Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 1;36(6):605-611.
doi: 10.1097/MOP.0000000000001404. Epub 2024 Sep 19.

Single center experience developing sustainable genetics clinical care: a model to address workforce challenges in medical genetics

Aaron Kinney  1 , Shelisa A Dalton  2 , Julie McCarrier  3 , Donald Basel  3
Affiliations
Review

Single center experience developing sustainable genetics clinical care: a model to address workforce challenges in medical genetics

Aaron Kinney et al. Curr Opin Pediatr. .

Abstract

Purpose of review: The national workforce shortage in genetics is being evaluated in order to identify a sustainable solution to the increasing demand for genomic services. An innovative solution to the short term needs is to integrate advanced practice providers (APPs) and embed genetic counselors into both outpatient and inpatient specialty care. Incorporating APPs into a genetic service is not unique in itself, but the method of implementation at Medical College of Wisconsin (MCW) was, at the time, unchartered.

Recent findings: There are >100 vacancies for board certified medical geneticists across the nation, training programs are not enrolling sufficient trainees to meet demand and more than a third of the current workforce plan to retire within the next 10 years.

Summary: The integration of advanced practice providers (nurse practitioners, midwives, physician assistants etc.) into both primary and specialty care has been an evolving practice since the mid-1900s and incorporating APPs into a genetic service was not unique in itself but the method of implementation was new at that time. This is a model to successfully develop a clinical practice model around a team-based structure incorporating nurse clinicians, advanced practice providers, genetic counselors, nutritionists, and physicians into an academic clinical genetics practice.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Box 1
Box 1
no caption available
FIGURE 1
FIGURE 1
Representation of classic genetic clinical dyad (a) with geneticist working closely with a genetic counselor. Proposed model for an integrated team based model (b) creating working collaborative partnerships between APPs and physicians, supported by nurse clinicians. The model change predicted a change in patient volumes from 2300 patients with 4.6 physician cFTE to an anticipated 3900 patients with 7.1 provider cFTE. APP, advanced practice provider.
FIGURE 2
FIGURE 2
The clinic work flow for new patients was established in such a way as to allow time for diagnostic consideration during the patient encounter. The APP was able to consult with the MD or utilize decision support tools while the GC was obtaining the family heath history and together, a management plan could be formed to optimize the patient experience and limit opportunity for medical error. APP, advanced practice provider; GC, genetic counselor.
FIGURE 3
FIGURE 3
Overview of process implementation with weekly review, continuing education, process evaluation and adjustment to improve the model of care.
See this image and copyright information in PMC

References

    1. Cosgrove J, Achman L, Holihan M, et al. Genetic services: information on genetic counselor and medical geneticist workforces. Government Accountability Office Report; 2020, GAO-20-593.
    1. Wang T, Carnahan C. A summary of physician demand and supply studies. 2018; Carnahan Group. https://carnahangroup.com/wp-content/uploads/2018/10/A-Summary-of-Physic....
    1. Jenkins BD, Fischer CG, Polito CA, et al. . The 2019 US medical genetics workforce: a focus on clinical genetics. Genet Med 2021; 23:1458–1464. - PMC - PubMed

    2. This work details the challenges within the genetics workforce and impacts this has to providing optimal care.

    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; 7:439–443. - PubMed
    1. McPherson E, Zaleski C, Benishek K, et al. . Clinical genetics provider real-time workflow study. Genet Med 2008; 10:699–706. - PubMed