Why Is It So Hard to Find a Genetic Counselor and What We're Doing About It

I grew up in a town of about 500 people in central Idaho. I absolutely loved it. The outdoors were right outside my door, the community was supportive, and everyone knew everyone. But our nearest hospital was an hour away. Seeing a specialist was at least a half-day trip. And certain types of care, the kind that requires specialists, academic medical centers, or long referral chains, were simply out of reach for most people I knew.

I left my little town to go to college and further my education, but never forgot what it felt like to grow up somewhere that healthcare felt far away, and I knew that genetic counseling, a field most people have never heard of, was even further out of reach than most.

But the access problem I witnessed isn't unique to Idaho. It's a national problem that plays out most acutely in rural states and communities across the country. Places where the distance between a patient and the nearest specialist can be measured in hours of driving, months on a waitlist, or simply a provider who says "we don't have anyone for that here."

What I didn't fully appreciate until I started practicing was how structural this problem is. It isn't just about supply. It's about how the entire system of genetic counseling was designed; built around urban academic medical centers, referral pipelines that add months of delay, and reimbursement models that create barriers at every turn.

This is exactly why I built Empower Genetics the way I did.

The Access Gap is Real

There are approximately 8,000 certified genetic counselors in the United States. That sounds like a lot until you understand where they work.

Large academic medical centers, major hospital systems, genetic testing laboratories, and specialty clinics in urban areas employ the overwhelming majority. Research confirms what anyone who has tried to find a genetic counselor in a rural community already knows: the further you are from a major city, the less likely you are to have access to one. Counties with practicing genetic counselors tend to be densely populated, urban, and comparatively wealthy. Rural counties are dramatically underserved and, in many regions, simply have no practicing genetic counselors at all.

For a patient in a major metro area, accessing genetic counseling through a hospital system is difficult, but often possible. For a patient in a small city, a rural community, or anywhere without a major medical center nearby, the picture looks very different. Long waitlists that stretch months. Referral requirements that add more time to the waiting. A specialist who visits one clinic one day a month. The answer is sometimes that there is no genetic counselor to see.

Genetic counseling access isn't just a convenience issue. It's a health equity issue.

Idaho is one example among many states where rural communities face the same access gap. The patients who need genetic counseling most are often the ones with the least access to it. This is a national issue, not just a regional one.

Why This Matters Clinically

It would be easy to read the access gap as an inconvenience problem. Instead, it is a clinical problem with real consequences.

Consider hereditary cancer. Variants in genes link BRCA1, BRCA2, MLH1, MSH2, and others dramatically increase a person's lifetime risk of cancers like breast, ovarian, colon, and uterine. When those variants are identified early in adulthood, there are meaningful options that can decrease the risk of developing cancer or catching it early when it's more treatable. Increased screening becomes available as well as prophylactic surgery, chemoprevention, and risk-reducing lifestyle changes. When these variants are identified after a diagnosis, after a cancer that might have been caught sooner is found, those options become much narrower.

Delayed access to genetic counseling doesn't just mean a patient waited longer. It can mean a preventable diagnosis wasn't prevented. It can mean a family didn't know they were at risk until someone was already sick.

The same logic applies across the other services I provide as well. A patient with an undiagnosed connective tissue disorder who has been told for years that her symptoms are just her anxiety. A patient whose antidepressants have never worked because their pharmacogenomic profile was never checked. A couple planning their first pregnancy who had no idea they were both carriers for a serious rare condition until they were already expecting.

In each of these cases, access to a genetic counselor that doesn't include a six-month wait and a complicated referral process changes the outcome.

What Telehealth Changes

When I built Empower Genetics, I made a deliberate choice to operate entirely via telehealth. Not as a compromise, but as the model.

Telehealth eliminates most of the logistical barriers that have historically kept genetic counseling out of reach for rural patients. No driving two or three hours each way for a 60-minute appointment. No taking a full day off work to reach the nearest specialist. No being told the next available appointment is in four months.

A patient on the other side of the state can book a session with me for next week without worrying about driving for a full day or booking a hotel. A patient in rural Utah or Oregon can access a board-certified genetic counselor without ever leaving the comfort of their own home.

The quality of care is the same. For the vast majority of genetic counseling services, there is no clinical reason that care needs to happen in person. The conversation, the family history review, results interpretation, and care coordination all translate fully to a telehealth format.

What Still Needs to Change

Telehealth solved the geography problem, but it didn't solve everything.

Awareness is still a significant barrier. Most people in rural communities don't know that a telehealth genetic counseling service exists, or that they can book an appointment without a referral from a physician.

I think about this as a long-term project. Building Empower Genetics isn't just about seeing patients. It's about changing what rural providers think of when they think of genetic counseling and making sure that the next patient who needs genetic information doesn't spend years looking for someone who can help.

That's what Empower Genetics is building one patient at a time.

If You've Been Looking, You've Finally Found Someone

If you live in a rural community in one of the multiple states we practice in, and you've been told you don't meet criteria for genetic counseling or that the waitlist is months long, I want you to know that there is someone who is ready to see you now.

Empower Genetics offers telehealth genetic counseling across multiple states. No referral required. No waiting months for an appointment. No driving hours to see a specialist.

Whether you're concerned about hereditary cancer risk, trying to understand a genetic test result, navigating a rare disease diagnosis, or just starting to ask questions about what your family history might mean for your health, this is exactly what we do. And we'd be honored to help

Book a telehealth consultion

This blog post is for educational purposes and does not constitute medical advice. If you have concerns about your genetic health, please consult a qualified healthcare provider.