Cassandra Runke

Mayo Clinic Labs @ Work

Thousands of people in hundreds of different roles work at Mayo Clinic Laboratories. Mayo Clinic Labs @ Work offers a glimpse behind the scenes into this busy reference laboratory, featuring staff from throughout the organization talking about what they do and why they do it.


What brought you to Mayo Clinic Laboratories, and how long have you worked here?

I graduated from University of Wisconsin – Madison with my genetic counseling degree 15 years ago. I was looking for a position in the Midwest, and Mayo had lab positions open. At the time, I didn't have much knowledge about laboratory genetic counseling, but I applied. So my first exposure to what a lab genetic counselor does was during the interview process. It sounded like a good fit for me. When I accepted a job in the Cytogenetics Laboratory, I thought it would be a great first job. That was 15 years ago, and I have no plans on leaving. I'm very happy with what I'm doing.


What is your job title, and what does your typical day-to-day work involve?

I'm a genetic counselor. Within the profession, a majority of genetic counselors are patient-facing. They discuss implications of genetic diseases or history of genetic diseases with patients directly. Until recently, I saw patients about 10 percent of the time in Mayo Clinic's Craniofacial Clinic. I'm stepping away from that for now, but I still definitely feel like a whole-hearted genetic counselor in my lab role.

The biggest difference in a lab role is that we're talking to clinicians or other lab staff, not providing direct patient care. We're working with clinicians to give them the tools to then give that information to their patients.

We connect with providers at multiple points. We get a lot of tests ordered by general practitioners who are not all that familiar with genetic tests. They may call us saying, "I've just seen this family, and I'm not sure what to order. Can you help me?" At other times, we're called in when, for example, a technical specialist in the laboratory sees something, and they need more clinical information, so we may recommend adding a test to clarify a result. In those cases, we talk to the clinician or their lab in the middle of testing. Then we may also speak with them on the other side of testing once we have results. Although our results can stand on their own, at times it's helpful to have a conversation to explain them further or to talk about how to explain results to patients.

Until a few years ago, my role as a genetic counselor involved a lot of examination of appropriateness of testing to make sure that the right test was ordered for each patient. I also provided enhanced delivery of results. I have since transitioned to a variant interpretation role. I now spend a majority of my time looking at the copy number variants, which means deleted or duplicated genetic material identified by cytogenetic testing. I examine the genes in those regions and the literature about deletions or duplications of those regions. I then draft an interpretation of that case and pass it on to one of our consultants.

I perform tasks associated with the development of new tests, too. In addition, I have a lead role as a liaison between the genetic counselor group and Mayo Clinic Laboratories. I serve as a funnel for common issues that our genetic counseling staff experience across the labs we serve, and then I see if there are areas for improvement when we answer questions from our clients or clinicians.


How does the work you do for Mayo Clinic Laboratories affect patient care?

Laboratory genetic counselors are a bridge between the labs and the clinicians. We understand genetic results well, and we have the ability to distill those complex concepts, explain them clearly to clinicians, and aid in writing interpretations and materials. As a lab genetic counselor, I affect a lot of patients on a daily basis. When I see patients in clinic, I'm obviously having an impact on that patient and their family, but there are only so many patients I can see in a day. Lab genetic counselors, when we help develop an algorithm for patient testing, for example, affect many more patients when those tests get ordered. Or if we explain to a physician about ordering a certain test for a specific disease, that's going to have an effect for all patients in that category who they see after that.


Is there anything about your work that people might find surprising or unexpected?

When I first started, less than 10 percent of genetic counselors worked in lab roles. Now, it's more than 20 percent. Individuals may not realize how much of my genetic counseling skills I use in my lab role, even though I'm not seeing patients directly. It's been a real evolution to have genetic counselors play a role in the laboratory, and I think our skills will continue to be applied to many activities and increase what we can do.


What’s the most fulfilling part of your job?

It always feels good when I can find an answer for a patient. When I can help with a diagnosis, answer a question, or provide a resource or information they didn't have otherwise, it's very fulfilling. I also enjoy my role as a mentor for potential genetic counseling students. It's hard not to feel fulfilled when you enjoy your job and you get the opportunity to share it with others during their career exploration. I love and enjoy working with the colleagues I have. We have an excellent team of genetic counselors with an array of expertise. It's always interesting to see what they're doing, and I know I can reach out to any one of them if there's something I'm unfamiliar with or if I have a question. We have a great team that serves Mayo Clinic well, and is a great resource for the clients who work with us and order tests through Mayo Clinic Laboratories.

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Tracy Will

Tracy Will is a senior marketing specialist at Mayo Clinic Laboratories where she covers innovation, specialty testing, and advances in laboratory medicine. Tracy has worked at Mayo Clinic since 2016.