The speed by which a person's genome can be analysed has increased phenomenally over the last few years, while the attendant costs have declined rapidly. Although the dollar1000 genome is not yet routinely available, if the pace continues, it soon will be. This has the potential to not only to transform the clinician's diagnostic and predictive ability, but clinical management will also be affected: preventative therapies, surveillance regimes, or treatments personalized according to genetic make-up mean that more people are likely to want to know about their genetic predispositions. Until recently, genetic diagnoses were often equivalent to the search for the needle in the haystack, and once found, at best offered only reproductive choices. This situation has changed over the last decade, and is beginning to impact on most all areas of medicine, and there are calls to prepare for this rapid transformation in practice.
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