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

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.

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Acknowledgements

We thank ABMGG, ABGC and NSGC. We thank Colleen Carlston for her helpful suggestions. This research was supported in part by the Marcus Program in Precision Medicine Innovation at the University of California–San Francisco.

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Correspondence to Joseph T. Shieh MD, PhD.

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The authors declare no conflicts of interest.

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Penon-Portmann, M., Chang, J., Cheng, M. et al. Genetics workforce: distribution of genetics services and challenges to health care in California. Genet Med 22, 227–231 (2020). https://doi.org/10.1038/s41436-019-0628-5

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Keywords

  • workforce
  • provider shortage
  • telehealth
  • telegenetics
  • disparities

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