The State Of Genetic Testing & Nutrition 2021

Genetic testing today is widely available, sophisticated, and affordable. It promised to alter the way people understood and interacted with their own physical bodies by giving them insight into their unique cellular make-up.

Yet that end goal of better health and increased wellness has never materialized.

Instead, genetic testing today is largely led by consumer brands looking to capitalize on genetic insights to sell supplements, meals plans, or exercise plans. The majority of consumers believe that genetic testing is only good for tracing ancestry.

What’s missing — the true promise of genetic testing — is the leadership of trained practitioners who are able to interpret results and provide actionable insights to their patients. These practitioners act as guides who show their patients ways to adjust their diet habits and lifestyle choices based on how their body naturally functions.

Following our recently published report on the “State of Consumer Genetic Testing,” where we focused on a consumer’s experience with genetic testing, we wanted to explore the practitioner side of things. How do functional medicine practitioners view genetic testing? What role does it play in their ability to identify and treat the root cause of their patients’ problems? Does the ability to offer genetic testing help them stand out today against a growing competitive landscape? Or are they finding no benefit at all?

METHOLOGY: 

On January 11, 2021, we surveyed 206 US-based health practitioners. 55% identified as doctors focused on lifestyle, functional, or integrative medicine, while 45% were licensed nutritionists or dietitians. 

KEY FINDINGS:  

Our survey revealed the following insights from practitioners when asked about their engagement with genetic testing:

• Genetic tests play a major role for one third of practitioners. 33% of our respondents found genetic testing to be core to their practice, with over 75% of their clients receiving a test.

• Practitioners believe it improves their ability to personalize treatment. They also believe it allows preventative measures, improves clinical assessment, and informs functional testing.

• Over half were confident in being able to deliver actionable results. While 53.9% were confident they could offer insights to their patients based on the results received.

• There are still things to learn. The range between those knowing how to deliver actionable results and those who didn’t shows that there’s more education needed in the field.

• There’s still skepticism. While many of our practitioners were confident in the value genetic testing could bring, some practitioners were still skeptical of what it could offer.

• Patients are asking about it more often. 31.1% of respondents saw an increase in patients asking for genetic tests.

• More practitioners want to use it. 39.3% will increase their usage of genetic testing in the future.

PART 1: PROFILE OF WHO WE SURVEYED

We wanted to hear directly from health practitioners who care for and interact with patients on a daily basis. Our respondents are either doctors who practice lifestyle medicine, functional medicine, integrative medicine, or nutrition health (55.8%), or licensed nutritionists or dieticians (44.2%). The majority of our respondents fell between the ages of 25 and 44 (53%), with 14% younger, and 33% older. Our gender split skewed female by 56% to 44%.

Our respondents came from a variety of work environments as well. While the largest portion (20.9%) work in a hospital, others work in large practices (18.4%), mid-size practices (18%), small practices (18%), or have their own practice (12.1%). The rest (12.6%) work in other environments.

GENETIC TESTS PLAY A MOJOR ROLE FOR ONE THIRD OF PRACTITIONERS.

Since understanding how genetics work can help health practitioners better help their patients, we wanted to know who was utilizing genetic testing in their practice. The majority of our respondents are testing, and in a major way: 32.5% of our respondents say it’s core to their practice, and that over 75% of their clients receive a test. The remaining respondents were about evenly split in their responses: 21.8% use genetic testing in combination with other services, so around 50% of their patients receive a test; another 22.3% only use genetic testing on less than 25% of their patients. 23.3% say they rarely use genetic testing, and that it plays no role at all in their practice.

While one-third of our health care respondents are utilizing genetic testing, it seems that the rest understand there’s some value to it, but may not be using testing to its fullest to help their patients understand how to improve their everyday health and wellness.

PRACTITIONERS ARE ORDERING TESTS OFTEN.

Over the past twelve months, our respondents have ordered a number of genetic tests for their patients. While only 8.7% have not used genetic tests with their patients, the rest have ordered tests, and are evenly ranged from 1–10 tests (17.5%) to 50+ tests (13.6%) over the past 12 months. These tests do scale according to how big the practice is, of course, but both doctors and licensed nutritionists across various-sized workplaces are ordering tests. In other words, it’s become part of the practice.

CONFIDENCE IN THEIR ABILITIY TO WORK WITH GENETIC TESTING.

Genetic tests can uncover a vast amount of information about a patient. But the real value comes from being able to interpret that data and use it to help patients live a healthier life. Therefore, we asked how confident our respondents were in their ability to work with genetic tests. Nearly 60% of our respondents were confident in their usage of genetic testing, with 29.1% saying they were very confident, and 28.6% saying they were generally confident. But 19.4% were only somewhat confident, and 22.8% responded that they weren’t confident at all.

CONFIDENCE IN ABILITY TO DELIVER ACTIONABLE INSIGHTS.

We then asked about their ability to deliver actionable insights to their patient, where they would take the unique results of a patient’s test and offer a blueprint for lifestyle choices that will bring greater health and wellness. We saw similar results as above, in that a little over half (53.9%) were confident in their ability (29.1% very confident and 24.8% confident), but the remainder were either somewhat confident (25.2%) or not very confident (20.9%).

Like above, where we saw the range of practitioners who used genetic testing with their patients, there seems to be an awareness of the benefits of genetic testing, yet a lack of understanding or awareness of how to really apply results to their fullest.

SUMMARY: 

While genetics plays a major role in the practice of one-third of our respondents, what’s clear is that there is a sliding scale of usage and application when it comes to genetic testing. Some practitioners order tests for nearly all of their patients, are confident in their ability to administer the test, and confident in their ability to offer insights from those tests to their patients. Yet just as many practitioners don’t utilize genetic testing in their practice at all, and lack the confidence to both work with the test and offer insights based on the results. This means that there’s room for more education and more adoption.

PART 2: EXPERIENCE WORKING WITH GENETIC TESTING

In Part 1 we looked at who was working with genetic testing, how many patients were getting testing, and how confident our respondents were in offering actionable advice to their patients. But was the initiative for genetic testing just coming from health care practitioners? As it turns out, it’s more of a collaboration between practitioner and patient.

PATIENTS ARE ASKED ABOUT GENETIC TESTING OFTEN AND THAT NUMBER IS INCREASING FOR MANY.   

It’s one thing for practitioners to be proactive in offering genetic testing, but it’s another for patients to seek it out — and it looks like they are. While 20.4% of our respondents replied that their patients do not inquire about genetic testing, the remaining practitioners replied that their patients are asking about it: 27.7% have patients who occasionally ask for it, 23.3% have patients who often ask for it, and 28.6% have patients who very often ask for genetic testing.

This could be the result of an increasing trend, as 31.1% of respondents saw a rise in patients inquiring about genetic testing.

THE REASONS WHY THEY ORDER TESTS.

The fact that both practitioners order tests and patients ask for tests is reflected in the results around why genetic tests get ordered in the first place. 26.7% of those test orders are patient-initiated, while 31.1% are practitioner-initiated. In 22.8% of the cases, another health care practitioner has recommended one, with 19.4% of orders fell into the “Other” reasons category.

SUMMARY: 

These questions simply uncovered that genetic testing isn’t being pushed from one side or the other, but rather that both practitioners are offering genetic tests, and patients are asking for them. Working with genetic tests should be collaborative: The patient wants to improve their health, make lifestyle changes, or wants to discover something about themselves, and the practitioner is the one to not only order the test, but to decipher the results and offer an actionable path forward.

PART 3: VIEWS TOWARDS THE VALUE AND IMPACT OF GENETIC TESTING.

Now that we’ve looked at some of the hard numbers around genetic testing and who gives them, we wanted to ask about the value practitioners believe genetic testing brings. While the test itself may simply provide a set of data, the key is interpreting that data to provide patients with changes they can make to their lifestyle, awareness around prevention, and to provide a more tailored clinical experience.

WHERE PRACTITIONERS SEE IT ADDING VALUE: 

Genetic testing can provide a number of different insights into how someone’s genes and their lifestyle work together, to both their benefit or their detriment. This is why a practitioner needs to know the value genetic testing brings to their patients. We asked them what they believed are the biggest benefits of genetic testing, and their responses were (in order of most popular):

• It improves the ability to personalize treatment: Practitioners know that genetic testing can give them unique insights into a patient’s unique physical make-up and treatment requirements.
• It has predictive value and allows preventative measures: Genetic testing can give clues as to what may happen in a person’s body so they can take preventative steps now. 
• It improves clinical assessment: Knowing how genetics works with other physiological systems can help practitioners evaluate a complete picture of the individual. 
• It informs functional testing: Physiological function is informed by someone’s genetic make-up, and can give insights into what additional tests to order..
• It serves as a screening tool: Genetic tests can help practitioners know where to start with their patients.
• It empowers patients who want to take control of their health: Those wanting a better life can learn how their genes interact with their lifestyle choices so they can make better decisions to achieve better health and wellness.
• It informs targeted supplementation: Knowing how genes affect the body can also help practitioners recommend only the most neccessary and effective supplements.
• I don’t think genetic tests add value: Finally, some of our respondents believed that genetics actually doesn’t add value.

What’s exciting to note is that practitioners do see the various benefits of genetic testing and the value that it can bring to their patients’ lives.

GENETIC TESTING CAN IMPROVE GENERAL HEALTH AND WELLNESS.

Digging deeper into the value practitioners believe genetic testing can provide to their patients, we wanted to know if they believe genetic testing can provide personalized actionable insights that can improve a patient’s health and wellness. A little over half of our respondents (51.4%) agreed that it does, with 29.1% strongly agreeing. However, 36.8% disagreed that genetic testing could benefit a patient’s health and wellness. A large remaining percentage — 11.7% — weren’t sure.

GENETIC TESTING CAN IMPROVE DIET.

We asked the same question about whether genetic testing could improve a patient’s diet, and we saw similar responses. Half (50.5%) agreed that genetic testing could improve a patient’s diet, while 35.4% disagreed that genetic testing could help. Again, a large portion (14.1%) replied that they weren’t sure.

GENETIC TESTING CAN OFFER A COMPETITIVE ADVANTAGE.

Finally, in looking at how practitioners feel about the benefits of genetic testing, we wanted to know if they thought offering testing provided them a competitive advantage, in that they could offer something other practices or health professionals couldn’t. Again, around half (49%) of respondents agreed that it did, with 23.8% strongly agreeing. And again, 33% felt that it did not or would not give them a competitive advantage. 18% replied that they weren’t sure.

SUMMARY

In looking at these responses, we see an even distribution of practitioners who wholeheartedly stand by the benefits genetic testing offers their patients, and those who don’t. But why would something so straightforward as a genetic test create such a varied experience?

The fact is that the genetic test itself isn’t causing the difference in experience and belief, but how the results are used and understood. The array of answers we see is most likely due to application. Those who know how to interpret tests and provide actionable advice to their patients are probably seeing results. Those who may not know how to interpret tests and provide actionable advice to their patients are probably not seeing results.

PART 4: OUTLOOK FOR THE FUTUIRE

We found that both practitioners and patients are increasingly valuing the benefits that understanding one’s genetic make-up can provide. But we wanted to know how much of a role genetic testing will play in the future, and if there are any factors — like understanding how genetic testing will impact practice revenue — that will change a practitioner’s approach.

GENETIC TETING CAN DIRECTLY IMPACT AN ORGANIZATION’S REVENUE.

In building on the competitive advantage question earlier, we wanted to know if offering genetic testing had an impact on income. 47.5% of respondents said that yes, it did. This could be a result of the fact that offering genetic testing may be a draw for patients. It could also be that the practitioner is able to offer a more comprehensive, individually tailored experience for patients, and is thus in high demand.

FOUR OUT OF 10 PRACTITIONERS BELIEVE THEY WILL USE GENETIC TESTING MORE FREQUENTLY IN THE FUTURE.

As we saw earlier, some practitioners are seeing an increase in the number  of patients requesting genetic testing. Our respondents, in turn, said they would meet that demand, with 39.3% replying that they see genetic testing playing an increasing role in their patient offerings in the future.

42% BELIEVE THAT GENETIC TESTING WILL IMPACT REVENUE.

Our respondents believe that increasing genetic testing will go hand in hand with increasing their revenue. Since it offers a differentiator to other competitors, it allows them to create a more specialized experience for their patients. It seems to be a win-win.

WHAT WOULD NEED TO CHANGE TO OFFER MORE GENETIC TESTING?

What’s the key that would cause more practitioners to incorporate more genetic testing in their practice? Would it be more patients asking? More education around how to implement genetic testing? Or something else that would increase their willingness to offer more genetic testing?

The responses were evenly matched. Increased revenue and more education were both the highest responses at 27.2% each, in that practitioners wanted to know how genetic testing could increase their income or create a differentiator to their practice. They also wanted training and education on how to better incorporate testing into their practice. 24.3% desired more training and education on how to interpret a genetic test. The remaining 21.4% were staunchly against incorporating genetic testing into their practice.

CONCLUSION: 

Simply offering a genetic test to a patient isn’t enough, because data isn’t useful until it’s interpreted, translated and applied. Patients don’t have the ability to do that on their own, which is why they need knowledgeable expert practitioners who have seen the value genetic testing can bring to a person’s health and wellness, who can interpret and translate results, and who can create actionable paths for their patients that will guide them forward.

As we discovered in this report, there are some practitioners who are already doing this, and seeing results and success. But there’s still room for others to expand their understanding of genetic testing and its benefits so they can guide their patients towards better lives.

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