Why Are We Missing What Is Important In Personalized Medicine?
This commentary in the Genomics Law Report’s ongoing series What ELSI is New? is contributed by Steven Murphy, Helix Health of CT.
A 33 year old man with anxiety comes to the office. He says he has some worsening of his anxiety. It causes chest pressure. I saw his brother last week for a physical. He told me his father had a heart attack at 50.
The TIMI score for risk puts him at a 0.8% all cause 30 day mortality risk. No big deal right? His Reynolds Risk? 2%. Do I send him for a genetic test? No. I send him for a stress test. Why? Family History.
There are more people with Family History, than with faulty SNPs.
The results? Grossly abnormal test. He now has a coronary artery stent.
The algorithms aren’t refined for personalized medicine or family history. How can we expect Genomic data to change these algorithms?
How can we teach doctors genetics? How can we help doctors integrate it into care?
The attention is on the wrong things. How can we focus on what saves lives? How can we focus on what reduces costs? How can we focus on what is important with all the noise in this space?
Why are we failing physicians by lack of education? How can we demonstrate that this is a tool to augment care? Why are we failing patients by failing to educate their providers? That is the key here, not Open Bars, Blimps, TweetUps, or Public Relations.
Those things just create noise in the hurried clinician’s mind. Unless of course they (the clinicians) have already tuned out anything with the name “Genetic/Genomic” in it…….
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This post was mentioned on Friendfeed by Berci Mesko, MD: Why Are We Missing What Is Important In Personalized Medicine? (fantastic commentary from @helixhealthct) – http://www.genomicslawreport.com/index…...
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[...] for the doctor-patient relationship. Discussions during this weekend’s BIL:PIL conference and a recent exchange with Dr. Steven Murphy, with whom I’ve disagreed, occasionally vigorously, for years prompted me to put down my [...]
You want to know what’s important in personalized medicine, Dr. Murphy aka THE GENE SHERPA? Respect for the patient/consumer’s wishes. We all know you have a dim view of personal genomics, it’s no surprise you’d speak so dismissively of the role of personal genomics when you’ve campaigned for years (unsuccessfully) to put companies like 23andme out of business.
Until you recognize that people have the right to their own genetic information, you’ve no business at all telling people what they should or shouldn’t be doing with it.
We agree that educating doctors is important, and I think we share the pessimism that real change wont’ happen, but unlike you I think doctors are in for a rude awakening when patients start flocking to responsible practices like @carepractice and leaving you to stew in your paternalism, wondering where all your patients went.
@Mr. Gunn
Wha? You set up a strawman argument and shill some medical practice which is similar you ours?
Very, very confused am I.
-Steven AR Murphy MD
I’d respond, but I’m afraid I don’t even know what you’re trying to say.