Can Ireland's clinical genetics services crisis be turned into an opportunity? It's possible, and might be the best way of investing Irish health care €€

Just bumping up the number of clinical genetics consultants, while valuable, is probably not the sustainable solution 1/ https://twitter.com/keelinodonoghue/status/1328378214717288448

2/ It's safe to say that clinical genetics is changing rapidly, and that models of clinical genetics delivery are extremely variable worldwide. Nice overview here: https://www.frontiersin.org/articles/10.3389/fgene.2019.00552/full

3/ A few notable changes:
a. New genomic tests, including exomes/genomes, with increased complexity of information
b. Ordering of genomic tests by colleagues in other specialties
c. More testing overall
d. Clinical genetics expanding into common diseases/population health

4/ Our old clinical genetics service model, with lengthy in-person family interactions with consultant geneticists and genetic counsellors, is a privileged service model that has no hope of surviving.

We can't hire enough people to meet contemporary demands using this old model.

5/ The study cited earlier describes 5 potential clinical genetics delivery models.

In Ireland's case, bringing the country's outstanding GP resources into the planning process early would probably be a sensible step @ICGPnews

6/ And it goes without saying that a public, national genome project that directs carrier screening and tunes polygenic risk scores to the Irish population is a non-negotiable part of the foundation for these services.

7/ Bottom line -- Ireland's difficult can be Ireland's opportunity. In fixing the clinical genetics services, there's massive potential to innovate and future-proof these services so they can be cost-efficient and excellent, serving patients who have been neglected for too long.

*difficulty

(This is what happens when you try to get too smart with paraphrasing Daniel O'Connell)