Oncology Rounds

How your genetic counseling program can go from 'good' to 'great'

by Deirdre Saulet

The field of genetics is evolving rapidly. Recently, our team spoke with Sandra Brown, Mary Freivogel, and Erica Ramos from the National Society of Genetic Counselors to understand how the role of cancer genetic counselors is changing, how to set up an effective counseling program, and more.

Read on to find out what we learned about building a comprehensive genetic counseling program and how to attract genetic counselors to your cancer center. 

Question: For those who may not be familiar, what is the range of responsibilities owned by genetic counselors?

Answer: Genetic counselors (GCs) are health care professionals who have advanced training in genetics and counseling, which makes them uniquely well-suited to play a pivotal role in cancer genetics. GCs are the most visible when they provide personalized guidance to patients who are seeking to understand hereditary contributions to cancer in themselves and/or relatives. Key tasks provided by genetic counselors include: risk assessment, identification of appropriate genetic testing, interpretation of genetic test results, and education, guidance, and support for patients and their families.

GCs also work in laboratories to ensure proper test utilization, interpretation, and reporting of test results. They can also help build out test offerings that are both comprehensive and actionable for their organizations. In addition, some GCs work on research studies related to hereditary cancer.

Q: What are the biggest challenges facing genetic counselors across the country today?

A: The field of genetics is changing rapidly and becoming increasingly complex. In cancer genetics specifically, there has been a recent explosion of multi-gene panels coupled with a rapid expansion in the number of laboratories offering genetic testing. This means that GCs have to guide the patient through the individual decision about which test makes sense clinically, in addition to evaluating the quality of the laboratory, the clinical utility of the genes included on the panel, and the cost of the test (both to patients and insurance companies).

As research continues to build the evidence base for cancer genetics, we are now touching more patients. At the same time, consumers are becoming more engaged in decisions about their own genetic information and treatment decisions. These factors are making access to experts, such as genetic counselors, even more important than ever. GCs are constantly challenged to keep up with changes in patient demands and evolving evidence, and we must remain flexible and adaptable to accommodate them. Our workforce is relatively small, and we must be creative and nimble in order to maintain high-quality clinical care while maximizing efficiency.

Q: What do you think are the key components of an effective, comprehensive cancer genetic counseling program?

A: The most effective cancer genetics program will use GCs both to improve patient care and to leverage their unique knowledge and skills to evaluate and develop robust cancer prevention services.

GCs are most effective and efficient when working at the top of their license and have necessary support staff and resources. This allows them to utilize their expertise in roles where they have a unique contribution to make. For example, a GC is more efficient and productive with the support of a genetics assistant, who can schedule patients, obtain family history questionnaires, submit authorizations, maintain databases, query data for program reports, and support screening protocols.

As a member of the cancer team, a GC can support community outreach and physician education events, inform and update genetics standards, develop screening programs, deliver program and survey reports, and advise tumor board and cancer committee recommendations.

Q: Given the shortage of genetic counselors, what advice do you have for cancer program administrators who are trying to attract genetic counselors to their program?

A: First off, a competitive salary is important, and the National Society of Genetic Counselors Professional Status Survey (PSS) can aid in benchmarking a GC’s salary. Beyond just base salary, a competitive compensation package includes financial support for continuing education and takes into account the time needed to delve deeply into complex cases, contribute to community events, deliver physician education seminars, and/or publish journal articles or research posters.

Of course, culture and the program’s mission are also extremely important. The PSS found that GCs report high job satisfaction when they have a position that offers stimulating and interesting work, a supportive and respectful environment, involvement in program development, opportunity for advancement, and when the GC role is valued. GCs are looking for engaged and knowledgeable leadership, supervision with cohesion and autonomy, colleagues who respect and value their contribution, and a program with a genuine interest in developing a top-notch cancer genetics program. In short, it’s vital to demonstrate that GCs will be a supported and respected clinician in and beyond the clinic visit.

To find a genetic counselor in your area, visit http://www.findageneticcounselor.com.

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