“Traditional versus Non-Traditional” ?

To be honest, I really dislike that phrase.

Related to Allie’s recent and timely post as well as my own recent job change, I have been thinking about “traditional versus non-traditional roles”. This phrase sometimes feels like code in “Genetic Counselor Speak” for seeing patients versus not seeing patients, or , employment in a genetics clinic in some capacity versus some engagement with genetic testing companies/interpretation of testing (admittedly, research counselors seem to fall somewhere in-between).

Non-traditional roles always seem to focus on the “genetics” side of being a genetic counselor, but there is little discussion regarding non-traditional roles related to the “counseling” side of being a genetic counselor.

Perhaps this is because GCs see some degree of counseling as intrinsic to the “traditional” model. Perhaps this focus on the genetics side is because there is little pay or other tangible incentive to take a counseling-centric approach. Perhaps it is primarily because we are not as well-trained to take on the more intensive, long-term counseling roles some patients made need as we are trained to take on the more intensive genetic interpretation roles. Perhaps many genetic counselors have less interest in this side of our field.

But, there is no doubt that the current emphasis in clinical genetics and genetic counseling is on factual information, patient education, patient autonomy, and yielding a profit (understandably) and NOT on therapeutic counseling. There is often less time to focus on the counseling side of our work unless you work extra hours, which leads to increased risk for burnout along with a decreasing ability to connect with patients and even coworkers. However, I think there is an alternative niche out here for us GCs with an interest in this type of “non-traditional” role. I think there is another way for GCs to remain interested in their work and grow.

I have been fortunate enough to feel that I frequently form a strong/meaningful patient-counselor bond and I do tend to derive a great deal of satisfaction from this, in both settings I have worked. But, I worry about burnout…I worry my abilities may diminish over time, or, equally scary, not improve without additional support.

Because I want to be as engaged and productive as possible in all areas of my life (as most of us want) without burning out, I can’t help asking myself the cliché question:

Do I work to live or live to work?

I think many genetic counselors face this question as the demands of “traditional” genetics roles become overwhelming and tiring (ordering and coordinating testing, keeping up on new trends in genetics, administrative tasks, insurances, attention to varied patient needs, etc, etc, etc..)

I do not want to live by either mantra above. I want my work to be meaningful, thought provoking, and impact others in varied ways. I want to be engaged with my work. At the same time, I do not want to work to be only defining factor to who I am or control my ability to engage in other interests, relationships, hobbies, travel, [insert your interest here]. I think the increasing demands on genetics departments from a genetics point of view can make it harder to find a satisfying work-life balance, particularly when it has been shown that the greatest deal of satisfaction from work often comes from the personal meaning we can find in our patient care. See quote from Genetics in Medicine in 2009:

We show here that increased “personal meaning in patient care” is inversely related to distress and burnout. Increased meaning may be derived by forming strong connections with patients. Such connections are fostered through bearing witness, which has been described by Naef as a fundamental process of “being there and being with, listening and attending to, and staying with persons as they live situations of health and illness, shape their quality of life, search for meaning, struggle to make difficult choices, and experience intense moments of recognition, fear, joy, and sorrow. (“Distress and burnout among genetic service providers” in Genetics in Medicine Volume 11, July 2009)

My recent silence on the public side of this blog has been partially related to some sense of disillusionment and internal confusion about where this profession is heading, where my own career is heading, and how much control I have over that in light of the economy and demands on genetics departments (perhaps common concerns to many GCs these days). When I hear or read someone is moving into a “non-traditional role” I get a little worried – where is the space for a “non-traditional” role that allows for more in-depth analysis with patients of the issues and implications of hereditary disease on people’s lives and families? Where is a role for me when/if I get “burnt-out” from the “traditional roles” of a GC in a genetics clinic?

Burnout and work-life balancing are big issues in many professions, but I wonder when and how often other GCs are feeling this strain. I wonder how many other GCs see furthering their counseling skills as another opportunity for a “non-traditional” role.

9 Comments

Filed under Jessica Giordano

9 responses to ““Traditional versus Non-Traditional” ?

  1. Rachel

    Thank you for this great article.

    I have often reflected on the fact that I fear that the “counselling” aspect of genetic counselling is becoming less emphasized in many of our positions. While saying this, I have never actually considered that furthering my counselling skills could be looked upon as a “non-traditional”. This article has given me something to think about.

    With regards to your question on whether other GCs find it difficult to find a good balance, I feel that this is a very real concern that many of us have and I can definitely say that I have felt this strain. I have been a GC for just over 2 years, but I have already left one position for not allowing me to find the work/life balance that I desired. I have also watched a number of my colleagues take stress leaves due to burn out. Thanks again for bringing this important issue into focus.

  2. Beth Balkite

    Perhaps the programs need to prepare students for the wider world of genetic counseling with less emphasis on “traditional” jobs and more emphasis on meaningful employment. My experience has been that recent grads are well prepared for a variety of positions but have been encouraged to go down a traditional path by their programs.

    • New GC

      As a recent grad floundering in the job search under mounting financial pressure, at this point my ideal GC job seems pretty irrelevant. I would jump on any opportunity in my area, traditional or not. I hope a non-traditional job won’t hurt my future employment opportunities, but at this point I don’t have a way to evaluate the risk, and I also need to find a job for the present.

      Beth- What sort of “non-traditional” positions do you think new grads are qualified for? I would appreciate suggestions of new avenues to pursue.

      • Beth Balkite

        I think new grads have the knowledge, skills, and abilities to work in any area of healthcare. Their skills translate into areas such as research, education, and other types of counseling. These skills are needed as genetics/genomics continue to become even more integrated into medicine in general. For example, the American Academy of Family Physicians supports the “medical home” model, a team approach to helping families with children with special needs. At present there are no genetic counselors on this “team” that goes into the home and works with the families. Is this a new area for GC’s, because there is money to support it? If you have not read chapter 17 in A Guide to Genetic Counseling, it may give you ideas of jobs you have not thought of. Pages 532-534 list many different positions beyond the more traditional genetic counseling jobs. Sometimes we have to be very creative in our thinking when jobs are not forthcoming and approach hospitals, practices, community outreach groups and market our services to them.

    • Jan

      I would agree Beth. At one point I lost my gc job and had to think ‘how can I use my skills in another venue’? I found a position that used our great communication and people skills as well as analytical skills. In fact, the job description called for being able to communicate technical information from one group to another (sound familiar!). As a rule (at least back then) I think it was hard for genetic counselors to think about what they could do if the traditional job wasn’t there. Think outside the box and be open to other possibilities.

  3. New GC

    Thanks for the ideas, Beth, I will definitely take a look at the sources you suggest!

  4. Leslie

    As someone who is preparing for a career in genetic counseling, I find these past few posts very valuable. Although I have found the “traditional” (sorry, Jessica!) role very appealing, I’m enjoying reading about the other career paths I might take. Thanks to everyone who has contributed in the comments.

  5. Kathryn Spitzer Kim

    I want to comment on the idea that it takes extra time to “focus on the counseling side” of our job. Counseling should not be an activity separate from providing information: it can be an approach to giving information (the psychoeducational model of counseling). It is a way of communicating that makes sure the information is delivered in a personally relevant way rather than a cookie cutter approach that presumes all people want the same information delivered in the same way. It is because we are counselors that we are more useful than a recorded message. If we lose the counseling approach, our unique profession will cease to have a reason to exist.

  6. Meena

    Thank you Jess for your thoughtful article. I would like to leave a comment or two about the non-traditional counselling role I currently work in as I have found it difficult to come to terms with and I thought I would share my journey.
    Two years ago, I graduated with a genetic counselling degree with a feeling of great delight at what I was going to be able to do. The amazing feeling of being able to help the public and to be integrated into the web of society as a “pillar” gave me a sense of meaning. Initially, I found it difficult to obtain a job in the months after I graduated. I then gratefully accepted a full time casual position at the only prenatal/peds clinic around and worked there for a year before being laid off. It was a wonderful experience and I loved every moment of my counsellor-patient interactions. Alas, in the current climate, health care cuts and all, I could not stay. Then as this position was coming to an end, serendiptiously an opportunity in industry came to me. Let me tell you–it is very important to network! Although it was not my ideal job, I thought it would be pretty stupid if I did not take it, especially since I was quite intrigued by the job specifications and it was a full time, permanent, benefit giving, student debt reducing, marriage stabilizing, perks providing, challenging and interesting job that would still require the use of my genetics knowledge–who could ask for more?
    I have now been working as an account manager, in the prenatal and newborn screening business for approximately 8 months. At the beginning, I loved the newness of it all; I learned things I never knew before and I was meeting key opinion leaders. It was a steep learning curve– after all, it was not like I was trained to be a hot shot in business. It then became scary as I quickly learned that my compassionate, soothing, help the world sort of attitude needed to be armoured with an edginess to make sure I did not get walked all over, to keep me on guard and to get what I wanted for my clients and myself. Of course, there was the money thing too, I needed to actually care about making money to reach company goals. It quickly became overwhelming because in the midst of it all, the question came up “am I meaningfully helping people?” I realized that my heart was sinking because I did not have the patient interaction, you know, where your patient gives you that “thank you for being here”, or the visit after the baby is born showing you how grateful they are that everything is alright. I agonized over what I really wanted out of life and sought to be enlightened. After a couple of months of questioning everything about my job, I realized that in fact I was helping people. My clients come to me at their times of need which include ordering items, technical assistance, purchasing new things, expanding screening etc. It may not be what I was trained for exactly, but I still get the thank you’s, I still get opportunities to educate and be educated by these clients, and I still get to learn about what makes society tick. Furthermore, I know what happens in the genetic testing world and how policies are formed. I am still using empathy while communicating with my clients and assessing their needs , so I do not fear that my contracting skills will ever be lost! I meet the smartest people- a lot of whom are my colleagues and clients and, at the same time, I have so much fun! Oh, and the money thing comes easily when you are honest, empathic and helpful.
    For a while there, I could not see past the fact that I was not a genetic counsellor anymore, but once I got over the initial shock and looked past the expectations I never knew I had, I realized that I am not far from being the genetic counsellor I knew I was meant to be.

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