Comments for The DNA Exchange

Comment on Corporate Sponsorship and Genetic Counseling: Questions and Suggestions by Luba Djurdjinovic MS

Luba Djurdjinovic MS — Mon, 14 May 2012 13:08:06 +0000

Thank your for raising this issue.
It was very interesting to see the range of sponsorships and the price tags. NSGC exhibitor sponsorship packet clearly states that this is an optimal corporate approach to access the “power” of genetic counselors in gene testing lab selection. If, NSGC has not developed policies/code defining boundaries around corporate $ and NSGC activities- the time is now!
I fully agree that the membership and the public who access our website need to understand the reasons we benefit from corporate sponsorship, % of annual revenue and full disclosure of sponsorship level and commercial entity(s) linked to it.

This is an important issue.
Luba Djurdjinovic MS

Comment on Corporate Sponsorship and Genetic Counseling: Questions and Suggestions by Christine Barth, MA, CGC, LGC

Christine Barth, MA, CGC, LGC — Thu, 10 May 2012 18:49:29 +0000

Bob: As usual your comments are pointed and should not be taken lightly. Having just left a CME Director position during which I was faced daily with resolving conflicts of interest re: commercial support and CME presentation bias. I do think that these issues should be addressed by both NSGC and the ACMG (& G).
In response to suggestion #9: I would love to adda Bob Resta dartboard to my genetics toy collection which , of course, includes the Steve Keiles bobblehead!

Comment on Are We There Yet? by Corporate Sponsorship and Genetic Counseling: Questions and Suggestions | The DNA Exchange

Wed, 09 May 2012 02:48:54 +0000

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Comment on Are We There Yet? by Dick Dorkins

Dick Dorkins — Tue, 01 May 2012 16:40:30 +0000

Appreciate your making this program available; hope there’s wi-fi at the conference. Also, just wanted to let you know that I am available for a keynote lecture or perhaps some light and witty after-dinner remarks on the findings of Project Dick. I have a talk on genetic identity that I call, “Am I *the* Dick or just *a* Dick?” that always has them rolling in the aisles and spitting in the cups. Have your technician call my technician.

Comment on Are We There Yet? by Katie Stoll

Katie Stoll — Tue, 01 May 2012 05:40:56 +0000

I agree with Allie that there are genetic counselors doing great work and filling important roles in industry. That said there is an inherent conflict of interest in situations where genetic counselors are employed by corporate labs to directly interface with patients as clinicians. Corporate genetic testing laboratories are big money, and very competitive. The shareholders interests are the ultimate priority and the success of a company comes with the utilization of the tests that they offer. This priority is in conflict with patient autonomy. Of course genetic testing companies are doing a lot of good, and our profession would likely not exist without them, but it is a very complicated situation. I find it concerning that genetic counselors working in clinical settings, employed by genetic testing labs, are asked to follow standards that are not adopted by our professional organizations but are created by the corporate laboratories. I believe there will rapidly become pressure for lab-GCs to offer more and more testing options to their patients outside of the standards recognized by our professional guidelines. In these instances I think the line between genetic counselor and sales representative is blurred. I am not criticizing the genetic counselors that work in these roles. I know there is a lot of pressure – I imagine both subtle and direct. I am however concerned about the genetic counselor that is employed by a lab but working in a clinical setting regarding his/her ability to provide counseling that is without bias. Ultimately the success of a corporate lab depends on the utilization of their tests, and therefore so to does the job security of the genetic counselor. This presents a significant conflict in that when a trusted healthcare provider offers a test, there is some underlying implication that it is a good test. Uptake in these settings is likely high, and the case can be made that patients seem in favor of the tests being offered – why else would they consent to them? A lot of publications are coming from the practices that corporate laboratories support, and these will inform policy that then will impact all of us. Industry is basically shaping the standard of care with regards to genetic testing. As Bob said, this is new territory. It would seem that now is the time for our professional organization to work on developing ethical guidelines regarding how corporate laboratories and the testing they provide impacts our patients in a clinical setting. We, as a body of genetic counselors should define our role – not the corporate laboratories.

Comment on Are We There Yet? by Robert Resta

Robert Resta — Wed, 25 Apr 2012 03:06:18 +0000

Allie – I honestly can’t say what specifically motivated this post; the most honest answer I can provide is that like most of my posts it popped into my head, more or less out of nowhere or at least not directly connected to any thoughts that were otherwise running through my head at the time. Kind of like a guests who paid an uninvited but interesting visit and once they were there you didn’t want them to leave. It’s great that genetic counselors are working for labs, opening up new territory for us all. Believe me, labs are far better places for employing genetic counselors. I worry about all of us, not just lab-based counselors. As a profession we haven’t discussed conflicts of interest in detail, and in tough economic times when money is hard to come by and everyone has to economically justify their positions, it’s easy to step into conflict of interest quicksand. Besides evoking a little smile with my post, I am hoping to stimulate more open and honest discussion at conferences, on the listserv oops I mean Forum, in research and published papers, and among our elected representatives at the NSGC and ABGC so we can establish guidelines that can make it clear when ethical boundaries are crossed. I think many of us birds are living in Cloud Cuckoo Land, and don’t want to acknowledge the potential for problems here. The issues are not unique to the genetic counseling profession; everyone in medical care experiences these conflicts. We are just somewhat newer to the conflicts because of the rapid expansion of genetic testing over the last few years.

Comment on Are We There Yet? by Allie Janson Hazell

Allie Janson Hazell — Wed, 25 Apr 2012 02:17:47 +0000

Creative, clever and provocative as always, Bob. Very curious to hear what motivated this post. While I agree that conflict of interest in our profession is something that needs to be explored and talked about (and something you’ve written about before), I also know there are a lot of wonderful genetic counselors working in industry filling a valid and needed role. Would love to hear a little more about your thinking behind this!

Comment on Are We There Yet? by Sarah

Sarah — Tue, 24 Apr 2012 20:14:20 +0000

Great post! Very creative!

Comment on Three Counseling Tip-lets To Make Your Job Easier by AnneM

AnneM — Tue, 24 Apr 2012 13:56:31 +0000

Better still is the suicide double slash, particularly after the patient has seen that the other dead people get the single slash. That’s definitely a moment to use some sleight of hand distraction technique.

Comment on Are We There Yet? by Katie Stoll

Katie Stoll — Tue, 24 Apr 2012 07:20:48 +0000

Wow! Thanks for this post, Bob! It has me really fired up! Brings me back to another wonderful post of yours: Blind Spot: Genetic Counselors and Financial Conflict of Interest*. June Peters posted a very well thought out comment to that post in which she presented some excellent ideas of how the NSGC could work towards a more sound ethical framework that could steer our professional organization in the opposite direction from the way you have portrayed the NSGSS here. How do we take that next step? I feel like I am spinning my wheels thinking about these issues and wishing there was something more I could do to shift the balance in our field to a place of less corporate influence. Can we grow a big enough collective voice to do that? I absolutely want to be a part of that voice…but where to begin?

* http://thednaexchange.com/2012/01/15/blind-spot-genetic-counselors-and-financial-conflict-of-interest/