Genetic counseling is a specialized health care profession at the intersection of human genetics, clinical medicine, and patient support. Individuals often seek these professionals when considering genetic testing and wonder about the specific medical actions a genetic counselor can perform. A common question is whether they can directly order the sophisticated laboratory tests they discuss. Understanding the genetic counselor’s distinct function within the medical team clarifies their authority and their unique contributions to genetic health care.
The Primary Function of Genetic Counselors
Genetic counselors are health care professionals with specialized master’s degrees who focus on providing detailed education and risk assessment to patients. Their initial work involves a thorough analysis of a patient’s personal and family medical history, often constructing a detailed pedigree to visualize inheritance patterns. This process allows them to determine the probability of a genetic condition occurring or recurring within a family, which forms the basis for their guidance.
They are trained in non-directive counseling, meaning they present information about genetic conditions, testing options, and potential outcomes in an unbiased manner. This empowers patients to make fully informed and voluntary decisions that align with their personal values and beliefs. Their role is separate from diagnosing or providing medical treatment, which are functions reserved for physicians and other medical providers. Instead, they provide the context, support, and specialized knowledge necessary for navigating complex genetic information.
Legal Authority to Facilitate Testing
The ability of a genetic counselor to independently order a genetic test is not uniform across the United States; it varies significantly based on state-level licensure and the specific policies of the employing institution. The concept of “scope of practice” defines the procedures and actions that a licensed health professional is legally permitted to perform. In some states, the licensure law explicitly grants genetic counselors the authority to identify, order, and coordinate genetic tests as part of their practice.
However, in many other states, the legal language is more restrictive, often limiting the counselor’s scope to “identifying and coordinating” testing. This requires collaboration with a physician to sign the final test requisition. This collaborative model often involves the genetic counselor selecting the appropriate test and managing the process, while a physician acts as the ordering provider of record. The trend in state legislation is moving toward recognizing genetic counselors as independent providers, but this evolution is not yet complete.
The Practical Steps of Genetic Testing
Regardless of who signs the final requisition, the genetic counselor is the primary coordinator and logistical manager of the genetic testing process. Once a test is recommended, the counselor ensures the patient provides informed consent, understanding the test’s benefits, limitations, and potential implications for their family.
A major function of the genetic counselor is navigating financial and administrative hurdles, particularly prior authorization. Because genetic tests can be expensive and complex, insurance companies often require a detailed justification of medical necessity before agreeing to coverage. The counselor’s expertise is used to prepare this documentation, ensuring the correct Current Procedural Terminology (CPT) codes are used and that the selected test panel is appropriate and cost-effective. The counselor coordinates with specialized laboratories, tracks the sample collection, and monitors the entire process until the results are ready for interpretation.
Communicating and Interpreting Complex Results
Once the laboratory returns the genetic data, the genetic counselor’s specialized expertise is indispensable in translating the technical report into understandable, actionable information for the patient. Genetic test results are often highly technical, detailing specific changes in DNA sequences, or variants, that may or may not be clearly linked to a disease.
The counselor is skilled at explaining the clinical implications of findings, such as a pathogenic variant that confirms a diagnosis or a variant of unknown significance (VUS). They provide specialized risk communication, helping patients understand what a positive or negative result means for their future health and that of their relatives. They also provide necessary psychological and emotional support, helping patients cope with the news of an inherited condition and providing referrals for medical management based on the findings.