Holly Zimmerman, MS, CGC® is an Assistant Professor and Genetic Counseling Program Director at the University of Nebraska Medical Center. Dr. Omar Abdul-Rahman is a Friedland Professor and Director of Genetic Medicine at the Munroe-Meyer Institute for Genetics and Rehabilitation at the University of Nebraska Medical Center.
Throughout their careers, the two have worked closely together to provide a level of holistic patient care, leaning into each other’s strengths. They were nominated for ABGC’s Spotlight program by Kate Wilson, MS, CGC.
How did you two meet and come to work together?
As a first-year genetic counseling student, I emailed the Division Chief for Genetics at the University of Mississippi Medical Center. I was originally from Mississippi (MS) and curious what genetics looked like there. The chief forwarded the email to Omar who had just joined as a new geneticist. Over my winter break, I visited the campus and met with Omar who introduced me to the Genetics team. Omar became a member of my thesis committee as I was studying potential barriers MS physicians face when considering genetic referrals. We stayed connected as I completed my degree, and we eventually created a genetic counseling position at the medical center there. I officially joined in June, 2007 and worked for ten years as a genetic counselor there. I cannot believe it has been 16 years since we first crossed paths. I still have the email I sent.
When I was first exploring a position in Mississippi, I remember negotiating for a genetic counselor. The chairman at the time told me if I could recruit one, he would pay for them. He was confident I would not be successful, but about six months after I started an email was forwarded to me from my chief. I was so excited to see that there was a genetic counseling student at the South Carolina program who was from Mississippi and wanted to explore job opportunities back home. It was a long road from there, especially because the University of Mississippi did not have a job description for a genetic counselor. We started from scratch, meeting with human resources to craft something totally new.
But that was only the beginning of the many barriers we overcame as we worked together to establish a new genetics program.
How can genetic counselors and geneticists best collaborate to leverage the workforce?
In thinking about the relationship we had at the start of our journey together, we learned that you must begin with a fundamental philosophy that is based on mutual respect and acknowledgement of each person’s roles and skill set. From that starting point, you can determine the best strategy based on which skills are needed and match that with the patient population in the moment.
Right, so whether it is an inpatient consult, a person with a concerning family history, or a child with developmental issues you can design a system to meet those needs using a flexible and dynamic workforce of geneticists and genetic counselors, among others, ensuring that providers are working to the top of their scope. By engaging genetics providers with a sense of meaningful purpose, we can reduce professional burnout and provide an improved level of patient care.
Why did you choose to go into your profession?
My mother provided experiences early in my life that fostered a love of people. She engaged in our community and my sister and I worked with her from a young age – serving soup at a shelter, filling requests at a food pantry and spending time with children who used wheelchairs to get around. She showed us that life is richer when we connect with others and shaped how I approached people and my studies. I wanted the same combination in my career and was lucky to discover the field of genetic counseling.
When I was growing up my pediatrician happened to be a clinical geneticist. When I was in high school, she learned about my interest in basic genetic principles and took me to genetics lectures at the hospital. I clearly remember hearing Judy Hall talk about imprinting for the first time at age 16 and realized this was what I wanted to do for a living.
What is like working with each other regularly? How has that helped your work?
This can vary depending on geneticist and specialty. I thoroughly enjoyed working with a clinical geneticist in a clinic and in the hospital. As part of our team approach, Dr. Rahman and I reviewed the patient list for the week and talked through the medical history and potential etiologies. As part of our discussion, I learned more about pediatrics and dysmorphology. It was inspiring to hear Omar’s passion for finding answers for patients and learning more about his knowledge and expertise to diagnose patients. He is a proud “Smith descendant.”
As a pediatrician and geneticist, Dr. Rahman taught me how to navigate a medical system. He is a champion of genetic counselors and on more than one occasion has advocated for their recognition as providers and faculty roles. He brings the same energy to patient care. For me, he embodies being human while also being a provider. These are experiences I first saw with Omar, and I admired his approach.
I remember when I was a “baby geneticist,” as a former mentor referred to it, and thought I had all the tools necessary to provide patient- and family-centered care. I worked alone for two years before I was fortunate enough to recruit Holly to join our division in Mississippi in 2007.
Working side-by-side with Holly in clinics and in the inpatient units taught me the true meaning of patient- and family-centered care. I was focused on finding an answer, but often forgot to consider where the family was in that journey. Holly was incredible at detecting nuances in patient interactions that allowed her to probe deeper and understand what the family was truly experiencing.
There were several instances in which families divulged emotional, physical, and financial challenges that could not be addressed with another genetic test. I learned that each of us brought a unique skill set that created an incredible synergy, resulting in a far more holistic patient experience than either one of us could have achieved alone.
ABGC Spotlight is a monthly series that features Diplomates, health care professionals
and students sharing their unique experiences with genetic counseling.