I’ve been talking to my genetic counseling colleagues a lot lately about the state of clinical genetic services. In spite of daily news bombshells (good, bad and other), it’s not looking good for us. Here are a few quotes:
“The current clinical genetics model is unsustainable.”
“Genetic counselors are overworked, understaffed, and don’t know what to do about it.”
And my personal favorite, “The genetics clinic here is a sh*t show.”
Clearly clinical genetics is in crisis. So what’s a genetic counselor to do?
We have valuable expertise. Why spend time on something that doesn’t require your knowledge and may not even require a person at all! Figure out what can be peeled off from your responsibilities that can free up your time to do the things that DO require your specific skills. You can delegate to technology by automating steps in your workflow (e.g. pedigree drawing) or to other people, like genetic counseling assistants. Don’t have a GC assistant? Maybe it’s time to ask for one!
Streamline Your Processes
Consider aspects of your process that may be unnecessary or could be made more efficient. Take patient letters, for example. They seem mandatory, right? Well, maybe not. Research done by Corissa Androich, MS, CGC, CCGC in 2009 showed that Cleveland Clinic patients referred for genetic counseling for hereditary cancers preferred a folder with information at the time of the visit over traditional patient letters. Patients’ understanding and satisfaction were the same between the groups, but the information folder saved genetic counselors an average of 30 minutes per patient. This freed up precious time for other things. What other steps in the workflow of your clinic could be streamlined?
Tweak Your Practice
Within the session itself, there may be things that you can change. Unlike some of the other suggestions, this category is largely under your control and can probably be implemented relatively easily. Many genetic counselors still use a flip book to explain genes and chromosomes. Is this something you’d consider changing? In an age when you can use you tube to learn almost anything, this is one area where technology really may be your best friend.
Use Alternate Service Delivery Models
Providing genetics services by telephone, video conferencing, group counseling and other non-traditional methods are called alternate service delivery models (SDMs). A National Society of Genetic Counselors task force published an analysis of the advantages, limitations and barriers of SDMs (Cohen et al., 2016). While there’s room for improvement, SDMs make genetic services more convenient to many patients and genetic counselors can add patients to their schedules sooner, which improves access. While there are barriers now, it will become easier for genetics clinics to implement SDMs as they gain acceptance in other areas of healthcare.
Advocate for Yourself
While some of these changes may be easier to do than others, change can be difficult. Even if you’re ready to change, other key people may not be. Once you’ve defined the problem and come up with some possible solutions, you might want to find a champion who can help you make it happen. You’ll need to be determined and open to possibly difficult conversations, but keep coming back here and follow me on twitter (@genexperts). I will be posting solutions that others have used successfully, including supporting data on cost savings and other benefits. Who knows, maybe it’ll be just what you need to hire a genetic counseling assistant!