Wagner Chelsea, Stein Quinn, Singletary Claire N
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
University of Texas Genetic Counseling Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
J Genet Couns. 2021 Dec;30(6):1757-1766. doi: 10.1002/jgc4.1444. Epub 2021 Jul 15.
In recent years, it has become apparent that patients expect genetic counselors to be able to address questions about insurance coverage for genetic testing and perform 'genesurance' tasks in and out of genetic counseling sessions. Anecdotally, many genetic counseling graduate programs have begun to incorporate genesurance training in some capacity. However, the amount, modality, and potential barriers to this training had not been previously studied; therefore, this study aimed to elucidate current graduate program practice regarding genesurance. Program Directors of Accreditation Council for Genetic Counseling (ACGC) accredited programs who had students enrolled as of July 2019 (n = 50) were recruited through the Association of Genetic Counseling Program Directors (AGCPD) listserv and invited to complete an anonymous electronic survey via Qualtrics. Program Directors (PDs) from 25 ACGC accredited programs located in the United States completed the survey and were included in the analysis, responses from two ACGC Canadian programs were excluded due to small sample size and differences in healthcare systems. Responses were analyzed using descriptive statistics and open-ended responses were coded utilizing latent qualitative content analysis. The majority of respondents from the United States, 96.0% (24/25), report incorporating genesurance training into their curriculum utilizing a variety of training modalities including classroom, clinical, and online experiences. Most (81.0%) felt their trainees were adequately or very prepared to discuss genesurance issues. Despite varied methods of teaching modalities, PDs identified barriers to providing this training, including time constraints within the curriculum, lack of interest in the subject, as well as acknowledging the constantly changing landscape of billing and insurance. Despite these barriers, a baseline understanding of the impact of insurance on offering genetic testing and insight into how insurance impacts clinical practice may be beneficial to genetic counseling trainees, as it reflects the current genetic counselor's workflow and practice patterns.
近年来，越来越明显的是，患者期望遗传咨询师能够解答有关基因检测保险覆盖范围的问题，并在遗传咨询 session 内外执行“基因保险”任务。据传闻，许多遗传咨询研究生项目已经开始以某种方式纳入基因保险培训。然而，此前尚未对这种培训的数量、方式和潜在障碍进行研究；因此，本研究旨在阐明当前研究生项目在基因保险方面的实践情况。通过遗传咨询项目主任协会（AGCPD）的邮件列表招募了截至2019年7月有学生入学的遗传咨询认证委员会（ACGC）认证项目的项目主任（n = 50），并邀请他们通过Qualtrics完成一项匿名电子调查。来自美国25个ACGC认证项目的项目主任完成了调查并纳入分析，由于样本量小和医疗保健系统差异，排除了两个ACGC加拿大项目的回复。使用描述性统计分析回复，并利用潜在定性内容分析对开放式回复进行编码。美国的大多数受访者，即96.0%（24/25），报告称已将基因保险培训纳入其课程，采用了多种培训方式，包括课堂、临床和在线体验。大多数（81.0%）人认为他们的学员在讨论基因保险问题方面准备充分或非常充分。尽管教学方式多种多样，但项目主任们指出了提供这种培训的障碍，包括课程时间限制、对该主题缺乏兴趣，以及认识到计费和保险情况不断变化。尽管存在这些障碍，但对保险对提供基因检测的影响的基本理解以及对保险如何影响临床实践的洞察可能对遗传咨询学员有益，因为它反映了当前遗传咨询师的工作流程和实践模式。
