Genetic counselling in private practice - an Australian perspective
Australian genetic counsellors historically have been employed as part of a clinical genetics unit either in a hospital or an outreach setting in the public health sector. In 1990 a small group of genetic counsellors myself included were employed by NSW Health and it was also at this time our profession in Australia was established. I was employed at Sydney's Royal North Shore Hospital providing a prenatal genetics service with a clinical geneticist employed part time. Some years later an outreach paediatric and adult genetics service was established with the clinical genetics unit at Sydney Children's Hospital. In 1998 I joined Sydney Ultrasound for Women [SUFW] a multi centre private practice specialising in obstetric and gynaecological ultrasound. The practice recognized genetic counselling to be an integral part of providing a prenatal testing service with the growth of testing in chromosomal and genetic disorders. The team I joined consisted of obstetricians with subspecialities in maternal fetal medicine, obstetric ultrasound, clinical genetics and obstetric sonographers. This was a new direction for the practice as four of the six doctors had not worked with a genetic counsellor.I was moving into uncharted territory for the second time but on this occassion I had no colleagues to compare notes with or brief me on what to expect.Isolation from my colleagues working in the public health system and a lack of understanding of my role in private practice has been at times frustrating and lonely.
Private referring doctors and their patients have high expectations of the professionalism, expertise, care and the environment of the practice. They are paying for a service and expect the best. Therefore it is not uncommon to work long hours and miss lunch breaks but at the end of the day the satisfaction of seeing a couple appreciate the time and care given to them all but makes up for the downsides. Nearly eight years later I can look back and see my role in the team has evolved and grown. Education, persistence, expanding my medical network and a good working relationship with the team has been the key to successful intergartion of the genetic counsellor into private practice.