Over the weekend, the CEO of Pennsylvania health care provider Geisinger announced that its doctors will now offer patients DNA sequencing “as part of routine preventative care.” Right now, most doctors offer genetic screening only when they suspect something is wrong, but the move suggests that soon, DNA tests could become a normal part of our checkups. This could protect us by identifying diseases early, and, thankfully, Geisinger has trained its doctors on how to properly interpret these tests. But that’s not true across the board, and if DNA tests are really going to go mainstream, every health care provider needs to follow suit.
Under the new plan, Geisinger — and not the patients themselves — will foot the bill for the tests. Though it’ll cost the health care provider about $300 to $500 per patient, the idea is that it’ll save money in the long run by catching diseases early, according to Forbes. Geisinger, which serves about 3 million people in Pennsylvania, is certainly not the largest health care provider in the US, but it seems likely that others will offer the same service because various technology advancements have made sequencing cheaper and more accessible than ever before. Today, sequencing is about 400,000 times cheaper than it was in 2001. As these tests become more common, we need to make sure training keeps up.
There is a truly overwhelming number of genetic tests that doctors can order: 75,000 on the market, and 10 new ones entering the market every day, according to a recent study. (The study excluded consumer DNA tests like 23andMe.) Many of these tests are redundant, some of them are for very rare diseases, and it’s nearly impossible to keep up with what each one offers and how it specifically works.
Meanwhile, a study of primary care providers in New York showed that only 14 percent of them were comfortable interpreting these results. “Those with more experience of genetic testing, of any kind, did not feel more prepared or more confident,” Carol Horowitz, the Mount Sinai health policy professor who conducted the study, told The Washington Post. “How are we going to help primary-care providers, who are barraged with all these genetic tests — some of which are very actionable and important, and some of which are not.”
As major health care providers adopt routine genetic screening, they need to train their doctors to understand which tests to pick, how they work, and how to interpret the results. Otherwise, overwhelmed doctors may order the wrong test, or they may misinterpret the result — confusing patients and potentially leading to wrong diagnoses or false positives.
There’s a second part of training, too. It’s not enough that doctors understand the benefits of the different tests and feel confident sharing the information. They need to be trained to make sure patients understand the pros and cons of getting their DNA sequenced. Genetic screening could catch diseases early and help save lives. But, depending on the exact test and what information is shared, it could also reveal information that is difficult to handle — like whether you will develop the neurodegenerative disease Huntington’s, or are more likely to have Alzheimer’s disease or breast cancer.
Humans are irrational, and research shows that having access to this type of genetic data can change how you see yourself and how you live your life in ways that you don’t like. Sometimes people just don’t want to know and that should be okay, too. The test holds a lot of information and potential for both good and bad, and that means as they become more widespread, all health care providers need to be responsible for implementing these plans.