In a recent DNA Exchange blog post, Bob Resta wrote about his love/hate relationship with genetic testing (Genetic Counseling ≠ Genetic Testing). He describes the reasons that genetic counseling sessions have become bogged down with genetic testing options and the fact that many people mistake genetic counseling for “getting a test.” Bob makes a lot of good points in his post: there are too many test options to cover, many genes on panels have dubious clinical utility, and genetic counselors spend too much time explaining the minutiae of genetic tests and not enough time listening to and counseling their patients.
Commenters agreed with him, with one saying that Genetic Counselors “feel like car salespeople, ‘do you want the basic or the deluxe model?'” Yikes!
Isn’t it time to change?
Genetic counselors are some of the brightest, most passionate people I know. They care very much about their patients and about doing the right thing. They want to help people understand genetics and utilize the progress that comes from it. Out of necessity, many have invented creative ways of delivering services just to keep their heads above water.
Sometimes it seems like genetics healthcare delivery is a 4-way tug of war between hospitals, laboratories, payers, and providers. Everyone seems to have an agenda, and they do not always align. Add in the sometimes complex physician-genetic counselor dynamic and it may feel like another rope has been added to the crazy fray.
The problems with delivering genetics services may feel insurmountable but they’re not. Bob is right that the time spent talking about genetic testing options needs to be put in its place. There are other things that genetic counselors probably should spend less time on as well. Some solutions may involve technology, but many will not. For example, a few places have had great success hiring genetic counseling assistants and yet monster.com has only 4 listings for “genetic counseling assistant” and nearly EIGHT HUNDRED for “genetic counselor,” showing that this fix hasn’t taken off yet.
Given that clinical genetic counselor positions have become very difficult to fill, hospitals will be forced to find alternative solutions. Let’s make sure that genetic counselors are part of finding those solutions. It’s time to show our value as clinical genomics experts and reclaim the most rewarding aspects of being a genetic counselor.
Let’s end the tug of war.
I’ll be discussing this in more detail in future posts. I’d love to hear from you about your challenges in the workplace and the solutions you’ve considered or implemented. email@example.com.
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