Genetic specialists trailing research boom.

• Author: Goodwin, Kristine

The rapid pace of genetic discoveries is nothing short of extraordinary. Today, genetic tests are available for 1,500 diseases--up from 100 in 1993. Advances in newborn screening mean infants are routinely tested for a growing number of genetic conditions.

At a time when states are grappling with rising health-care costs and a swelling population with chronic illnesses, these tools offer new ways to help patients prevent and manage chronic diseases.

While some call this a genetics revolution, sure to change the practice of medicine, there's concern that the ball is rolling too fast for the current group of health-care workers to keep pace.

The problem has been building for the past few years. "There is a serious mismatch between the expansion of knowledge and clinical applications in the field of medical genetics and the size of the medical genetics workforce," according to a 2005 Genetics In Medicine article.

Many primary care providers--the doctors and nurses working the front lines of patient care--lack the training and knowledge to deliver basic information about genetic services and don't know how to integrate new findings about genetics into their practices. Surveys indicate a majority of non-genetics physicians have only a fair-to-poor knowledge about genetics.

FEWER GENETICISTS

The specialized field of clinical geneticists is dwindling and appears to be falling short of current and future demand. Clinical geneticists--MDs who work directly with patients to diagnose and manage genetic disorders--are often called upon by other health-care providers to manage these often rare conditions.

Moreover, within the field of clinical geneticists, certain specialty areas have far fewer than others. According to the American College of Medical Genetics, there are only 200 metabolic physicians in the United States--a small number of specialists to treat a growing number of children identified through newborn screening programs.

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In total, that's about one full-time clinical geneticist per 600,000 people, according to the American College of Medical Genetics--short of one per 250,000 people, which the Royal College of Physicians recommends. With an average age of 52, about one in five geneticists plan to retire in the next 10 years.

As is the case with provider shortages in general, some areas are worse than others. Clinical geneticists typically cluster in big cities that have an academic health center.

A bright spot...