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In Reply: Dr Lipinski and colleagues question whether primary care is ready for the genetics revolution and raise important issues about informed consent, primary care physician discomfort in providing genetic counseling, and utility of genetic testing. We agree that there are multiple challenges in translating genetic testing to practice; that was the reason for our Commentary. Genetic testing is already occurring in practice before fully confronting these challenges. We advocate an evidence-based and planned approach involving education of clinicians and a nationally recognized organization that makes decisions on the suitability of tests for practice. We recognize that many genetic tests are not ready for general use and emphasize the need to simultaneously address behavioral, environmental, and public health approaches to impact health outcomes.

Dr Klein notes that clinical laboratories are already subject to both governmental regulation and voluntary professional guidelines and states that enhanced regulation should be approached with caution. . . . [Full Text of this Article]

Tina L. Cheng, MD, MPH
tcheng2@jhmi.edu
Department of Pediatrics

Ronald D. Cohn, MD
McKusick-Nathans Institute of Genetic Medicine

George J. Dover, MD
Department of Pediatrics
Johns Hopkins University
Baltimore, Maryland

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