Genetic information can raise the stakes of a clinical conversation in ways that go far beyond test results. Dr. Adam Cifu and Dr. Sonia Kupfer reflect on how uncertainty, evolving evidence, and family implications shape the way physicians counsel patients. Kupfer draws from her experience in clinic to illustrate how recommendations may shift over time, while emphasizing the responsibility of helping patients feel supported, informed, and firmly in control of decisions that can affect far more than just one person.