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Empowering primary care health professionals in medical genetics: How soon? How fast? How far?


  • Karen Greendale,

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    • Corning Tower, Room 780, Albany, NY 12237-0678.
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    • Karen Greendale, MA, CGC, is director of the Genetics Education and Information Program, Bureau of Chronic Disease Services, New York State Department of Health. She is a board-certified genetic counselor and a previous president of the National Society of Genetic Counselors. Her interests include public health genetics, cancer genetics, and quality issues in genetic services delivery.

  • Reed E. Pyeritz

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    • Reed Pyeritz, MD, PhD, FACP, FACMG, took his doctoral degrees at Harvard and his postdoctoral training at the Peter Bent Brigham Hospital and Johns Hopkins Hospital. He has served as the clinical director of the Center for Medical Genetics at Johns Hopkins, president of the American College of Medical Genetics, and president of the Association of Professors of Human and Medical Genetics. Currently he is chief of the Division of Medical Genetics at the University of Pennsylvania School of Medicine.


Applications of genetics to the practices of medicine and public health are important today and will only become more compelling as our understanding of the human genome evolves. Because of a perceived lack of medical genetics professionals, it is generally believed that primary health care providers (PCPs) will need to assume prominent roles in delivering clinical genetics services. However, a number of studies indicate that most PCPs are neither well enough educated in genetics nor interested enough in becoming so to effectively contribute. Those who advocate empowering PCPs must be aware of potential problems with any approach thus far suggested for achieving this goal. Moreover, any analysis of this model must consider the potential ramifications for medical genetics professionals, patients, and families. In this article, we explore some of the unique features of the culture of medical genetics services and service providers. We discuss how important this culture is to clinical outcomes and the likelihood that its positive attributes would be preserved in a PCP model of medical genetics service delivery. © 2001 Wiley-Liss, Inc.