To the editor: I would like to thank Heald et al1 for their article on the labor intensive nature of providing cancer genetics services. A similar prospective study was also recently published.2
Both studies report that an average initial visit with a genetics professional takes time (84 minutes2 to 105 minutes1); an average follow-up visit lasts 74 minutes.2 Finding ways to efficiently provi genetic counseling services is critical in light of the limited numbers of credentialed genetics counselors and credentialed advanced practice nurses in genetics.
About 41% of the time is spent in direct clinical time with patients and families, including initial visit counseling, phone consultation, and follow-up visits.2 The rest of the time is spent in other indirect care activities, including previsit activities, risk calculation, clinical trials enrollment, correspondence, teaching, and administrative duties.2 As administrators look to develop and expand cancer genetic services, they should consider the time-consuming nature of providing such services.
JNCCN is committed to providing a forum to enhance collaboration between academic medicine and the community physician. We welcome comments about the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), articles published in the journal, or any other topic relating to cancer prevention, detection, treatment, supportive care, or survivorship.
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References
- 1.↑
Heald B, Gustafson S, Mester J et al.. A time study of cancer genetic counselors using a genetic counselor-only patient care model versus a traditional combined genetic counselor plus medical geneticist care model. J Natl Compr Canc Netw 2013;11:1076–1081.
- 2.↑
Mahon S. Allocation of work activities in a comprehensive cancer genetics program. Clin J Oncol Nurs 2013;17:397–404.
