Before I started my rotation with UPMC’s
Utilization Management team, I was nervous. This was my first clinical
rotation, and there’s always the fear of the unknown when doing something new.
Looking back, I was initially worried that I wouldn’t do a good job, or I’d be
unable to answer questions about a condition or testing technique in front of
the counselor. After completing this rotation, I can confidently say that I did
not need to be so anxious about the start of this rotation.
A few days before my rotation began, I was paired with a
genetic counselor “buddy” who would guide me through everything from reviewing
patient charts, assessing how appropriate specific testing is for a given
patient, and to generally being my point of contact for the entire
rotation. As soon as I met my “buddy,” I knew this rotation would be a great
experience. On day one, I was able to view patient charts to gain a better
understanding as to why one particular patient would receive one specific
genetic test while another patient would receive a different genetic test even
if they came in with the same concerns. As time went on, I became more
confident in my abilities to analyze records and understand why a particular test
was offered. Eventually, I met more genetic counselors who work in the Genetic
Testing Clinic and are on the Utilization Management team. I was able to
observe telemedicine cases, result disclosures, and even participate in cases by
taking family histories.
I expected to see times where a testing review came in,
where genetic testing wasn’t warranted or appropriate, and consequently, the UM
team would have to tell a patient or provider that they couldn’t or shouldn’t
have testing based on what’s seen in the patient’s chart. However, that was
never really the case. More often, when a situation came up where the UM team
thought that the testing ordered was not appropriate, we were able to have a
discussion with the physician to talk about why he/she would like to order that specific test, or
if a different testing option had been considered. The UM team wasn’t created
to tell people “no,” it was created to help determine if the most appropriate
test is ordered so that the patient receives the best treatment. In addition to
reviewing testing requests, the UM team also helps educate physicians, nurses,
and other healthcare professionals on why testing is being ordered, and what
specific tests are the most appropriate for their patients, among other things.
I developed a new appreciation for all the different things UM genetic
counselors do on a daily basis.
I appreciated the flexible nature of the rotation and the
variety of activities available to me. A great aspect of this rotation was that
the counselors were fantastic about asking if I wanted to join in on a case
with them. Additionally, I enjoyed getting to talk through example situations
with the genetic counselors. They would ask questions like “so what would your
next steps be?” or “and what if that test came back negative?” which really
made me think through my responses. I knew that there was rarely a right or
wrong answer to their questions, but I always appreciated their feedback.
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| Michael Gosky, class of 2021 |
