Monday, October 24, 2005

Genetics is Here?

Genetics is Here? - I was quite surprised today to find Sciona, a company that sells direct-to-consumer genetic testing. Apparently, you can purchase their kits in select pharmacies, swab your mouth, and send in the sample. In a few weeks, Sciona will send you a report with nutritional and lifestyle recommendations based on your genetic makeup. This a remarkable turn of events. When, in the history of medicine, has bench science (here the Human Genome Project) skipped over the medical establishment and been made available directly to the public? There is, of course, much ado about the scientific legitimacy of such products (see the story in the Denver Post), but if Sciona can prove its products' validity and utility, it could further enable consumers to manage their own health sans physician.

If Sciona is not careful, it is this disconnect of physician and medical information that could be its own downfall. The medical establishment, and physicians in particular, are significantly vested in being the gatekeepers of medical information (they didn't go to medical school for nothing!). So you can bet that anything that removes the physician from the mix is going to meet with some resistance. The case in point here is total body scans. A year or two ago everyone (hospitals and physicians) was worried that imaging centers would steal all our business by offering total body scans without a physician referral (this was for out-of-pocket payment of course). The fad eventually died a natural death because the medical establishment made a concerted argument that total body scans didn't statistically lead to better health outcomes. While this argument may work again against Sciona, it may also wear thin on a public that is increasingly interested in managing their own health.

If Sciona is successful, this product could truly ease us into the age of genetics in medicine. Without much difficulty, one could imagine primary care physicians adding genetic screens to their H&Ps. Among other uses, hospitals could use the information to increase the efficacy of pharmaceuticals. Now there is no doubt that there are significant ethical issues surrounding the use of genetic information, particularly how it is communicated and kept private; nonetheless, we appear to be entering a very exciting era of medicine even sooner then most of us expected.


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