In the case of the patient in this scenario, at least now you will have the opportunity to become informed about DTC-GT and to have a meaningful discussion with him before he receives his genetic test results. You will be willing to review the data—even just the risk identification for Parkinson’s disease, if he so chooses—and counsel him if there is a high risk for the disease. Indeed, you may well have been planning to request a neurological consultation, because Parkinson’s disease was one of your differential diagnoses based on his laryngeal and musculoskeletal symptoms, even before he offered the information about the genetic tests. Support him, inform him, and work with him on a diagnosis and treatment plan as appropriate. Above all, be his physician.
Explore this issue:July 2017
Dr. Holt is professor emeritus in the department of otolaryngology–head and neck surgery at the University of Texas Health Science Center in San Antonio.