Deborah Brugman, MS, CGC, is a genetic counselor at Indiana University's Department of Medical & Molecular Genetics. Previously, she has done pre-natal genetic counseling and helped coordinate a Down syndrome clinic. Brugman, 27, received her undergrad at Purdue University and her master's in genetic counseling at the University of South Carolina.
8:00 a.m. On Mondays we see cancer patients, and I usually see two to three new patients every Monday. The visits run about an hour and a half each. I get in the office and prepare the charts of the cancer patients I am going to see and make sure I have the paperwork for the visit, which includes the patient's registration form and the consent form. I make sure that my records for the patients are up-to-date and accurate.
9:00 a.m. I see the first patient of the day. It can either be someone with a family history of breast cancer or have breast cancer themselves. I get a thorough personal medical history and family history from the patient and review it.
10:00 a.m. I speak with the on-call physician about the patient's history and figure out the possibility of the patient having an underlying condition or a hereditary predisposition to cancer. We talk about the appropriateness of testing for BRCA1 and BRCA2, the most common genes associated with breast and ovarian cancer. There are some other conditions that the doctor and I have to check for after running through the histories to see what is appropriate for the particular patient.
10:15 a.m. Both the doctor and I come in to talk with the patient and come up with a summary plan and talk about whether they would like to do testing or not.
10:30 a.m. I have the second new patient of the day, and I run through getting the preliminary medical histories, confer with the doctor and then talk with the patient about next steps.
12:00 p.m. During lunch hour I return phone calls and read up on some medical literature.
1:00 p.m. I see another new patient and do the same steps I did with the other two.
2:30 p.m. I generally have a results session in the afternoon where I discuss the results of genetic testing with the patient. The doctor I work with is a very good phlebotomist, so he draws the blood for the tests, and then we ship it out.
3:00 p.m. I have another results session with a different patient.
3:30 p.m. I dictate letters and type them up from the earlier patient visits. I make sure all the paperwork is submitted for insurance or letters of medical necessity for testing. I also gather more medical records for the patient or the family. For instance, I request pathology results from the patient's surgeon.
5:30 p.m. I wrap up from the day's clinic, and prepare for the next day's patients.
6:30 p.m. I leave the office and get refreshed for the next day.