An Evaluation of the Current Relationship Between Genetic Counselors and Palliative Oncology Providers at Mayo Clinic

Introduction: There is growing evidence to suggest that the integration of genomics into the palliative oncology setting is not only critical for the identification of individuals who may be at increased familial risk; but that it is also a key component of providing family centered care - a concept at the heart of both genetic counseling and palliative care alike. Barriers to this integration have been well described, and some strides have been made in describing the current genetic practices and policies within palliative oncology. However, most of this research has been in the form of broad literature reviews performed outside of the United States. Methods: To better describe regional genetics-palliative practices, an online, qualitative survey was distributed to both cancer genetic counselors and palliative oncology providers at four of the US Mayo Clinic locations. The survey was used to illuminate the current processes, policies, and relationships between the groups; as well as to identify potential improvements. Results: Responses were received from 15 MD/DOs, 9 PAs, 16 NPs, 27 RNs, 4 GCs, and 8 “Others,” of which 54.4% worked primarily in hematology & oncology, 35.4% in palliative care, and 6.3% in genetic counseling. 89% of palliative care providers and 62% of oncology providers reported never or only once yearly referring patients for genetic counseling; citing that they were (1) unaware of genetic counseling resources or referral processes, (2) uncertain on how genetic testing would influence patients’ medical management, and (3) felt it was out of their scope of practice. Similarly, each genetic counselor that responded reported never or once yearly receiving referrals from palliative care. Conclusion: While additional, larger studies are required to most accurately represent the practices of genetic counselors and palliative oncology providers at the Mayo Clinic, this study suggests that providers across all specialties surveyed would find additional resources for referring patients to both palliative care and genetic counseling to be useful. Thus, future efforts could be directed towards educating palliative oncology providers on the role of genetic counselors, as well as educating genetic counselors on the role of palliative care.