Genetic Counseling Assistants: an Integral Piece of the Evolving Genetic Counseling Service Delivery Model

Abstract

This study explores the potential impact of the genetic counseling assistant (GCA) position on the efficiency of the genetic counseling field, evaluates attitudes regarding expansion of the genetic counseling field to include the GCA, and presents data on GCA endeavors and GCA job tasks as reported by GCAs, certified genetic counselors (CGCs), and program directors (PDs). Data on GCA roles and attitudes toward different aspects of the GCA position were collected via surveys of CGCs who have worked with GCAs, PDs who have and have not had experience with GCAs in their programs, and GCAs. We analyzed responses from 63 individuals: 27 PDs, 22 CGCs, and 14 GCAs. GCAs' impact on efficiency was calculated via internal analysis of genetic patient volume per genetic counselor within the University of Texas Southwestern (UTSW) patient database prior to, and since the addition of, a GCA to the practice. The response rates for PDs, CGCs, and GCAs were 27 %, 79 %, and 61 %, respectively. Every CGC stated the GCA increased their efficiency. CGCs with a GCA reported a 60 % average increase in patient volume. This figure was congruent with internal data from the UTSW cancer genetics program (58.5 % increase). Appropriate responsibilities for GCAs as reported by CGCs and PDs (>90 %) include: data entry, shipping tests, administrative tasks, research, and ordering supplies. Regarding GCAs delivering test results, there was response variation whether this should be a job duty: 42 % of CGCs agreed to GCAs delivering negative results to patients, compared to 22 % of program directors. Twenty-two percent of PDs expressed concern about the job title "Genetic Counseling Assistant." Ninety percent of CGCs felt that GCA was a career path to becoming a CGC, compared to 42 % of PDs. Eighty-three percent of GCAs who decided to apply to CGC graduate programs were accepted. We conclude the addition of a GCA to a genetic counseling practice contributes to increased efficiency and is one way to expand the reach of the profession.

Clinical Cardiovascular Genetic Counselors Take a Leading Role in Team‐based Variant Classification

“…Applying this frame to variant review activities, we can identify tasks that could be performed by other members of the healthcare team to allow genetic counselors to focus on tasks higher in their scope of practice. For example, some aspects of gathering additional data could be performed by others, such as genetic counseling assistants (Pirzadeh-Miller et al 2017), while critical review of the available data and discussion of the classification with cardiologist and geneticist colleagues is likely best performed by genetic counselors.…”

Optimizing efficiency and skill utilization: Analysis of genetic counselors' attitudes regarding delegation in a clinical setting

“…Delegation to numerous staff positions including personnel to manage insurance authorization (Uhlmann, Schwalm, & Raymond, ), genetic counseling assistants (Pirzadeh‐Miller et al, ), and additional clinical personnel (i.e. non‐genetics professionals) can directly aid in the genetic counseling process (Cohen et al, ; Cohen & McIlvried, ; O'Shea et al, ).…”

“…This increasing demand for GCs across multiple sectors of healthcare, including clinical, commercial, and other domains, has led to concerns about a shortage of genetic counselors (Hoskovec et al, ; Pan, Yashar, Pothast, & Wicklund, ) such that the supply of GCs in direct patient care will likely not meet projected demand until 2030 (Hoskovec et al, ). The genetic counseling profession has adopted multifaceted strategies to address this shortage including (a) expansion of the number and size of Accreditation Council for Genetic Counseling (ACGC) accredited Genetic Counseling Programs, (b) the adoption of alternative service delivery models such as telephone genetic counseling, telemedicine, and group counseling (Cohen et al, ; Kinney et al, ; Platten et al, ), (c) the development of genetic counseling assistant positions (Pirzadeh‐Miller, Robinson, Read, & Ross, ), and (d) collaborations with non‐genetics professionals to provide genetic services for routine indications (Cohen & McIlvried, ; O'Shea et al, ). Per the 2018 National Society of Genetic Counselors (NSGC) Professional Status Survey, 62% of GCs are utilizing multiple service delivery models (National Society of Genetic Counselors, ) and genetics clinics are implementing online tools that improve efficiency by allowing patients to share their own medical information prior to a clinical appointment (Pritzlaff et al, ).…”

Genetic counselor workflow study: The times are they a‐changin’?

“…The investigators identified 15 different tasks performed by GCAs, many falling in the category of PRA. Furthermore, GCs who worked with GCAs increased their patient volumes on average by 60% (Pirzadeh‐Miller et al, ). As such, employing GCAs may be one way to help GCs spend a larger proportion of their time in session with patients.…”

“…There has been one study investigating GCA job responsibilities and the impact of GCAs on GC efficiency (Pirzadeh-Miller, Robinson, Read, & Ross, 2016). The investigators identified 15 different tasks performed by GCAs, many falling in the category of PRA.…”