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This article draws on 2 years' worth of ethnographic observation of team meetings to explore decision‐making in an NHS clinical genomics service. The focus of discussions was on ambiguous genomic results known as VUS or Variants of Uncertain Significance, which may be pathogenic but which also may turn out to be benign. In examining decision‐making around such results, we note how, in contrast to much policy and promotional material in this area, clinicians in these meetings (clinical geneticists and genetic counsellors) place great emphasis on parental phenotypes and whether the parents of a patient share the symptoms and signs of the suspected condition. This information is then combined with the result of genomic tests to decide whether the variant a patient has is responsible for their condition. This article explores the way in which clinicians attempt to flexibly enrol parents into genomic explanations through informal diagnosis of their possible phenotypes and the way in which actually meeting parents allows some clinicians to trump explanations based on documentary or photographic data. The paper sheds light on the way that earlier scholarly understandings of such decisions (around, say dysmorphology) remain relevant and explores claims that laboratory tests overrule clinical decision‐making. [ABSTRACT FROM AUTHOR]

Questions pertaining to patient adherence and provider roles are part of the classical repertoires in sociological and health services research. While extensive research programmes consider why patients do not follow medical advice, less is known about how practitioners assess patient adherence. Similarly, there has been much work on provider roles changing with the organisation of healthcare, but less attention to the ways providers conceptualise, choose and strategically enact practices in the course of their work. Using data from a year-long ethnographic study of two diabetes clinics, I examine some of the stances medical practitioners actively choose and enact in their treatment of diabetes patients – educators, detectives, negotiators, salesmen, cheerleaders and policemen – and how they tailor their actions to specific patients in order to maximise their adherence to treatment regimens. Findings suggest that the notions of ‘patient adherence’ and ‘physician roles’ are conceptually broader and more fluid than what is captured in existing literature, and this rigidity potentially impairs our ability to learn more about the everyday practices of medical work. [ABSTRACT FROM AUTHOR]