Telemedicine in genetic counseling

Abstract

Genetic counselors help patients understand and adjust to the psychological, biological, and familial implications of hereditary conditions. Genetic counselors have graduate training in the biology and biochemistry of genetics and the psychology of counseling. There are 32 accredited graduate programs training genetic counselors in 22 states in the United States and 3 provinces in Canada. In North America, genetic counselors are certified by the American Board of Genetic Counselors, Inc. As of the end of 2013, there were 3260 certified genetic counselors in the United States and 235 in Canada. In 2012, full-time certified genetic counselors earned between $30,000 and $120,000 per year. Some employers also provide budgets to the genetic counselors for purchase of books, travel to professional meetings, continuing medical education studies, and occasionally sabbaticals. However, the most meaningful benefits for the counselor are the reactions from the patients they counsel. These reactions are important as they help to balance the burden the counselor faces of dealing with many patients whose own prognoses are poor. Genetic counseling is unusual in that family members often accompany the patient in the counseling session. Because of the limited number of genetic counselors, many patients live far from the nearest one. Recently technology has made it possible to offer counseling by telemedicine. These sessions are similar to face-to-face counseling sessions. They begin with introductions and discussions about the nature of heredity. The counselor then reviews the patient’s family medical history. The counselor assesses the risk for a hereditary condition and presents options for genetic testing. Finally, the session focuses on medical management and familial issues.