Predicting the Future of Genetics

All in the Family (History)

That, according to Rackover, is the heart of the matter—the essential piece that many clinicians overlook. Genetic tests are tools that can assist patients and providers in formulating health care plans. But amidst the buzz that surrounds any advancement in clinical practice, clinicians are losing sight of the fundamentals. The first step doesn't have to be ordering a genetic test. The first step is asking the right questions and listening to the answers.

Family history provides the first clues to a genetic puzzle; it is what can help a provider determine whether genetic testing is warranted. There are instances in which you don't need a genetic test to decide the appropriate course of action; you just need common sense.

Don't believe it? Here's food for thought: Rackover conducts physical exams for the military. One day, he saw a young Korean woman. On her preliminary screening survey, she mentioned having seen a health care provider in the previous year and receiving a prescription for oral contraceptives. There is nothing unusual about that. Except ...

"When I looked at the family history, I saw her mother had a stroke. So I asked, 'How old was your mother?' figuring she was, well, old," Rackover says. "Well, she was 38! And then she told me that both her aunts had a pulmonary embolism."