Sunday, September 30, 2007

About Helix Health of Connecticut.

Well, I have been getting alot of questions regarding our personalized medical practice on Park Avenue in New York City. I have been reluctant to tell everyone, but I figure that I might as well let everyone in on our "secret"

My philosophy is the power of genomics should empower patients and providers. Together as a team we can prevent some horrible diseases and avoid some horrible adverse drug reactions. How do we do this? We take the skills from a multidisciplinary team and identify risk. We feel that the most powerful genomic tool out there is family history (Sorry Hsien). This has been validated over and over again in epidemiological studies.

In fact when Mike Leavitt indicate in his foreward of his Personalized Health Care report

"One part of the foundation for such a change is our rapidly growing understanding of the human genome and the processes it directs. We envision health care that could:
  • predict our individual susceptibility to disease, based on genetic and other factors;

  • provide more useful and person-specific tools for preventing disease, based on that knowledge of individual susceptibility;

  • detect the onset of disease at the earliest moments, based on newly discovered chemical markers that arise from changes at the molecular level;

  • preempt the progression of disease, as a result of early detection; and

  • target medicines and dosages more precisely and safely to each patient, on the basis of genetic and other personal factors in individual response to drugs. "

I thought he had read our business plan. But then I realized, anyone with an insider view would have to conclude the same thing. This IS personalized medicine. I think that the fields we will see explode are services which Helix Health of Connecticut is offering.

The problem I have always had with academic genetics is 3-fold.

  1. Most geneticists are pediatricians (8 in 10) and have not been trained in adult chronic diseases or even used most medications that are intended for adults.
  2. Traditional genetic care offered in the "Ivory Towers" is diagnose and adios. They have no desire to offer close follow up. In fact, in the time that I worked at an academic center we did very little to recontact those difficult clinical genetics cases. Only metabolic patients get the close follow up needed.

  3. There is NO privacy at a big center. In most places you are pushed through like a means to an end.

The last problem I have with traditional genetics lies in how we acquire medical information.

In a clinical genetics appointment of 45 min to 1 hour you get a fam hx from the genetic counseling student which takes 20 minutes, they attempt to take a medical history (despite having no medical training), they then present to an attending or fellow (10-20min), who then comes in a confirms the information. Now with 15-20 minutes the attending has to explain complex genetics and inheritance to you, send off subtelomeric, CGH, karyotype, genetic tests, etc. And you get ONE follow up appointment and may wait 6 months for another appointment.

In a cancer genetic situation you do have more time. Perhaps if your counselor is good, you get adequate follow up and acquisition of information. You may be seeing a geneticist (Who has not trained in adult oncology) or you may be seeing an oncologist (Who never trained in genetics) If you even see a physician at all. This is not to knock my CGC friends. They have truly great talent and training, but learning what to do with your Plavix is not one of them. In fact our head counselor said "When I took a family history and it looked like there was early heart disease I said to myself 'I know something is there, but what do WE do about it?' Therefore the problem lies in the training or perhaps in the team.....

And please do not get me started with the Chop Shop known as "prenatal genetics/high risk OB clinic" Where the standard is to get as many people as possible into and out of the counselors office and the into and out of the amnio as quickly as possible. Where is the CARE in that? Is there any PRE-Conception care out there? There is at Helix Health of Connecticut!

What kind of medical informatics system is employed at most academic centers? Archaic at best in most. At least where I and my partners have been. When even the highest powered EMRs cannot distinguish between maternal or paternal lineage, then you have a problem. We have developed our own.....

Lastly, where is pharmacogenomics? Where is chronic disease risk stratification? Oh I forgot, geneticists don't do this, nor is there training for this in classical genetics fellowships.
All of this and more is available in my vision of what personalized medicine should be. Helix Health of Connecticut is Personalized Medicine for the 21st Century(TM)

The Sherpa Says: Helix Health of Connecticut of CT is my dream, my vision and the tip of the personalized medicine spear. I know this may seem like an advertisement, it is not. It is the road map which all personalized medicine practices should follow. When you take Prediction, Prevention and Privacy to the highest standards of care, you are bound to succeed.


Anonymous said...

It doesn't sound like an ad.

It is one.

Hsien Lei said...

Congratulations, Steve! It's taken a lot of hard work for Helix Health of Connecticut to get to this point.

FYI, no need to apologize to me about your insistence on family history. Please do be sensitive, however, to those of us who don't know our family medical histories either because we are not in contact with our extended family or because some people (not me) are adopted.

Steve Murphy MD said...

I too am missing an entire side of my family. My father disowned myself and my brother when I was 13. I have great belief in our epigenome and our genome. It will be amazing....ONCE we have the data and understand what's going on there.

Steve Murphy MD said...

To anonymous. Next time let me know who you are and we can have a good discussion about this.

Hsien Lei said...

Steve, Life is crazy, isn't it? :(

Misha said...

Great post. "Diagnose and adios" indeed. I think what makes it worse is that too often the diagnosis is equivocal at best. I love OMIM, but sometimes I think it's clinical genetics' answer to Wikipedia.

Hercules said...

well, it can't be an ad because there is no call to action.... but under what circumstances would someone contact Helix Health of Connecticut? I am middle-aged and in good health, I don't take any medication, and I have no family history of anything that I know of -- so would I go to Helix Health of Connecticut on the same circumstance as I would my family doctor (I fall ill with something, or go for a check-up), or would something else have to happen to make me want to call Helix?

Steve Murphy MD said...

Well, Good questions the Shmoopies.
I think it pays to have a personalized medicine evaluation if 1) you have familial history risk of cancer, sudden death, heart attacks, miscarriage etc. 2) you have had an adverse drug reaction or have this in your family 3) you are planning to start a family and come from high risk ethnicities or some genetic disease runs in your family 4) You are just concerned
Give us a call and our counselors can speak with you.

Jon Wyman said...

I agree with the schmoopies. There exists a clear and definitive line that separates ads from all other communications. Any description that leads to better comprehension and utilization should never be thought of as an ad.

Medical Journalist said...

"Most geneticists are pediatricians (8 in 10) and have not been trained in adult chronic diseases or even used most medications that are intended for adults."

Really?! Why is this? Can you point me to any resources about this?

Steve Murphy MD said...

medical journalist,
Send me an email at and I will forward you the pdf articles. You can go to and ABMG to review this data. Or just do a PUBMED search.