The authors reply: We read Professor Mahon’s comments regarding our article1 with great interest and appreciation. We agree that the nature of providing genetics services can be time-consuming and must be accounted for in program development. We also acknowledge the additional tasks that are time-consuming, yet critical, for program development that were not captured by their study, including interfacing with referring providers; meeting educational needs of patients, providers, and trainees; and allowing for travel time for the genetics professional to provide greater access for patients at locations convenient to the patients.
Those in the field of medical genetics do not doubt that these services benefit patients and improve their experience in the health system. Indeed, the practice of genetics has always been value based and not volume based.2 Unfortunately, only limited data are available in the medical literature to support this. To this end, genetics professionals need to document the benefit added by their services and that the field can grow and expand with the changing climate of health care. The National Society of Genetic Counselors (www.nsgc.org) has prioritized assessing and establishing outcome measures for genetic counseling. To that end, they have tasked their Access and Service Delivery Committee with this goal, particularly as the Centers for Medicare and Medicaid Services transitions the physician quality reporting system from voluntary to mandatory for physicians and eligible health care providers in 2015. We hope that the data from Heald et al1 and Mahon3 can serve as a basis for study development to prove the value of these services.
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.
Eng C. Editorial: molecular genetics to genomic medicine practice: at the heart of value-based delivery of healthcare. Mol Genet Genomic Med 2013; 1:4–6.