Genetics Workforce: Distribution of Genetics Services and Challenges to Healthcare in California

PURPOSE: Access to genetics healthcare 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 (MG) and Genetic Counselors (GC) in California. To assess distance traveled for care, we computed the distance patients traveled for n=288 visits to 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 MG, 1:100,000 for GC, and 1:1,520,000 for biochemical MG. Genetics providers are concentrated in major metropolitan areas in California. People travel up to 386 miles for genetics care within the State (mean=76.6miles). 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 healthcare options, training, and modified models of care.