ACMG Medical Directors' Special Interest Group survey: Current challenges for medical genetics clinics

The American College of Medical Genetics and Genomics Medical Directors' Special Interest Group (SIG) began in 2021 as a forum for directors of medical genetics clinical groups to share questions, concerns, current practices, and solutions regarding clinical operations. We report on the first 4 years of the SIG-its membership growth and SIG activities. We also present quantitative and qualitative results of a nationwide survey of 66 SIG members addressing recurrent questions from members regarding: wait times, volume of referrals, clinical workload expectations, and independent practice of genetic counselors (GCs) and advanced practice providers.

Cross-sectional survey of American College of Medical Genetics and Genomics Medical Directors' Special Interest Group members.

We found that clinical full-time equivalents expectations are higher for medical geneticists than advanced practice providers, which were higher than for GCs. In 76% (44/58) of programs, GCs see patients independently, although many require a medical geneticist cosignature for orders, and only 51% (30/59) of programs report that GCs can bill independently. Clinic wait times for routine visits vary by subspecialty; the longest wait times are for general pediatric and adult genetic services (49% [21/43] of visits had wait times > 6 months), whereas wait times > 6 months were reported for only 26% (9/34) of cancer genetic visits, 7% (3/43) of biochemical genetics visits, and 0% (0/26) of prenatal visits. Urgent visit wait times were generally less than 2 weeks.

Wait times for clinical genetics appointments continue to increase compared with surveys from previous years. Medical genetics clinics are comprised of a heterogeneous workforce, and strategies to reduce wait times are similarly diverse.