The highly specialist, hub and spoke model of Clinical Genetics, as described by the Royal College of Physicians in the UK in 1991, is under the spotlight. Whilst this has underpinned the successful delivery of genetics services historically, it may not be able to deliver genomic healthcare on its own, at scale, simply because genomic testing is no longer contained - any clinician can now order a genomic test, irrespective of their discipline. The professional group of genomic counsellors are now questioning whether there is need for an evolution of their roles. Do we persist in being attached to past models, or do we embrace new models of care and take a direct role in 'mainstreaming' the skills of genomic counselling?. We conclude the genomic counsellor profession and the translated skills of genomic counselling have much to offer in shaping the future of medicine as genomic technologies become part of routine clinical practice.
Copyright © 2019. Published by Elsevier Masson SAS.