Genotypic testing in clinically defined HHT: would Osler approve or turn in his grave?

Modern diagnostic possibilities pose a number of challenges. When is a precise genetic diagnosis justifiable in today’s climate of cost-cutting? We would like to pose that question to Sir William Osler. Sir William was a keen observer, a master ‘translator’ of science into clinical medicine. Would he have required or supported genetic testing? We treated a patient whose case reminded us of Sir William’s belief that clinical exactness was the ultimate aim, regardless of cost.