Direct-to-consumer genetic testing

Several years ago, one of us (N.H.R.) wrote on the increasing need for all pediatricians, not just those with special training in medical genetics, to understand genetic testing [1]. We discussed the importance of the genetic counseling process in ensuring patients and parents understand the potential benefits, limitations, and risks of a genetic test, as well as the meaning of the result. The focus was on the increasing number of genetic tests available to healthcare providers that would affect the management of their patients. The assumption was that healthcare providers would be 'gatekeepers' in partnering with the patient to decide which genetic tests were appropriate, ordering those tests, and explaining the results. This model is, however, being subverted by direct-to-consumer (DTC) genetic testing.