Friday, January 15, 2010

Enter the "Not" DTC Genomics Rep

An attractive male/female (depending on doctor) walks into the office.

"Hi I would like to talk with Dr X"

Receptionist "Who are you, sweetie?"

Rep "I want to talk with the doctor about the FUTURE OF MEDICINE"

Receptionist "Huh?"

Rep "Just let him know that I am offering DNA testing"

Receptionist "Hold On........."

Doctor comes out.

Rep "Hi doctor I am with...."

Cut off by Doctor "I know, I know, Myriad right? You have been coming around here for a couple of years now" "Ya know, I know nothing about DNA"

Rep "No doctor, I am not with Myriad. I am with naviGENICS"

Doctor "Who? Eugenics?"

Rep "No Navigenics, would you like to come to our open bar where we will talk about the FUTURE OF MEDICINE?"

Doctor "Hmmmmm......"

Rep "Don't worry doctor, we will have a report you can show your consumers (Law 1 broken) and we will let you customize it for your practice (Law 2 broken)"

Doctor "Ok I will see you there."

That's the future of naviGENICS strategy in NYC.......

But what I really want to know is:

1. Do the limitations of Pharma gifts also count for Labs. Can you say trips to the Bahamas?

2. Do the minuscule amount of MDVIP docs matter that much as a market? Prob not.

3. Will Navigenics now pursue the GENE Store idea that I pitched to Dietrich Stephan in 2007?

Listen, if the rep strategy worked for Myriad, why won't it work for naviGENICS? This is a good path for them. I envision a whole slew of lab reps in the future. Now if they could only have a test that is worth some clinical utility.........

In order to gain the state license, Navigenics had to meet several requirements, including hire a doctoral-level scientist with expertise in genetic molecular testing, pay a $1,100 fee, and respond to deficiencies cited by inspectors with a plan of correction.

Most important, however, was Navigenics' conceding to not market its services directly to consumers, as clinical labs are forbidden from doing under state regulations. "They have acknowledged that DTC will not work for them" in New York, Kusel said. "They can only operate through physicians' orders."

The Sherpa Says: Imagine TV ads in NYC that say "If you want to know your future, ask your Doctor.....naviGENICS doctor that is. IMHO, a test with little clinical value doesn't get tested for unless you spend millions on marketing and advertising the way MYRIAD has. Oh, and they have a very clinically relevant test........


RenataM said...

Love your provacative posts because they provide a window and perspective those who want progress in the State of NY and NYC need to see/hear from those who - I am assuming - do not.

Now, since I am African American and a friend of JayZ's - I would appreciate your limiting your focus on the incindiary EUGENICS angle. It seems an insensitive and strange fusion with the company you reference...and totally unnecessary and a distraction from your meaningful posts and practice in this area, methinks. Just sayin you should not BRAND an association with ANY of the pioneering cos. in this space with EUGENICS...especially in a very diverse NYC/NYS...for reasons you are well acquainted with.

Otherwise, I will watch with fascination your assault on Navigenics - and, I assume - any other cos. who work with NYS Department of Health to honor the law(s) and pioneer this terrain.

Have a great MLK holiday weekend - and, in honor of, let's get off the EUGENICS kick!

Daniel said...

Wow, looks like you're pretty screwed now, Steve. I can see why you're resorting to the desperate eugenics smears.

Steve Murphy MD said...

My point has nothing to do with eugenics at all. Merely that the physician has no clue about anything genetic other than that horrible and dark period of a horrible and evil empire. Which a whole lot of people still reference.

Seriously, did you read this post? And even crazier, why no complaint of a prior post?

@Daniel, no. I am not screwed, there are 8 million in NYC. If they advertise, then we all win from awareness. But lose by being confused as not clinically relevant or useful.

Seriously Daniel, you and Renata are reading into the post....

Steve Murphy MD said...


BTW, They have the brand. Not me. But, that being said, in what world is taking a database of unsuspecting consumers and giving them little if any useful information (other than Armd and PGx) in return called progress? Progress is what 23andMe are doing. This is status quo at best.

Steve Murphy MD said...

Why does everyone forget I am PRO personalized medicine and genetic testing?but I am not PRO medicine being practiced without a license.

RenataM said...

Steve - you are widely read and respected. Notwithstanding particular loyalties and/or business biases - we should all be happy NYS has crossed this threshold. And, to the extent you smear the company that did the heavy lifting to manifest this success with the word EUGENICS - totally inappropriately, which has no correlation with the company itself and/or its known plans - you demean the industry, NYS and all of our fellow NYC'ers in this most DIVERSE City/State. In certain quarters the word EUGENICS has, as you well know, a negative and frightening connotation. To use this word in the context of an industry or any of the pioneering companies we ALL hope will progress - alarming some of the very clients we ALL aim to serve - is strange. Perhaps THAT is the reason your commitment to the success of the industry itself is being called into question.

I am sure 23andMe nor any other company in the space would want to be advantaged by branding a competitor with the word EUGENICS, inappropriately. They are, as you say, a worthy company and do not need to smear anyone to succeed.

Nor do you.

Be well.

Steve Murphy MD said...

I am very glad you read my blog. You raise several concerns. I would like to address them.

NYC is super diverse.
I completely agree. As does my part hispanic part caucasian heritage.
THIS is why the naviGenics tests, which are based on study results from white men and women are least likely to be helpful for NYCs diverse population. Think about it this way.

If we have results of economic growth from Russia, can we use it to predict the economic growth of the US? Maybe, but probably not.

2. Limiting the focus away from Eugenics

Renata and Daniel, I in NO WAY. I repeat No WAY said naviGenics was engaged in EUGENICS.

I respect the people over there and there is no way that they would be involved in any of these things.

Eugenics is a horrible past of a horrible empire. AND HAS NOTHING TO DO WITH MY POSTS.

I used it as an example of physicians' ignorance of genetics....

3. Assault on naviGenics or any other company who works with NYS DOH

I have no assault here. I am merely pointing out that a lab operating in NYS has to abide by certain rules.

4. I should be proud that navGenics has crossed the threshold...

I am curious as to what you think is a threshold. I only see a DTC Genomics company, offering a test which may not be so useful for people who aren't caucasian.

The heavy lifting was done by the NYSDOH by investigating these companies and protecting the people of the empire state.

Lastly, I think you confuse my support of personalized medicine with personal genomics. These are 2 very different things. Personally, I support PM. I think PG is a curiosity that is useful, but in the end will prove to be not worth nearly as much as PM. Personalized Genomics IS NOT personalized medicine....Nor is naviGenics EuGenics......plain and simple.....

Thanks for reading,

I appreciate it.


Andrew Y said...

RenataM : Your offense with the term "eugenics" is misdirected. Steve used the term for dramatic effect appropriately, which is that most people (including doctors) do not know anything about human genetics except its negative connotation with the taboo subject of "human diversity."

"Perhaps THAT is the reason your commitment to the success of the industry itself is being called into question. ... I am sure 23andMe nor any other company in the space would want to be advantaged by branding a competitor with the word EUGENICS"

Steve is a medical doctor. His business is closest to that of a lawyer. He doesn't complete with any medical labs as a business, and in fact, it is illegal for a medical practice to operate anything but orthogonal to the operations of a medical lab. Thus, your proposed motive for Steve's attack on DTC is also misdirected.

Steve hates DTC tests because they are biochemical medical tests marketed like fashionable consumer luxury fads, not because they have any affect on his business as a medical doctor.

Steve Murphy MD said...

Andrew Y,
I don't hate DTC Genomics. I disapprove of their marketing strategy. I also disapprove of anything which detracts from the seriousness of Personalized Medicine and the healing of human beings from illness. This FAD won't last, no matter how hard they try to fit in. Why? The downplayed the gravity of medicine in order to make some things which are rightly serious seem like "fun" Thus alienating the people who most need to adopt tools similar to theirs.

It is a shame, they should have engaged physicians first.

If you want to waste your money on a fortune teller, go ahead. But don't try to use your PR people to make a fortune teller "seem" like a physician.

renatam said...

Navigenics' business model seems to be working with physicians and medical institutions - and they have accomodated the requirements of the State of New York in order to do so - and did not do business in our diverse State/City for two years in order to respect the LAWS. There is no other responsible action to take - IF the goal is to work legally w/medical professionals in our State/City.

I suspect Navigenics will diversify their client base now that they have the legal basis to broaden their client pool. I look forward to participating as an African American w/Native American and German heritage once removed in my own my own home State/City. I prefer engaging my own Cornell physician before, during and after the results are the oldest member of my own family, having lived longer than three grandparents and both a boomer.

I am no physician. There IS a consumer stakeholder perspective and sometimes being a provacateur doesn't serve that audience, who lack the sophistication to process your real meaning...any more than you would serve/be served by joining the NBA tonight...or be asked to play piano at Carnegie Hall this weekend. Unsure what your ballet chops are for the NYC Ballet. Do tell!

As for those of us who have followed the dawing of this era, campaigned for a President we believed would help usher it in...every step is something to celebrate...and we would all do well to focus on how we can be effective by participating in an affirmative way.

Be well.