“…2,15,22,24,25,37,40,41 PCPs reported an inability to obtain a consultation with clinicians in four studies, noting that the location of the nearest genetics center was too inconvenient for patients to be able to access. 22,24,29,40 Chen et al 29 found that 24% of Alabama pediatricians surveyed were unable to obtain genetics consultations for their patients, 67% said it was difficult or not possible to obtain a face-to-face genetics evaluation, and 58% reported it was difficult or impossible to obtain a remote genetics evaluation. Iredale et al 22 found that rural location played a major role in access issues because of isolation, lack of social networks, poor transport, decreased accessibility, and lack of referral patterns to secondary and tertiary facilities.…”