Abstract
The purpose of this study was to review trends in physician referrals, indications for referral, and payor mix for genetic consultations for common, chronic conditions of adulthood. There were 57 patient visits in 1997, 126 in 1998, and 157 in the first 3 quarters of 1999. The gender and age distribution did not vary from year to year. In 1999, 90% of patients were female, and their average age was 51 (range 22-77). 65% of patients were referred by a physician in 1998, and this proportion increased to 80% in 1999, p=0.006. The majority of patients were referred because of a family or personal history of breast or ovarian cancer, this accounted for 65% of consultations in 1998 and 71% in 1999. In these years, only 20% and 11% of patients were referred because of a personal or family history of colon cancer/polyposis, respectively. Histories of other cancer types accounted for 8% of referrals in both years. Only 4 patients (3%) were referred for cardiovascular risk assessment in 1998 and 10 (6%) in 1999. For both years, 3 patients were referred for hemochromatosis and 2 for porphyria. In 1998, 20% of patients paid cash for their genetic consultation, 20% were MediCal/Medicare, and the remainder used other forms of insurance. In 1999, only 10% paid cash (different from 1998, p=0.03), 17% were MediCal/Medicare, and 73% used other insurance. Follow-up surveys have been mailed to patients seen in 1998 with a possible inherited cancer susceptibility; thus far 36 have responded and none have reported experiencing insurance discrimination. In conclusion, these results demonstrate an exponential growth in patient referrals over the past 3 years with a significant increase in physician referrals. The largest number of patients seen have been women at risk for breast and/or ovarian cancer with disappointing patterns of referral for other cancers, cardiovascular disease and other common conditions. This trend may be due in large part to the high visibility regarding the availability of BRCA testing. The trend in increasing use of insurance for genetic consultations suggests that patients have become less fearful of insurance discrimination, which may be due to the lack of evidence that such discrimination exists.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gordon, O., Hixon, H. & Scheuner, M. Trends in a clinical genetics program for adults. Genet Med 2, 64 (2000). https://doi.org/10.1097/00125817-200001000-00056
Issue Date:
DOI: https://doi.org/10.1097/00125817-200001000-00056