This approach is short sighted, makes a number of assumptions, and does not address liability issue. When does the testing stop? Assumes that a patient will have a life-long relationship with the ordering MD, but that is rarely the case in any field. What happens when the ordering MD is no longer following the patient or the patient has moved onto others? The ordering MD receives a notice of an update 5yrs, 15, yrs or 40 yrs later, but how does he/she get in contact with a person who is longer a patient? What about the liability? This approach places liability onto an ordering MD for a life time so why order a test? This has NEVER been the case for any testing. Running a Chromosome test 20 yrs, the report was the report based on the available science as of the date of the test report. Why should exome or genome testing be different? The ordering MD is not receiving updates on a CMA ordered 20 yrs ago. It is well understood that science progresses and testing improves so it I had concerns today on a patient that had a CMA run 20 yrs ago, I would simply rerun the test - period. I would not be receiving updates for the past 20 yrs. Also what happens when the ordering MD retires? Who has the liability to report out updates to the patient on a test ordered 30 yrs ago?