In the 2019 Q2 issue of Perspectives, Callie Diamonstein described the daily life of an inpatient pediatric genetic counselor. I (Tia) immediately connected with this piece.
The article highlighted several aspects of my inpatient role, including a reliance on psychosocial skills to help families navigate moments of crisis, and how genetic counseling skills can be adapted to a variety of settings. It also validated my experiences, as I was not previously aware how many other genetic counselors were providing similar services. At the time, research on inpatient genetic counselors focused on their role in reducing genetic testing costs in the inpatient setting. However, limited information was available about genetic counselors providing care in the inpatient setting — including which specialties they practiced, the patients they saw, and how they provided care.
Since then, research from genetic counseling students Cheyla Clark and Emily Magness (previously presented at the 2020 NSGC Annual Conference) found that inpatient care comprises part of the full-time effort of many genetic counselors. Indeed, inpatient genetic counselors provide care to patients in almost every medical specialty over the lifespan, from prenatal to adult genetics, in practice settings varying from the NICU to oncology and cardiovascular units. This research also identified that genetic counselors are invigorated by the fast-paced setting of inpatient care, enjoy close collaboration with other healthcare providers, and feel valued by both their patients and medical teammates.
This research supports practicing genetic counselors’ observations that we are uniquely positioned to serve inpatients: many, if not all, inpatients and their families are in a state of crisis. Beyond ordering and coordinating genetic testing, we are also trained to work across disciplines, provide education and counseling simultaneously, and advocate for our patients — skills that are crucial in the inpatient setting.
Of note, although many genetic counselors provide inpatient care in tandem with a geneticist, some provide care autonomously. Given that there are more genetic counselors than clinical geneticists, we can fill some current gaps in inpatient care by providing family history assessment, informed consent, coordination of testing and utilization management, and patient follow up. Further research is needed to define genetic counselors’ roles in inpatient care and to determine the outcomes of providing genetic counseling in this unique setting.
To help facilitate further research and knowledge of this specialty, the newly-founded Inpatient SIG includes genetic counselors with experience building inpatient programs and working through tough cases. It also includes genetic counselors and students who are looking to establish an inpatient role at their institution or who seek to learn more about inpatient care. The SIG aims to bring inpatient genetic counselors together to improve patient care, develop the groundwork for evidence-based inpatient genetic counseling, and advocate for wider adoption of this role. If you are interested, please join the Inpatient SIG through the Membership portal.