For new patients, the physician or genetic counselor will ask questions about the current medical problems and past medical history of the patient and the patient's family members (brothers, sisters, parents, aunts, uncles, first cousins, grandparents, and others). The physician will then perform a physical examination of the patient. Next, the physician will discuss his/her impressions about the condition, what is known about the genetics of the condition, provide a diagnosis when possible, and recommend any needed laboratory testing or evaluations. Genetic testing is usually performed on blood or urine samples. Genetic counselors are available to talk with the patients and families about the diagnosis, genetic risk assessment and inheritance, as well as provide information on community resources and address any additional concerns or questions the patient may have.
Johns Hopkins Hospital is a teaching hospital, therefore, in addition to the physician and/or genetic counselor, a medical fellow, resident, or genetic counseling student may be involved in the patient's clinic visit.
An initial genetics evaluation is approximately 1 ½ to 2 hours long. Other appointments or radiology evaluations may be made in conjunction with your genetics visit as well.
After the visit, the physician will write a clinic note that summarizes the evaluation including the family and medical history collected, diagnosis, inheritance and risk assessment, any laboratory tests or evaluations recommended, community resources identified, and the timing of the next follow-up visit, when applicable. A copy of the clinic note will be mailed to the patient, as well as to the patient's primary care physician and the referring physician. Hopkins physicians will be able to access the clinic note on an in-house electronic medical record database.
Each insurance company is different, however, usually genetics evaluations are covered by health insurance. Some insurances require that you can only have radiology and laboratory services performed only through certain outside facilities. In these instances, we will attempt to work with your primary care physician to obtain appropriate services outside of our institution for our review. Many times, specialized genetic testing services require pre-payment or insurance preauthorization before it can be sent out.
