The goals of expanded gene panel testing seem beneficent – to enable better diagnosis and treatment of complex diseases with the ultimate aim of improving health. In reality, though, there remains a disjuncture between these hopeful goals and what we can achieve in practice. Our sequencing capacity continues to outpace our ability to interpret the volume of genomic data we generate. Similarly, our diagnostic capability continues to exceed the availability of treatments. One consequence is that panels may generate results with unclear significance, limited to no clinical utility, or no relation to the original purpose of testing. Variants of uncertain significance (VUS), or those associated with low- to moderate-susceptibility genes, can leave patients confused or with information on which they cannot act. Why, one might ask, does the scope and scale of gene panels continue to grow despite a limited ability to interpret them?