All very good questions, and I can provide what little information I got from a month long rotation in medical genetics, but don't take my word for it. I understand that the majority of Medical Geneticists are in major cities and are affiliated with academic centers. However, the few that are not, usually have to cover a very large geographic area in order to obtain sufficient cases, and unfortunately, the very unusual/interesting cases end up being referred to major centers. ALso, the majority of the patients treated by geneticists are children, and by the time they have reached adulthood they no longer need to be followed by the same geneticist since a dietary regimen or other treatments have been put in place during their childhood and they can be followed by a sufficiently adept internist.
Finally, regarding the question pertaining to Obstetricians, I believe that typically these patients are referred to a maternal-fetal medicine specialist who has been trained as an OB/Gyn and done a fellowship in MFM.
Anything else? You can take what knowledge I have with a grain of salt. THis is what I gleaned during my rotation in Med Genetics at CHLA.
R
