Monday, July 28, 2008

Out of touch...

Sorry about that. I have been busy writing a book that will hit to store shelves in a couple of months. Here's an excerpt................... "If you were looking for a college level description of personalized medicine, buy another book." As I write the book, I include the raging debates......

Lot's of things continue to rage. Including the debate on genetic test regulations. Debate is a good thing. Disservice to patients is not. This article in the Washington Post covers it well. And the CDPH is not going to back down from that debate . I think that some DTC companies are providing even better online service than most healthcare providers terms of providing information. But are they providing better healthcare? No. They don't provide healthcare. So there is a huge gap here. What about the doctor who would be willing to guide a patient in choosing genetic testing? What about the doctor who would be willing to tell the patient "You don't need that need this test" That would be a nice service. I just await the Fed's response....

On another debate front, I had a clinician chide me for advocating genetic testing to avoid adverse drug reactions. He said...."The science is too young" I said to him "Well maybe your practice style is too old".....he then said..."Show me the data, and I will consider using it" I promptly asked him if he would like help in interpreting the tests....He scoffed. I wonder if he saw the recent study on statins, or heard the CliniCast on Warfarin and genetic testing?

That is the huge debate in medicine right now. Doctors who think they can interpret the tests, but aren't wiling to use them. Doctors who can't interpret the tests and are using them. Doctors who can't interpret and aren't using.......and guys like Helix Health of Connecticut.....The latter being as rare as a dinsoaur egg. But don't worry. We are priming up to pull a Jurassic Park move. Don't worry, we have thought about the ethics and legal issues first and foremost.

The ethical debate has been huge...including Thomas Goetz's push for Autonomy over Beneficence. You know.....I am often quoted as saying "Genetic testing left medicine, when you could give your DNA via sputum instead of blood". I just don't see how a change in body fluid, changes our outlook. I am not certain that spit is an different than blood. Ethically, they are the same when I collect them.

Speaking about ethics......I am certain we are going to see a lot of fly by night companies trying to "Deliver genetic care, without training". Personally, I think that a provider needs about a year of intense apprenticeship to get up and running. Anything less than that would be just pulling the wool over your eyes.

The Sherpa Says:

Yes, I have been out of touch with the blogosphere.....I have been working on some really big things. Don't worry, I haven't been out of touch with the revolution. I have been helping to foment it.....from the inside ;)


Anonymous said...

That was an impressive story you shared with us (The Washington Post story).

As far as fly by the night companies go, a person should have at least 2 or more years of experience AFTER training before they do anything that resembles starting a company.

Steve Murphy MD said...

Does any post training experience prepare to start up a national company? Maybe a medical practice.....maybe. But definitely not a national company.


Steve Murphy MD said...

Even more so...other than Helix Health of Connecticut....What practice could train you to be a genomic medicine specialist?