Should genetic counselors be licensed?
Genetic counselors are currently licensed in Utah. Outside of Utah, genetic counselors practice without a license. Most are well-qualified and ethical health care professionals. Many are board-certified by the American College of Genetic Counseling, but certification and licensure are two different things.
There has been a push in the genetic counseling community in recent years to support licensure in other states, and eventually nationwide. As the availability of genetic testing increases, so does the risk of an unqualified (or underqualified) person hanging out their shingle, calling themselves a genetic counselor, and endangering the well-being of those who choose to pay them a visit. Licensure ensures that healthcare professionals are qualified to perform their jobs and defines their scope of practice. It also gives the public a course of action should they want to file a complaint.
Counselors in a number of states are in the process of drafting legislation to require the licensure of genetic counselors. Some state groups have gotten as far as a bill on the floor only to uncover unexpected opposition from other lobbying groups. Because these changes have to occur on a state-by-state basis, we are learning about the best approaches as well as the barriers as we go.
Doctors, nurses and other allied health professionals are licensed. Massage therapists are licensed. Hairstylists are licensed. Realtors are licensed. The list is long.
It makes sense to me that if the person cutting my hair needs a license, so should a genetic counselor. After all, hair grows back. The impact of genetic testing and diagnosis can change a person's life.
What do you think?
Nicole Teed, MS, CGC
licensure
I do not agree that licensure will 'ensure that healthcare professionals are qualified to perform their jobs and defines their scope of practice'- and I do not think this is the intention of licensure. Licensure is an important topic for genetic counselors, but more has to do with reimbursement and recognition by insurance companies (which is critical to the future of genetic counseling) than quality of service provided. The above comment makes it sound as though anyone can practice as a genetic counselor, when in fact the more concerning issue is other providers providing genetic counseling without training. I have yet to meet an individual who calls themselves a genetic counselor and is not trained as such. The certification exam is designed to provide a delineation between genetic counselors and other practitioners. It is rare for a genetic counselor to be employed (at least in the state of California) without either having passed the certification exam or planning to take it. I think it is misleading to suggest that without licensure there is no 'quality control' for genetic counselors.
-California genetic counselor
response to California genetic counselor
I agree with some of your points, including the fact that there are already some quality controls for hiring genetic counselors into healthcare organizations. However, licensure adds another checkpoint for consumers, and provides a forum (the state licensing board) for assuring credentials are adequate and for filing complaints. Certainly, an individual can file a lawsuit against a counselor for medical malpractice, but that recourse is individual- and/or institution-specific.
Within the genetic counseling community, there is much weight put on the fact that licensure leads to better reimbursement. I think there is a lot of sense to this, and agree that genetic counselors should be able to bill for their services in the same way other allied health professionals can.
However, we cannot expect the public to carry a flag for us towards better reimbursement. That is our interest, not theirs. As far as I'm concerned, the reason the public (and, by extension, the lawmakers) should be concerned about our cause is for the reasons I discussed.
Wanna-be Genetic Counselors
When I had lived on the east coast, I too thought that all practicing "Genetic Counselors" were trained as such...until I started working in a region of the country that is underserved when it comes to genetics professionals. I have had several referrals whose relatives in other states had seen a "genetic counselor," only to find out that this person was a social worker who decided to 'pick up the genetics portion' of her cancer patients' concerns. I know that many social workers are very knowledgeable, have training and are certified, but this individual was giving inaccurate information about BRCA mutation testing, family risk assessment, saying that BRCA mutation testing doesn't have false negatives, etc, very basic information that any genetic counselor should know. QC may not be important in areas of the country where true genetic counselors are providing the care, but in states where 0, 1, 2 or 3 "genetic counselors" reside, this is a significant concern...it's difficult to reinforce the significance of certification in regions where the population doesn't understand what you're doing in the first place...
When I think about a genetic
When I think about a genetic counselor with no diploma or with a fake diploma, it makes my mind go crazy because such persons can have a great influence by the nature of their activity field.
Licensing those who provide genetic advice
Nicole, I had no idea genetic counselors were not licensed. I very much agree they should be. Perhaps I can research Utah's licensing standards and find ouutwhat they are and how the requirement for licensure came into being. I believe midwives may also be licensed here.