The (MEDICAL) Revolution Will Be Genome-Ified

I recently learned that for $100,000 I can buy a map of my very own genome, the full set of genes that run my organism. In about five years, however, it could cost me just $1000. This interests me because that map could save my life by helping me stave off deadly illnesses. For example, the map could alert me that I have a certain set of inferior gene variations that mean I would almost certainly get chronic obstructive pulmonary disease (aka COPD) if I started to smoke cigars every day again. Or it could tell me that I don’t have the defective genes that mean my coronary arteries would be lethally clogged by the time I’m age 75 if I continue to eat plates of beef and cheese all week long. My genome map could also reveal whether I’m one of those human beings who develops a severe muscle disorder from taking statins, which are widely-used cholesterol-lowering medications. It would also inform me whether I have the genes that almost inevitably trigger Parkinson’s disease, in which case I could start taking a drug that prevents its evil shaking from taking hold. The list of diseases that such genetic maps could play a crucial role in preventing in the near future—from diabetes to cancer to Alzheimer’s—goes on and on.

I caught wind of this looming medical revolution, called genomics, at the University of Miami’s 2009 Global Business Forum earlier this year. According to Pascal Goldschmidt, dean of UM’s Miller School of Medicine, and Jeffery Vance, chairman of the school’s Dr. John T. Macdonald Foundation Department of Genetics, genomics has the power to transform the sometimes sickening business model on which our medical establishment is based. “Genomic medicine has the potential really to move medicine from a reactive discipline to a preventive practice,” Vance declared at one of the forum’s sessions. “As physicians we hardly ever see anybody when they’re not sick. ”

Unfortunately, the genomic revolution may not liberate us from preventable diseases without a struggle. Some ordinary people, including friends of mine, will want to remain ignorant of whatever illnesses they are genetically susceptible to. But these folks not the reactionaries who trouble Goldschmidt and Vance most. Doctors are.

“This is going to be very complicated. There’s going to be a lot of information. We’re going to have to deal with it. And certainly doctors are not currently ready either to absorb that level of information or to explain it to patients who are scheduled just 15 minutes apart in their clinic,” Goldschmidt said at the session, in his Belgian-tinged English.

“Physicians get paid to take care of the sick,” Vance emphasized. “Physicians are going to be the problem.” That’s because doctors eschew information they don’t understand out of fear it could make them liable to malpractice lawsuits. And most doctors don’t understand genetics, Vance explained. He noted that medical schools must begin to prepare their students for a genomic future.

“When the era of genomic medicine does come, doctors, physician assistants and nurses will read and understand a patient’s genetic information as easily and routinely as pilots now read computerized flight data in the cockpit, “Goldschmidt predicted. “It’s going to be a great business opportunity in the area of managing information,” he assured. Eventually insurance companies will also have to get up to speed and cover genomics-based diagnoses and treatments, the two UM geneticists concurred.

Meanwhile, it’s time for those of us with genomes yearning to be sequenced to start taking action. I’m not crazy about sit-ins, but next time I’m sit-ing in my doctor’s office, I plan to ask him to please get ready for the genomic revolution.