Download “SWOT” Analysis- Division of Genetics, Department of Pediatrics

“SWOT” Analysis- Division of Genetics, Department of Pediatrics
Strengths:
Strong regional reputation for clinical excellence and service to adults and children.
Well-established referral base
Excellent Genetic Counselors (all with Master’s degrees from accredited programs, and either
certified or eligible for certification by the American Board of Genetic Counseling).
Well-established network of outreach clinics, covering most of central and western Virginia.
There is a 35-year history of monthly outreach clinics that reach from Bristol to Winchester
Good working relationships with the Virginia Department of Health. About half of the salaries of
our genetic counselors is covered by a service contract from VDH.
Well-established Enzyme Replacement Therapy program for lysosomal storage diseases
Well-established Metabolic Diseases Program for the diagnosis and treatment of patients
(children and adults) with inborn errors of metabolism.
Good working relationships with the Cytogenetics Lab and the Biochemical Genetics Lab. (Both
of these labs were originally in our Division but were taken over by the Hospital within the past 10
years)..
The shortest “time to appointment” of any genetics group in a multi-state region. This is much
appreciated by referring physicians as well as families and patients.
The only “in house” biochemical genetics lab in the state (amino acids and organic acids)
Tradition of excellence in medical education at all levels.
Weaknesses:
Under-staffed relative to the patient volume and demand
Lack of critical mass and infrastructure to establish a strong research presence
Genetic counselors are underpaid (relative to regional and national norms)
Lack of visibility within the Health System
Lack of marketing of genetics services by the Health System and the University (this is a longstanding problem)
Difficulty in “transitioning” Pediatric patients to adult care, since there are no adult physicians
at UVA who are certified by the American Board of Medical Genetics. (Our Division sees children and
adults with genetic diseases).
Opportunities:
Given the advent of “next generation sequencing” and the use of genomics in clinical medicine,
we are in an ideal position to expand our clinical activities. The nature of genetics patients is such that
they can bring additional patients to the Health System and can generate secondary referrals for
imaging, other consultations, etc.
The Battle Building will provide opportunities for multidisciplinary clinics that include Genetics.
Coordination of these clinics may be challenging.
Opportunity to develop disease or discipline-specific clinics that incorporate genetics. The new
Cardio-Genetics program that has recently received Buchanan support (to Matt Thomas, ScM) is an
example.
Threats:
Some of our funding comes from the Virginia Department of Health. This has been stable over
the years, but we are still vulnerable to budgetary changes at the state level.
The University has imposed a 10% overhead on our state contract; this amounted to a 10%
reduction in the amount of our contract, which is used primarily to support salaries for genetic
counselors and travel to our outreach clinics. This has proved to be a significant hardship on our division
and activities.
There is concern that genetics activities will be dispersed within the Health System. “Genetics”
has never been a sub-speciality of any specialty; the American Board of Medical Genetics is a freestanding Board that is recognized by the ABMS. Fragmenting genetics activities within the Health System
will be counter productive.
There is lack of support from the Health System to deal with the issue of pre-authorization for
genetic testing. This is a current problem and will only grow larger as more tests are developed and the
demand for such testing grows.
While there is no immediate threat to our clinical genetics service, there is a large Division at
Children’s National Medical Center in D.C. that has the potential to establish outreach clinics in the
northern Virginia region.
The failure of the Health System and the State of West Virginia to establish an ongoing working
relationship has been a problem for us, since there are few geneticists in WV, and UVA or our outreach
clinics would be closer to many WV patients.
There needs to be a long-term commitment on the part of the SOM to increase faculty in the
Division of Genetics to allow for orderly transition when the current Division Chief decides to retire.
. Respectfully submitted,
William G. Wilson, MD
Chief, Division of Genetics
Department of Pediatrics