Harsh on All Fronts!

I am often accused of being overly critical....whether it is of the Genetic Counselors, or the Physicians, or maybe the Scientists. I am definitely critical of DTC and even more so of the Medical Geneticists....

In fact, I praise each of these groups at such a low rate, that many think I am looking to isolate myself from the entire field.....I am not. I just point out problems in our backyards so that we can clean them up.....

I was told the other day by a senior Geneticist that what I had done to the Genetic Counselors had then questioning their roles. I had thrown academic genetic departments up in arms, trying to now figure out how to bill legally for what they are doing....

Is that such a bad thing? To make people accountable for what they do.....to help motivate them to lobby extra hard to get paid what they should. Rather than break the law and just exist?

I strategically pick issues and attack them. I know that it upsets most who read this blog when they hear shortcomings in their own fields.

The pediatric geneticist who gets mad because I say they don't know what Plavix is.....

The DTC company who I say is "playing doctor" without any of the liability.....

The PhD Geneticist who says that I devalue what they do......I don't I just think we need not hype every little discovery....

My point is not to keep picking on us.....it is to help motivate us towards change.....

So I now will give you a rare Atta Boy.

1.) DTC, thank you for putting genetics into the public eye. Your millions of dollars spent on PR has helped raise awareness of genetics. Misdirected as you may be, the public is now aware that we can do genetic tests.....

2.) Human Geneticists, thank you for your tireless hours of work to discover new genes and new functions. We would have nothing without you. I can understand why you are so proud of your work and why it often comes across over zealously in the news....Thank you for your efforts,

3.) Genetic Counselors, thank you for working so hard to keep our field alive. When geneticists abandoned cancer genetics and you picked up the torch we needed you most. You have kept us true to genetic principles and spoke out against great atrocities. In addition, you spoke against false advertising.......Thank you

4.) Adult Physicians, you have felt the burden of my wrath most......but guess what, you have done the greatest thing of all, you have carried on the traditions of medicine and kept primary care alive this long....Without your work we wouldn't even have a thought of Personalized Medicine. Working long hours for continuous pay cuts by insurers, you have fought to keep patients cared for. How could you have the time to learn genetics?

5.) Medical Geneticists, thank you for caring for patients with monogenic diseases, studying new ways to investigate and care for them. To the small batch of you teaching adult doctors genetics, thank you. To those teaching medical students, thank you. We need you now more than ever.

The Sherpa Says: Now don't let that get to your head, we have a lot of climbing to do, so eat a big breakfast and let's get going!

Education Initiatives

I have been sick with a nasty virus this week. Vomiting has been the order of the day....yuck :(

Because of this, I will keep this post extremely short but useful. The SACGHS meeting was held last month and I think it was huge. There are a lot of good webcasts that are a must watch.

The rate limiting step of personalized medicine is physician uptake, and the rate limiting step in uptake is education. The SACGHS meeting on the 20th of November was huge reviewing efforts and ideas for education

Overview of Session
Barbara Burns McGrath, R.N., Ph.D. Research Associate Professor at the University of Washington School of Nursing. She reviews nicely the outline for the day and gives us a guideline.

Please check out the lecture given by the National Coalition for Health Professional Education in Genetics Executive Director. He describes a database similar to the one we are working on.

In addition, we need to utilize physician extenders. The advantage of having nurses in genetics is the fact that they have had some education in medication dosages and medical conditions. The same applies for physician assistants in genetics. But they will never replace the counseling abilities of professionals who have trained for 2 years in the field of genetic counseling.

Elizabeth Pestka, M.S. Assistant Professor of Nursing at the Mayo Clinic College of Medicine describes the 80 or so nursing organizations. It turns out 40 of those, 50% agreed to help include genetics into the nursing competencies. In 2006 there was a meeting to implement these competencies into practice.....This is where I sat back in awe. It is 2006 and they are just getting around to integrating these competencies? We are screwed for the next 4-5 years! But it turns out according to Nurse Pestka that these proceedings often take up to 17 years to become integrated!!!

I have worked with a nurse geneticist at Yale and I have to tell you how wonderful it is to share call with a nurse practitioner who is trained in genetics as well. I think we can really leverage our efforts with these talented individuals....I hope it doesn't take 17 years!

The Sherpa Says:
Now if we can only train genetics counselors in medicine!!!

The Genetic Counselor

Thanks to Bertalan over at Science Roll for pointing out a new blog/website called Genetics Counselor. This website has some interesting YouTube videos on it today. I tried to access the "blog" but was forbidden. I have to caution you all......Do not trust health care info unless the website is at least HONcode certified. I have no clue who writes for this site, their credentials, or their aims. That being said, the issues brought up in the video are REAL. I am most opposed to DTC because of these precise problems, including the lack of human contact while "phone" counseling. Another issue is the difference between counselors and geneticists.

The genetic counselor is different than the Geneticist is several ways.

1. Geneticists have Medical Doctorate, Genetic counselors have an MS usually in a genetic field.
2. Geneticists have taken pharmacology, microbiology, human anatomy, histology, pathology and several other medical school courses that counselors have not.
3. Genetic counselors counsel patients but can order tests and give health care guidance ONLY under the care of a physician. (sometimes reasonably so, sometimes not)
4. Counselors have a log book of 50 cases seen. To sit as a Geneticist you have 150 cases, 2 years of residency (at minimum) and 2 years of Genetics Fellowship (At minimum)
5. Neither field is BETTER. We are just DIFFERENT from each other.

The Gene Sherpa Says: There are great counselors out there and there are also some bad ones please ask to also speak with the geneticist or physician if you feel uncomfortable with the counselor. Personally, I have the best Genomic Counselor in the world working with me. She is brilliant, talented and looking to move Personalized Medicine to the public.

Neat content in San Jose

On rare occasion I will make mention of a great resource that a town or website has. The Tech Museum of Innovation located at 201 South Market Street San Jose, CA 95113 (408) 294-TECH has a great exhibit where you can explore the technology available to geneticists and counselors. In addition it raises the awareness about the Ethical, Legal And Social Implications of genetics and ourselves.