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Beware doctors bearing genetic tests!!!!

Posted Oct 22 2008 6:18pm

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Today I am back on the soap box.
But I will also give a little worthwhile and scary data as well.
Yesterday I was at a cocktail party for the physicians in my upscale new england/new york town. I was speaking with an "educated" gastroenterologist. In fact this physician has been in practice for 29 years, went to medical school at Cornell, and is now part of a large practice in suburban NY. He told me that some "lab reps" fromMyriadwere now going to offices of Gastroenterology, Hematology/Oncology, and Primary Care physicians extolling the benefits of genetic testing for cancer predisposition. This physician said that because of this they are now testing younger patients forHereditary Non-polyposis Colon Cancer/Lynch Syndrome
He went on to talk about a 37 year old woman who had early polyps, was tested, and was positive for a mutation in a DNA repair gene called MLH1. I told him that was great. Then I asked him who he uses for genetic counseling. His eyes glazed over, seeming not to understand the question. Slowly as if to save himself he said " What does she need that for? She's not having any kids." OMG, I almost lost it. Slowly I said " If you fail to counsel a positive test result, you will get sued." Then his eyes lit up "I better go tell her to get counseling" he said.
  • Beware non-genetic doctors bearing genetic tests. 1 in 3 misinterpret tests for colon cancer.
  • GI doctors maybe more likely to elicit cancer history in the family, but areless likely to notify ATRISK family or even let the patient know family is at risk
  • In my education study that I will be presenting at the Association of Program Directors in Internal Medicine in San Diego I found some scary things as well.
  • Residents in academic and community programs consistently fail genetics knowledge exams
  • The confidence of an Internal Medicine resident physician in performing family histories is inversely proportional to their performance on knowledge exams!
  • Physicians in practice now are even worse than the training physicians today
  • But the scary thing is, the ones who have the confidence to DO genetics, actually have no knowledge in how to do it correctly.....That's why we need gene sherpas.
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