When the human genome was first sequenced two decades ago, experts saw two paths forward for genomics in healthcare. Either it could be a “boutique” area of medicine for the wealthy, or it could be a powerful tool for population health and prevention of common diseases for the masses. It would depend upon the vision and creativity of the physicians and genetic counselors working in the field to determine the way forward.
At Geisinger, a small team of genetic counselors led by W. Andrew Faucett, MS, LGC helped to build genomic medicine infrastructure no other health system can duplicate. Its aim is decidedly “not boutique.” Instead, genomics at Geisinger hinges on cutting-edge research dedicated to providing medically useful information to doctors in clinics ranging from oncology and neurology to primary care. This work is carried out by multidisciplinary teams in which genetic counselors play a prominent part.
“Geisinger encourages genetic counselors and prepares them for leadership roles,” Faucett said. “There are no preconceived restrictions on what a genetic counselor can do.” In the clinic, they are embedded members and leaders of the healthcare team. But beyond patient care, Geisinger invites its genetic counselors to consider unusual and nontraditional roles. GCs are principal investigators on research grants, oversee clinic operations and run institutes. “In addition,” Faucett said. “Geisinger genetic counselors, Amy Sturm and Brenda Finucane are both past presidents of the National Society of Genetic Counselors, and Adam Buchanan is the past president of the American Board of Genetic Counseling. These are the ultimate leadership positions in our field -- to have three people at Geisinger who served in these roles is pretty extraordinary.”
Given the diverse and important roles the system awards to both genomics and genetic counselors, Faucett said Geisinger is the perfect place to develop a genetic counseling degree program with a distinct point of view. And Faucett and team are now laying the groundwork for it. The program will rely on the knowledge, expertise, and diverse experiences of Geisinger genetic counselors who are national leaders in the field. Counselors like:
- Andy Faucett himself, who led Geisinger’s MyCode program, the largest health-system-based genetic study in country, which was the first to return medically actionable results to participants.
- Adam H. Buchanan, MS, MPH, CGC, the first genetic counselor to lead a genetics department at a major health system. “There is not another genetic counselor in a similar role in the country,” Faucett said. Buchanan is also past president of the American Board of Genetic Counseling.
- Amy Sturm, MS, CGC, co-director of the MyCode Genomic Screening & Counseling program and past president of the National Society of Genetic Counselors, leads research on “Gia,” a “cutting-edge” chatbot that helps patients understand their results and communicate their findings with family members. Amy also leads research related to health behaviors after receiving a result; “cascade testing” throughout a family; and how to build better genomics tools into the EMR.
- Brenda Finucane, MS, CGC, served as associate director of Geisinger’s Autism & Developmental Medicine Institute (ADMI) and is an international expert on neurodevelopmental disorders. She has held leadership positions at the National Fragile X Foundation and other patient advocacy organizations, in addition to being past president of the National Society of Genetic Counselors.
- Erin Riggs, MS, CGC, assistant professor at Geisinger’s Autism & Developmental Medicine Institute, is a principal investigator of the Clinical Genome Resource (ClinGen), a National Institutes of Health (NIH)-funded program dedicated to building an authoritative central resource that defines the clinical relevance of genes and variants for use in precision medicine and research. She led the development of the 2020 ACMG/ClinGen technical standards for the interpretation of constitutional copy number variants, a standard that will be adopted by clinical laboratories around the world.
- Cassidi Dailey Kalejta, MS, CGC, oversees clinical operations for the MyCode project and co-chairs Geisinger’s Genetic Counseling Professional Council (GCPC), first formed by W. Andrew Faucett, and is co-chair of Geisinger’s Genetic Counseling Professional Council. Directing operations allows her to use her counseling skills in a powerful administrative role that shapes clinical care and empowers her to serve as an advocate for clinical genetic counselors.
- Lindsay A. Bailey, MS, CGC, was named associate program director to help develop a genetic counseling degree program at Geisinger Commonwealth School of Medicine. Bailey’s goal will be to use her experience supervising clinical rotations to incorporate early, diverse, and meaningful clinical experiences into the proposed curriculum.
W. Andrew Faucett, MS, LGC
"We use genetics in news ways and have fewer roadblocks. Today, genomics can be used in almost every specialty, even family practice. It’s the future and Geisinger will be there before anyone else. It respects its genetic counselors and encourages them to realize their full potential. That’s why Geisinger is the perfect place to be a leader in the field."
Adam H. Buchanan, MS, MPH, LCGC
Director, Geisinger Genomic Medicine Institute
"Genetic counseling is growing rapidly, in different places and with different ways to practice. Geisinger is at the forefront of testing some of those ways. We are getting out ahead of disease, screening larger populations for risk. We are moving genetic counseling from a reactive to a proactive field and this means moving from specialty practices to primary care, and we have some pilot work underway in that area. At Geisinger, there is so much of opportunity to practice this proactive kind of genetic counseling. It’s just not available elsewhere."
Amy Sturm, MS, LGC
Professor, Genomic Medicine Institute and co-director, MyCode Community Health Initiative Genomic Screening and Counseling Program
"One thing about Geisinger is innovation, especially the My Code project. Most health centers don’t have a large segment of patients enrolled in a biobank coupled with genomics information. We have more than 200,000 individuals. It’s an amazing resource for research and building clinical programs."
Brenda Finucane, MS, LGC
Associate director of Geisinger’s Autism & Developmental Medicine Institute (ADMI) (retired)
"In 2012, I was recruited as the associate director for a newly formed Autism & Developmental Medicine Institute at Geisinger. I feel very fortunate to have spent my entire career in a scientific field that continually evolves. While it can sometimes be challenging to keep up with the rapid pace of new developments, it’s exciting at the same time, and there’s no room for boredom. Many past mysteries now make sense, but there’s still so much to learn. This is true for all practice areas in genetic counseling, and it will be a dynamic field to work in for decades to come."
Erin Riggs, MS, CGC
Assistant professor, Geisinger’s Autism & Developmental Medicine Institute (ADMI)
"There’s no way I would have imagined the career I have now at Geisinger. Being able to participate in genomics research, a field that is constantly evolving, has been so rewarding. Contributing my ideas to these efforts allows me to potentially impact the lives of individuals around the world."
Cassidi Dailey Kalejta, MS, CGC
"Overseeing clinical operations is a newer role for a genetic counselor in the workforce. The GCPC, also a unique opportunity for leadership, allows genetic counselors to strive for excellence in their various roles at Geisinger. Working directly with care teams and translating their needs to upper management is important and being the communication stream between those on the frontlines and those pursuing for more efficiencies helps build success for the entirety of the organization. I find fulfillment in bridging that gap and I like to remind genetic counselors that they have the skillset to step into these new and important roles."
Lindsay A. Bailey, LCGC
Genetic Counselor II and new associate program director, GCSOM’s proposed Genetic Counseling degree program
"Our program will focus on providing clinical experiences with a variety of different patients and indications. At Geisinger, genetic counselors are embedded in the care teams across a wide spectrum of specialties, so one educational goal will be to make sure learners feel confident tackling any clinical job, in any genetic counseling specialty. And we want to provide those experiences early in the curriculum. Also, Geisinger offers a great deal of nontraditional careers in genetic counseling, including research and administrative roles. We want future learners to gain exposure to the full spectrum of possibilities available in the field of genetic counseling."