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Southampton Hospital’s newest service takes preventative medicine down to the basic building blocks of life: a patient’s DNA.
The first genetic counselor on the East End, Emily Smith, started work at the hospital’s breast health center last month, testing for breast and ovarian cancer risk. The service eventually will be expanded into other areas of genetic counseling.
Ms. Smith’s job is more than just about physical health. In addition to identifying risks and offering DNA tests, she offers psychological support to help patients reach decisions.
Ms. Smith said her appointments with patients usually last between one and one and half hours as family trees are mapped out and investigated. Patients for whom it was decided their DNA should be tested will have at least two appointments, one pre-test and one post-test.
In the case of a woman at high risk for breast cancer, Ms. Smith said she may recommend yearly mammograms and MRIs, medication or a prophylactic mastectomy.
Genetic diseases cause tremendous anxiety, especially for parents who fear passing on a genetic abnormality to their children, commented Dr. Fred Weinbaum, Southampton Hospital’s chief medical officer and chief operating officer. A genetic counselor can provide support and let them know whether or not kids are at high risk—as well as other relatives whom a patient should warn of risks they may face, he said.
“It’s one thing to have a blood test,” Dr. Weinbaum said. “It’s another thing to know what to do with it.”
Seeing a genetic counselor is different than visiting a doctor because it non-directive, Ms. Smith said. She explained that while a doctor will tell a patient what to do, a genetic counselor says, “These are your options.”
“Genetics isn’t the be all and end all,” Ms. Smith said, pointing out that social and environmental factors, such as a bad diet, UV exposure and a lack of exercise, contribute to cancer risk.
Until the breast health center facility is complete, Ms. Smith is working out of the Southampton Hospital Annex, the former site of the hospital’s nursing home, which was closed two years ago. The annex now houses the Human Resources Department and osteopathic medicine students in Southampton’s growing medical education program.
The breast health center is in a transitional phase. All of the hospital’s breast care resources are being relocated to a state-of-the-art facility designed to improve patient care and comfort.
Human Resources relocated to the annex from the main hospital building to make room for the new breast health facility, which will bring pathologists, radiologists and other personnel for diagnosing and treating breast cancer all to one place.
Demolition is complete and reconstruction will begin soon, said Dr. Weinbaum.
The hospital has had a breast health center since 1996 and has developed a strong following among patients, said Marsha Kenny, the hospital’s director of public affairs and marketing. “People feel comfortable here,” she added. The hospital offers emotional support in addition to clinical support she said.
The hospital charges $75 for an appointment with Ms. Smith. It is not covered by insurance.
That lack of insurance coverage for visits is one reason it has taken this long for genetic counseling to come to the East End, Dr. Weinbaum said. “Insurers really haven’t caught on to the fact that this is an important and necessary service,” he said.
If DNA tests are performed, they are at least partially covered, however. If patients meet certain risk criteria, insurance providers will pay for at least 90 percent of the cost of a $3,000 DNA test for the BRCA 1 and BRCA 2 genes that indicate a high risk for hereditary breast or ovarian cancer, Ms. Smith said.
The DNA samples are sent to a Myriad Genetics in Utah to test for the BRCA genes and results come back in three or four weeks. The chance of having the genes is less than 1 percent in the general population, but family history of cancer can denote a higher risk, Ms. Smith said.
Ms. Smith said Southampton Hospital’s genetic counseling program is taking a grassroots approach to get off the ground. She reaches out to doctors, who, in turn, refer patients who have cancer or are at a high risk of developing cancer.
Originally from Connecticut, Ms. Smith studied genetic counseling at Northwestern University in Chicago before returning to the East Coast to accept the job offer from Southampton Hospital. While in school, Ms. Smith had a wide variety of on-site training, she said. She did her field work at University of Chicago’s cancer center, the University of Illinois Medical Center’s pediatrics department and Northwestern’s prenatal department.
Dr. Weinbaum said the Ovarian Cancer Research Fund made starting a genetic counseling program possible for the hospital. The fund provided a grant to recruit Ms. Smith and get started, he explained.
Ms. Smith will give a free seminar on genetic counseling in January as part of Southampton Hospital’s “Health Insights” lecture series. The date of the lecture has not been announced.
