Wednesday, October 22, 2008

The Howard Stern of Genomics......

The other day I was talking with Misha Angrist, who BTW is writing a book about this great adventure known as personalized medicine....... I had been telling him about how my views had been pissing off a lot of people. He said to me "You certainly have a skill for that" indicating that my proclivity for hyperbole was what could eventually put me under.....

I resort to hyperbole when I think something is so outrageous that I need to go crazy. That's why some have dubbed me the "Howard Stern of Genomics" (Thank you Jeff Gulcher for the monniker). I am still looking for my Stuttering John.....

But in all seriousness, I see some big problems with this ecosystem. I think the problems are on several fronts and we need to attack each one. Why? Each problem in itself is not a reason to go crazy, but when I see them all in the big picture.....I gets my goat. These problems are the proverbial 800 pound gorillas that the field just doesn't want to address unless it is pout out there against their will.....

Now can you see why I have mentioned problems with:

1. DTC genomics

2. Public genome exposure of uninformed participants

3. The woeful lack of genetic competence by doctors

4. The pi$$ poor reimbursement rate for services

5. Patent protected genetic tests

6. Silly CEOs not having a grasp in reality, or distorting it to promote/hype genomics

7. The lack of medical training for genetic counselors

8. The lack of genetics training for medical professionals

9. The horrible job of reporting genomics to the public

10. The lack of reputable VC/Investment firms willing to take a hit and invest in soically responsible genomics.

11. The fear of businesses upsetting their customers by speaking the truth....

So as you can see, I have had the chance to piss off just about all of the field.....and have done so in many ways.....

Do I do it for spite?


Do I do it because I dislike each and everyone of them?


Do I think they are doing good things?


Do I think we could do things better?


So if you are one of the myriad of people that are upset with what I have had to say......rather than get all mad and speak ill of me at cocktail parties or try to get my friends and coworkers upset with me or any other completely destructive things you are looking to do....

Ask yourself........."Is the Sherpa right?"

If I am not....then feel free to flame me.......

But if I am right, have the guts to admit it and go about changing our ecosystem.

Yes, I AM calling you out!



Anonymous said...

12: Genetics is not yet accepted as a medical specialty

13: All genetic counselors are not licensed

14: The hype by the media when a new study shows a gene could lead to this condition….a year later independent studies are not able to replicate the same finding. Websites, magazines, and the media will already have reported the gene(s) as being accurate. The population becomes misinformed.

15: Most people just think a genetic counselor deals with a female pregnancy….there are more options out there

16: Clinical geneticists, in general, are not leaders in the healthcare field…from what I’ve been observing

17: “Others” who want on the parade of genomic medicine without putting the “time” in…..(i.e., personalized genetic testing companies; with the exception of the DNA Direct).

Steve Murphy MD said...



Andrew said...

I don't know, Steve. It seems like it's hard enough to attack one institution, but trying to right all wrongs seems to be a mistake. There is only one Steven Murphy. I suggest: pick one objective and crush it completely, then move to the next when you have more resources.

It's not enough that others are wrong, YOU have to be right, and being right is very hard work!

Anonymous said...

I disagree with Andrew. A lot of the problems that Dr. Murphy pointed ou are related to each other. By working to "fix" one problem also leads to working on the other problem. For instance, if were were to try and get the field of Medical Genetics regarded as a medical speciality (I've seen doctors call the genetics department never knowing they had a genetics department...I'm dead serious), you will want the people who provide the care, counseling, and diagnosis to be licensed. To better prepare everyone for the field, training needs to be adjusted as time goes on. What worked with the training in 1980 does not work in 2009.

Andrew said...

I'm confused how one can disagree with the idea "don't fight battles you can't win" and expect to achieve anything with any reasonable confidence.

Anonymous said...

To protect the general public, you want the people who are providing the services to be licensed. This prevents people from pretending to have the knowledge and skills to provide the service (e.g., a psych counselor seeing a person for mental health issues and also doing genetic counseling for breast cancer). To have the specialy recognized by the accrediting specialties, the field should have the experts be licensed. Have the professionals being liscensed also prevents random start-ups by people without the proper training (this is why DNA Direct is the best DTC company out FAR).

Being able to charge for the service will help allow people who are leaders to enter the field.

It all works together.