Bridging the gap between Industry and Clinical GCs
By Sara Mokhtary-Myers, MS CGC
Just shy of four years after earning my master’s degree in genetic counseling, one of our team’s local laboratory representatives asked whether I might be interested in a liaison‑type role. My first instinct was to talk myself out of it. What could I—a self‑proclaimed “newbie GC”—offer to providers with far more experience than I had?
But then that familiar voice of curiosity kicked in. As a Californian who hadn’t seen much beyond my home state, I started fantasizing about the travel: seeing new places and meeting genetic counselors and providers across the country. I was also intrigued by the opportunity to develop skills that weren’t heavily used in my clinical role—public speaking, marketing, and collaborating with professionals outside my specialty. So, I took the plunge and submitted my résumé.
What followed was a four‑year adventure and a period of exponential professional growth. The experience fundamentally reshaped my understanding of genetic testing. I learned to see beyond genetics as a standalone service and instead recognize it as one component of a much larger healthcare ecosystem. I gained a deep appreciation for the inner workings of the laboratory and for the many people involved in moving a test from sample to report. As a clinical genetic counselor, I had been largely unaware of the sheer volume of coordination, expertise, and effort required behind the scenes.
As more genetic counselors move into industry roles, awareness of the diverse positions GCs hold continues to grow. Still, there remains significant opportunity to strengthen shared understanding—and to clear up persistent misconceptions—between clinical and industry settings. To help bridge that gap, I reached out to Texas‑based genetic counselors working in industry and asked what they wished clinical GCs better understood about their roles.
Here’s what they shared.
Collaboration on Complex Cases Can Have Meaningful Impact
Andi Lewis, a GC at Quest Diagnostics, shared a powerful example of how collaboration between clinical and industry GCs can directly affect patient care:
I was recently contacted via email by a genetic counselor asking about the current variant classification for a previously identified VUS in an epilepsy gene. The GC was hesitant about disclosing additional clinical information along with the request, so we proceeded with a formal variant re-evaluation. Unfortunately, the variant stayed classified as a VUS. After some prompting, the counselor agreed to get on the phone with me to discuss additional clinical information so that I could document it for the family members we had tested. After a second round of variant re-evaluation, the variant was upgraded to Likely Pathogenic! This was important because an unaffected sibling was exploring PGT-M for the familial epilepsy gene variant, which would have been challenging with a VUS classification. Some of the most important clinical details were not made available upfront, which could have expedited the variant classification upgrade for this family.
Supporting Providers Without Access to Clinical GCs
Industry GCs also play a crucial role in supporting non-genetics providers who order genetic testing—often at a much higher volume than clinical GCs may realize.
One GC, who wished to remain anonymous, shared:
Genetic counselors might underestimate the volume of genetic test orders we receive from non-genetics providers, especially at large reference labs such as Quest. As such, a lot of our work is supporting this cohort of ordering providers to ensure good genetic testing practices including: verifying orders to ensure accuracy, ensuring report language is clear, supporting operations/logistics of ordering complex tests, and providing support for understanding results in the context of their patient’s health history.
When in Doubt, Ask Your Lab GC
Differences in variant classification can be a source of frustration, but industry GCs can help provide important context.
Andi explained:
Each lab tends to have their own, customized variant classification scheme which is typically based on ACMG guidelines, but is not an exact match. Sometimes clinical genetic counselors are frustrated that they have classified a variant as one thing but the laboratory has it classified another way, or are frustrated by discordant classifications between labs. Labs develop their own schemes to better utilize their unique experiences and resources which your lab GC can help you to understand in the context of your clinical scenario.
Industry GCs Are Still GCs
A recurring theme from industry counselors was the misconception that moving into industry means leaving patient care behind.
Andi: I come from a clinical patient-care background and I haven't forgotten that, which called me to this profession in the first place. Every case that I handle is not just an accession number- it's a patient and a family, and it is important.
Damini Morah, Myriad Genetics: A big misconception is that a GC working for a lab has “sold out” and is only interested in the number of tests, not what is best for patients. Many GCs in the lab space have a strong clinical background and are very patient-centered! Lab GCs are only a representative of their lab, so it’s good to have honest conversations with full transparency.
My time in industry reinforced a simple truth: when clinical and industry genetic counselors communicate openly and collaborate, our shared expertise translates into better outcomes for the patients and families we serve.