Some Future Directions in Medical Genetics

Abstract

The future organization of our complex health care system and its regulation will be an important factor in personnel requirements in medical genetics. There are many problems. Over 40 million people are uninsured. How can we provide appropriate genetic services to this underserved population, and how should that be done? Health maintenance organizations (HMOs) are here to stay for some time. To reduce costs, these organizations utilize cost-effectiveness analysis to define the needs for genetic services. A likely outcome is increasing utilization of genetic counselors, rather than of medical geneticists in HMO settings, which is already happening in cancer genetics. There is likely to be more patient education in matters of genetics with attention to prevention—a welcome development. The specific organization of various genetic services and the role of genetics in medical care is difficult to predict at this time and will depend on scientific developments and how health care in the U.S.A. will be administered in the future. There is no question, however, that our field of science and practice will play an important role in the medicine of the future.