tag:blogger.com,1999:blog-8480427453110572235.post7048916094629004676..comments2010-11-24T03:23:58.837+11:00Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-8480427453110572235.post-15906743724425236922008-06-22T04:39:00.000+10:002008-06-22T04:39:00.000+10:00Daniel,<BR/>Thank you for censoring. As soon as I sent, I regretted my actions. I appreciate this. I often get pretty heated about something I truly believe in. That was very responsible of you. Thank you.<BR/><BR/>That being said. If you are interpreting a test result that will be delivered to the patient/consumer it is at the interface of patient/consumer where the clinical is being done. At least this is true in the US....If I am not mistaken, the same is true in Australia.<BR/><BR/>A lab sicetist can deliver a lab report to a physician and that is NOT medicine. Why? The physician will then re-interpret the report clinically. But if you do not have that buffer, then what the scientist in essence is doing...IS interpreting for that patient and giving them the clincal interpretation. It seems to me that all of this "Physicians want a bigger piece" argument can be countered with "Scientists want to skip physicians" something that has NEVER been done before. This sounds to me like a power grab by the lab guys.....NOT a power grab by the MDs. <BR/><BR/>Just my 2 cents.<BR/><BR/>Thank you once again for responsibly monitoring your comments. I still maintain that Richards "editing" of my comment changes its meaning entirely.I make no money off of the testing itself. I.E. no profit motive TO test or NOT to test.<BR/><BR/>-SteveSteve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-87418810987175533322008-06-21T17:11:00.000+10:002008-06-21T17:11:00.000+10:00Steve,<BR/><BR/>I have time for a very quick response.<BR/><BR/><I>What blows me away is how you guys cannot see that when the gene testing shifted from blood to spit that it turned you into market share rather than individuals......That is what's scary.</I><BR/><BR/>Firstly, we were no less "market share" when we were being churned through the grinder of medical centres, pathology services and diagnostic companies; and secondly, what could be more "individual" than the consumer choosing which tests (s)he will or will not have?<BR/><BR/><I>SNPs+ Interpretation IS medicine.</I><BR/><BR/>By that definition, I'm a clinician, and so is anyone else doing modern genetic research, genetic genealogy, or a host of other activities that are manifestly not medicine.<BR/><BR/>This sort of statement gives the impression that you're just trying to re-define anything you're interested in as being the exclusive preserve of the medical establishment.Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-3679375630949333142008-06-21T15:28:00.000+10:002008-06-21T15:28:00.000+10:00Steve,<BR/><BR/>I deleted your previous comment. You are more than welcome to attack Richard's argument as vigorously as you can, but I won't tolerate petty name-calling. I expect better from you.<BR/><BR/>I have saved the text of your comment - if you want me to re-post it without the insults let me know.Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-44903350923183395392008-06-21T10:46:00.000+10:002008-06-21T10:46:00.000+10:00This comment has been removed by a blog administrator.Steve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-24254206449125698242008-06-20T12:17:00.000+10:002008-06-20T12:17:00.000+10:00Ok, Guys.<BR/>I guess you don't get it. I get paid to see patients. Any thing...I mean anything that may increase patient referrals....may increase my patient load. As a physician, you can only see one person at a time...and at a 3 hour clip. Not in the terms of thousands of patients.... That being said<BR/><BR/>1. Increased regulation, may or may not increase patients. I would say it serves to scare patients away. It may initially lose me patients. GINA on the other hand actually brought us patients!<BR/><BR/>2. I have founded a medical education company too. This company actually benefits from the genomics exposure by the press. Regulations have not increased the demands for our education service.<BR/><BR/>3. I am for the best thing for the patient. What blows me away is how you guys cannot see that when the gene testing shifted from blood to spit that it turned you into market share rather than individuals......That is what's scary. If these tests required blood, then you would not be even arguing about regulation......<BR/><BR/>That is pretty disingenuous.<BR/><BR/>Althought I respect your opinions. I stand by mine. <BR/><BR/>SNPs+ Interpretation IS medicine.<BR/><BR/>Respectfully,<BR/>-Steve<BR/>www.thegenesherpa.blogspot.com<BR/>p.s. will this benefit me in the end? I couldn't argue that it would. That would be to premature and foolhardy. As Burril and Co points out!Steve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-55666324092711649972008-06-20T11:59:00.000+10:002008-06-20T11:59:00.000+10:00sciphu,<BR/><BR/><I>This however, should be implemented as a patient-right rather than industry-prohibition.</I><BR/><BR/>Well said.Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-31556303733815004872008-06-20T11:58:00.000+10:002008-06-20T11:58:00.000+10:00Steve,<BR/><BR/>I for one would be very interested to hear your response to Richard's points. <BR/><BR/>I've given you the benefit of the doubt by removing the term "financial" from my post, but in reality it's hard to see how your business model (whatever that is) would not provide <I>some</I> financial incentive for you to want to see these regulations in place. <BR/><BR/>Perhaps you could be explicit: <BR/><BR/>1. Do you have a financial stake in the future of Helix Health?<BR/><BR/>2. Would regulations requiring increased involvement of physicians in genetic testing benefit Helix Health?<BR/><BR/>3. If the answers are yes and yes, how can you say that you have no financial conflict of interest over this issue?Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-59515715930045791822008-06-20T11:14:00.000+10:002008-06-20T11:14:00.000+10:00[Comment censored by "thegenesherpa":]<BR/><BR/><I>Also to those impugning my ideals because of financial gain....beware. You don't know my business plan. I make NO money testing individuals.....I repeat I make NO money testing or NOT testing. This is to ensure that my patients TRUST me. To this effect.....</I><BR/><BR/>In that case, the presence of <A HREF="http://www.helixhealth.org/PaymentAndInsurance.htm" REL="nofollow">this page</A> on your website is puzzling. Are you sure you don't mean you "DO make money testing or NOT testing and hope to make a lot more by lobbying regulators to force people to buy my 'service'" (or cheerleading for such lobbying by your peers anyway)? I found your "I'm independently wealthy and live in Greenwich, CT, so I'm not interested in making any more money" gambit on Genetic Future hilarious and not quite convincing.<BR/><BR/>If your claim is that you work for Helix Health for free, you presumably still have equity in the company you founded, which will potentially net you much more in the long run than an MD's salary. That is, if your company can succeed. You are apparently not confident it can do so without the government building you a client base.richardhttp://www.blogger.com/profile/01542051220232421027noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-72093255777126688002008-06-20T06:51:00.000+10:002008-06-20T06:51:00.000+10:00You know, I'm starting to think that Dr. Murphy is just disagreeable by nature. He's deliberately conflating DTC genetic testing, which has had a troubled past, with the new services like 23andme. He could also be simply too dense to see the difference, but I'm going to give him the benefit of the doubt and assume it's intentional.<BR/><BR/>How about this: You see something in your 23andme profile that worries you, go get a real live doctor to prescribe a real medical test. Solved?Mr. Gunnhttp://www.blogger.com/profile/17434342767819948877noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-69834828449073872372008-06-19T19:04:00.000+10:002008-06-19T19:04:00.000+10:00This was such a thorough and balanced post. Thank you. I can tell you that I live in a country where genetic testing is regulated extensively: any pre-diagnostic or pre-symptomatic test can only be done by a few authorized (public) medical genetics centers, and must be followed by genetic counseling both before and after testing. These strict test-definitions actually include "innocent" tests like Cyp-testing for pharmacogenetics. I can promise you that you do not want a situation like this. Over-regulation hinders progress and takes away personal freedom. While I am sure that some regulation should be in place (like lab-analyses quality control and restrictions to avoid overselling of tests and/or test-results), medical counsel is not really that essential. This point is underscored by the fact that patients seems to largely ingnore the potential impact of even the most damning of genetic test-results (Huntington’s, see my three posts on genetic counseling on sciphu.wordpress.com). That said, patients that feel unsecure when faced with their own genetics (which is probably a lot of them) should most certainly have the opportunity to consult a physician knowledgeable in genetics. This however, should be implemented as a patient-right rather than industry-prohibition.sciphuhttp://sciphu.wordpress.com/noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-45890597617121245802008-06-19T12:36:00.000+10:002008-06-19T12:36:00.000+10:00Deepak,<BR/><BR/>I couldn't agree more: right now, personal genomics companies provide little value for money in terms of useful health information, but they're having a generally positive impact on the awareness of the community about genetic issues. They're currently doing the spade work so that by the time that personal genomics really starts to come of age (maybe in 3-5 years) the community will be at least somewhat prepared.Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-2343198252538600192008-06-19T12:28:00.000+10:002008-06-19T12:28:00.000+10:00Hi Steve,<BR/><BR/>My apologies - I've removed the word "financial".Danielhttp://www.blogger.com/profile/07276690118219000204noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-28186416916963061452008-06-19T03:18:00.000+10:002008-06-19T03:18:00.000+10:00Daniel,<BR/>I am independently wealthy. I only see patients because it excites me and intellectually stumulates me. I do live in Greenwich Connecticut BTW. There is no financial conflict because I make NO money off of testing people. I repeat, I make NO money off of testing people. Unlike the testing companies. Please don't represent my position or interests until you actually do know the business model. I made the same mistake with Ryan Phelan. Don't repeat it.<BR/>-Steve<BR/>www.thegenesherpa.blogspot.comSteve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comtag:blogger.com,1999:blog-8480427453110572235.post-67091527925090143162008-06-19T02:48:00.000+10:002008-06-19T02:48:00.000+10:00I am sure my understanding is better :). However, we have an opportunity here. 23andme, just to pick an example, does a pretty good job of presenting genetic info, with some pretty good tools. Those can be used by people to learn and by the community to help raise awareness and make sure people are clear on what we know, what we don't, and the implications.Deepakhttp://mndoci.myopenid.com/noreply@blogger.com