distribution and number of genetics providers in California
(a) Geocoded practice locations of providers in direct patient care (MG in maroon and GC in blue). (b) Total number of certified providers in the State by genetics specialty, subset of the workforce dedicated to direct patient care (%) and estimated provider-to-patient ratio.
Figure 2.
Figure 2.. Distance to genetics healthcare services in California.
(a) A heat map of the minimum geospatial distance between each state postal code centroid to its nearest genetics provider. Desert areas correspond to maroon-colored dots, located >50miles away from genetics healthcare services. (b) Distribution of theoretical minimum travel distances from all postal codes to the nearest genetics provider. (c) Geographic distribution of within-state visits to UCSF (n=282). (d) Real travel distance of visits to UCSF (n=282).
See this image and copyright information in PMC

References

    1. Phillips KA, Deverka PA, Hooker GW, Douglas MP. Genetic test availability and spending: Where are we now? Where are we going? Health Aff. 2018;37(5):710–716. doi: 10.1377/hlthaff.2017.1427 - DOI - PMC - PubMed
    1. Hoskovec JM, Bennett RL, Carey ME, et al. Projecting the Supply and Demand for Certified Genetic Counselors: a Workforce Study. J Genet Couns. 2018;27:16–20. doi: 10.1007/s10897-017-0158-8 - DOI - PubMed
    1. GeneDx. https://www.genedx.com. Published 2000. Accessed March 1, 2019.
    1. ACMG Board of Directors. Clinical utility of genetic and genomic services: A position statement of the American College of Medical Genetics and Genomics. Genet Med. 2015;17(6):505–507. doi: 10.1038/gim.2015.41 - DOI - PubMed
    1. Cooksey JA, Forte G, Benkendorf J, Blitzer MG. The state of the medical geneticist workforce: Findings of the 2003 survey of American Board of Medical Genetics certified geneticists. Genet Med. 2005;7(6):439–443. doi: 10.1097/01.GIM.0000172416.35285.9F - DOI - PubMed

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