Thinking Differently About Genetic Counseling Service Delivery

With the increasing integration of genomic testing into medical care, there is a need to evaluate how genetic counseling services are provided, identify barriers to obtaining services, and establish ways to improve service delivery to ensure adequate patient access to high quality services. This article reviews the current status of genetic counseling service delivery including recent innovations. We describe some key factors that affect access and delivery including the time-intensiveness of genetic counseling sessions, the labor intensiveness of case preparation and follow-up services, and geographic barriers. Current remedies for improving access to genetic counseling services and their effectiveness are reviewed. Factors that potentially pose barriers for increasing access, such as reimbursement for services, are discussed. Finally, we propose ways for genetic and non-genetic professionals to work together to develop targeted strategies for enhancing access to genetic counseling services in their own practice areas.