Genetic counselor offers time, empathy, expertise

Robbin Palmer sits quietly and listens carefully.

That's a rarity in a medical industry in which practitioners feel pressure to increase revenues by seeing more patients more quickly, but Palmer needs first to listen carefully before she can do her work.

She works as a genetic counselor, providing information and support to families with a history of birth defects or genetic disorders.

Palmer,whose one-person business is known as Northern Nevada Genetic Counseling, doesn't conduct genetic testing.

That's another specialty entirely.

Instead, she gathers information about family histories, helps patients understand their genetic risks and reviews their options with them.

It's work that's growing in importance as researchers find genetic links to increased numbers of health conditions.

"Human development is awe-inspiring most of the time," says Palmer."But sometimes, things can go terribly wrong."

About 10 percent of all cancers, for instance, appear to be related to heredity.

Her work is time-intensive.

"We draw a person's pedigree, usually back to at least grandparents," Palmer says."This alone takes about half the time that a medical physician would have available for an appointment."

Because physicians have limited time, she says, they're often unable to cover issues of critical importance to families issues such as insurance coverage of genetic testing or the self-esteem issues that sometimes arise.

Emotional issues are just as important as scientific questions, and Palmer's work sometimes involves patients who simply need assurance that they are not at risk.

Palmer usually meets with patients at the offices of their physicians.

The Reno Diagnostic Center also provides space for meetings.

It's not unusual, she says, that a multi-generation medical history will point up a health risk entirely different from that which first caught the patient's attention.

Counseling sessions don't inevitably lead to full-blown genetic testing.

Palmer wants her patients to understand their risks on their own and make their own decisions.

A genetic counselor for 15 years, Palmer has worked in Reno since 1995.

Her interest in genetics dawned when she was a teen-aged volunteer working with developmentally disabled people.

She completed a doctorate in developmental biology from the University of Cincinnati.

After working as a laboratory researcher, Palmer grew weary of white rats and longed to work with people.

She returned to the University of Cincinnati for post-doctoral work in genetic counseling and was certified in 1990 by the American Board of Genetic Counselors.

Only California,Utah and Illinois require licensing of genetic counselors, and no licenses yet have been issued in California because regulations haven't been written.

Although she's been in business in northern Nevada for a decade, Palmer describes her service as "way,way,way underutilized in Reno." "I will do about anything to get the word out," she says."Most of the physicians here know what I do." To spread the word, she's involved with March of Dimes.

She attends a weekly physician conference on breast cancer.

In the meantime, she keeps herself updated about the fast-changing field through a steady round of professional conferences and Webbased discussions with specialists in genetics.