Genetic Counselor-Genetics Clinic

The genetic counselor is a licensed health care professional with a specialized graduate degree and experience in the areas of medical genetics and counseling. Genetic counselors work as members of a health care team, to provide genetic risk assessment, counseling, information and support to individuals and families affected with birth defects or genetic disorders, as well as those who may be at risk for a variety of inherited conditions. Genetic counselors serve as patient advocates and refer individuals and families to appropriate support services. They also serve as educators and resources for trainees, other health care professionals and the general public. Genetic counselors may engage in research activities related to the field of medical genetics and genetic counseling. Laboratory genetic counselors assist clinicians with genetic test identification, ordering, and perform duties related to result interpretation. The genetic counselor demonstrates and supports the philosophy, mission, values, standards, policies and procedures of Nationwide Children's Hospital.

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PRINCIPAL DUTIES AND RESPONSIBILITIES Clinical Genetics/General Duties

1. Assists staff in obtaining necessary medical records and information to facilitate referral triage and scheduling.

2. Obtains medical, psychosocial and family histories to help assess genetic risks and patient/family needs.

3. Assists in determining differential diagnosis, appropriate test selection, and plan of care with physicians.

4. Transmits information about genetic risks and mechanisms using counseling skills and visual aids if appropriate.

5. Discusses testing options available including advantages, disadvantages, risks, and limitations of the laboratory analyses.

6. Assists family in assimilation of the information presented, and in adjustment to its implications so that they can make appropriate decisions.

7. Makes appropriate referrals to community and health care resources when necessary in collaboration with physicians.

8. Interprets results in collaboration with physicians or other ordering providers. Contacts patients individually with laboratory results; answers any questions regarding their results and the implications..

9. Discusses family implications of testing. Provides follow-up support and additional consultation for families members as needed.

10. Summarizes findings for patient and referring physician with written or verbal communication, reviewed by the attending physician.

11. Tracks and manages for clinical and research purposes.

12. Provides training and supervision to genetic counseling students as appropriate and in line with level of experience.

13. Provides in-service education for outreach clinics, parent and community groups, students and other health care professionals, regarding genetics issues.

14. Provides in-service education for clinic staff, students, residents, and fellows.

15. Maintains and updates patient education materials and literature for use in the clinic.

16. Is familiar with and can discuss with faculty or patients/families relevant medical genetic literature. Clinical

Genetics/Specialty Clinics SPECIALTY CLINICS (CF, Muscular Dystrophy, Myelomeningocele, Williams syndrome, 22q deletion syndrome, Down syndrome, Complex Epilepsy Clinic, Craniofacial Clinic, THRIVE, PWS, NF, Cardiogenetics, Autism Center, Metabolic Clinic, SMA, Hematology/Oncology, etc.)

1. Facilitate development of Genetics involvement in new or existing NCH or affiliated specialty clinics

2. Includes all general genetics principle duties and responsibilities. Functions as the department liaison for genetic services as applicable.

3. Counsels families on issues of genetic diagnosis, recurrence risk, prenatal diagnosis, molecular and carrier testing and other relevant issues under supervision of clinic director.

4. Refers to appropriate clinical services based off clinical plan.

GENETIC COUNSELOR ONLY VISITS

1. Identifies patients appropriate for genetic counselor only appointments in collaboration with physician.

2. Facilitates scheduling of patients for appointments as needed, assists with collecting appropriate records prior to visit and reviews with collaborating physician as needed, completes independent consultation, completes documentation in electronic medical record, completes documentation for appropriate billing of appointment, creates and carries out plan of care in collaboration with physician.

3. Forwards clinic note and all other needed documentation to patient's primary care provider and all other applicable members of patient's healthcare team.

OUTREACH PATIENTS

1. Coordinates clinic schedule with local facility.

2. Obtains relevant records/charts for review.

3. Coordinates efficient acquisition and review of lab testing.

4. Travels to outreach clinics and assists physician as needed.

5. Writes counseling letter and/or provide disease-specific information to family when directed by MD.

6. Verifies follow-up appointments and specialty referrals are made.

INPATIENT CONSULTS

1. Is available by email, pager, and/or phone, at minimum, from 8:00am through 4:30pm Monday through Friday to acknowledge incoming consult requests. Communicates any gap in schedule availability with the attending physician and/or resident on-call as needed.

2. Reviews chart and obtains family and medical history on inpatient consults requiring genetic counselor involvement within 24 hours of notification.

3. Provides pre- or post-test counseling as indicated, reviews relevant lab results in conjunction with the attending physician and/or resident on call, and communicates results to the patient's family and healthcare team.

4. Responds to inquiries regarding genetic testing from other members of the patient's medical team and provides direction for the inpatient unit in selecting and ordering appropriate genetic testing.

5. Assists in maintaining a log of all consult patients regarding pending and resulted labs and follow-up recommendations.

6. Provides any appropriate follow-up communication to patients/families and providers as outlined in the Clinical Genetics/General Duties section.

Laboratory Genetic Counselor

1. Assists with process of sample accessioning by gathering additional information needed from submitting physicians and institutions. Gathers information regarding indications for study, medical and family history, etc. to provide optimal specimen handling and processing, and to allow accurate diagnosis and risk estimations.

2. Communicates test results to referring physicians, nurse practitioners, or other Genetic Counselors. Serves as a resource for information regarding genetic testing and identification of laboratories for follow-up/send-out testing. Maintains cost effectiveness, maximizing available resources for send-out testing.

3. Assists with searching the medical literature to provide further information in cases with abnormal cytogenetic or molecular genetic test results.

4. Assists with laboratory website development and maintenance. Assists in marketing activities in the IGM Clinical Laboratory through verbal and written methods.

5. Coordinates patient statistics for future use, utilizing computer programs suited to organize data.

6. Assists in training and teaching activities involving laboratory staff, students, residents, and fellows. Provides in-service education for laboratory staff, parent and community groups, students, and other health care professionals, regarding genetic issues.

7. Assists with the implementation of new laboratory testing.

Mentoring

1. Provides mentorship to GC-Is (if GC II), rotating GC students, medical students, fellows/residents Research Genetic Counselor 1. Identifies and recruits research subjects in accordance with IRB protocol and accrual goals. Keeps PI, co-PIs appraised of study progress. 2. Obtains and maintains IRB research training and certification. Helps develop and maintain IRB protocol for research. Handles IRB-related issues, including protocol updates and reports. 3. Develops and maintains research project database that maintains relevant research subject clinical and research data and demographics. Acts as liaison for project with research (and hospital) IS groups as needed. 4. Recruits families to research project as indicated in study protocol under supervision of study PI/co-PIs. Maintains accurate study subject records. Maintains appropriate confidentiality of all study materials. 5. Interacts with study families as primary contact person and answers questions about study for them. Primary contact to return results to participants as agreed upon with study PI/co-PIs. 6. Acts as administrator for study project and helps with selected administrative study activities, including those related to steering committees/case conferences/review boards. 7. Assists with preparation of manuscripts and presentations.

SPECIFIC JOB EVALUATION CRITERIA: 1. Performs Genetic Counselor duties outlined in job description. 2. Obtains and interprets complete pedigrees with accuracy and attention to detail. Pedigrees to be updated at each patient visit and documented in the chart. 3. Counsels families appropriately using clear simple language regarding patterns of inheritance, while maintaining the highest degree of professionalism and empathy. Seeks input from collaborating physician as needed. 4. Acts pro-actively to anticipate clinic requirements including testing availability, patient literature, support groups and research protocols. 5. Writes clear and comprehensive medical documentation. This includes but is not limited to clinic notes, letters of medical necessity, and summary letters. Direct-to-family communication should use language commensurate with family's level of understanding.

KNOWLEDGE , SKILLS AND ABILITIES REQUIRED

1. Two-year Master's degree in accredited program in Human Genetics, Genetic Counseling or a related field.

2. Must hold a current, valid Ohio license or a supervised practice license to practice as a genetic counselor.

3. Expertise in the principles of human genetics, including cytogenetics, molecular genetics, biochemical genetics, and human growth and development.

4. Excellent interviewing and non-directive counseling skills.

5. Extensive knowledge of social, legal, and ethical issues in genetics.

6. Board-Certified or eligible (if graduated in the last 3 years) to sit for the Genetic Counseling Board Examination administered by the American Board of Genetic Counselors.

7. Ability to draw a multigenerational pedigree, or family tree, preferably using a template as a guide.

8. Working knowledge of Microsoft office and Electronic Medical Record.

GC II specific requirements:

1. Minimum of three years' experience (full-time equivalent) in genetic counseling; and approval from the program manager and/or promotion by the Genetic Counselor Lead.

2. Board-Certified by the American Board of Genetic Counselors.

3. Must hold a current, valid Ohio license to practice as a genetic counselor.

4. Involvement and proficiency in subspecialty area.

MINIMUM PHYSICAL REQUIREMENTS

Sitting Frequently (34-66%) Talking in person/by phone Frequently Typing on a keyboard Frequently Standing/Walking Occasionally (0-33%) Must be able to see, hear, stoop, bend, and/or lift with or without accommodation. The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.

EOE M/F/Disability/Vet