November 6, 2015

ASHG Recommends State Licensure of Genetic Counselors

The medical specialty of genetic counseling is high in demand these days as genetically-informed medical care (genomic medicine, precision medicine) becomes the dominant paradigm in heath care. The National Society of Genetic Counselors (NSGC) provides the following definition of the field:
Genetic counseling is the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. This process integrates:
Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence. 
Education about inheritance, testing, management, prevention, resources and research. 
Counseling to promote informed choices and adaptation to the risk or condition. 
To date, about 20 states require genetic counselors to be licensed for practice (here is the Pennsylvania licensing law). The U.S. has a generally state-based model of professional licensure for medical occupations (M.D.s included). Now, the American Society of Human Genetics (ASHG), a primary professional organization in clinical genetics, has called for state licensure of genetic counselors across the U.S. From the ASHG statement:
Healthcare reform and the rapidly expanding role of genomics in many healthcare decisions will increase the demand for qualified genetics professionals. State licensure of certified counselors will help to ensure that the healthcare system has a qualified workforce to provide genetic and genomic services for the  growing number of patients and families who need them.
Many health plans recognize genetic counselors as important members of the healthcare team and depend on them to help ensure provision of state-of-the art genetic services, including the ordering of  appropriate genetic/genomic tests and the attendant pre-and post-test counseling and education. Licensure also provides genetic counselors with the credentials many hospitals need to approve billing and reimbursement for services. 
ASHG supports licensure already enacted by more than twenty states and encourages the remaining states to license certified genetic counselors as one way to increase access to high-quality  genetic/genomic services across the country. 
The NSGC has published model legislation for licensure. The ASHG’s recent recommendation in favor of state licensure signals the increasing need for standardized professional services, albeit with state variations (e.g., see earlier post on Virgina's licensure statute). At least five states have licensing legislation pending. A parallel observation on the trend toward genetic counseling licensure is to note that the services of such professionals are often incorporated into patient management by referral from treating physicians; however, some studies suggest that genetic counselors are actually underutilized in some sectors of genetic testing (see here and here), with the consequence that patients undergoing such testing may not receive optimal education and guidance about their test results.

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