Does Familiarity Breed Acceptance? New Program Encourages Young Doctors to Get Personal with DTC Genomics.

DoctorThe Genomics Law Report launched its new series What ELSI is New? yesterday with guest commentaries from Hank Greely and Misha Angrist. One of the issues that both Greely and Angrist tackle—from different angles and with decidedly different styles—is the widely acknowledged shortage of health care professionals qualified to understand and interpret genomic information of increasing prevalence and complexity.

By sheer coincidence, yesterday’s Boston Globe profiled a new program at Beth Israel Deaconess Medical Center that invites pathology residents to learn about DTC genetic testing in a novel way: by becoming customers themselves.

Doctors in their second and final years of pathology residency training will take the class – attending lectures and researching the science behind the tests. If they choose, they can look at their own test results, submitting a sample to the genetic testing company Navigenics.

Traditionally, the stock response for many medical professionals questioned about DTC genomic services has been that they generate information that is simply not clinically relevant (sometimes the commentary ends there, sometimes the caveat “at this time” is added). But as the cost of DTC genomic testing continues to fall, there is a growing sense, even among some medical professionals, that the healthcare system is unprepared for the coming deluge of genetic data demanding to be integrated into patient care, whether because it is (or becomes) clinically relevant or simply because of an increasing number of patients that demand their doctors read (and understand) their latest DTC printout.

In the Globe article, Dr. W. Gregory Feero, special advisor to the director of the National Human Genome Research Institute, notes that “efforts are being made to increase genetic competency among medical professionals, including nurses, physician assistants, and specialists.” Similarly, Dr. Bruce Korf, president of The American College of Medical Geneticists, believes that “efforts like the one at Beth Israel Deaconess are essential to give doctors the ability to evaluate genetics information, even though most of it is not useful now.”

Integrating the different domains of DTC genomics and traditional health care professionals is hardly a trivial task, and the Beth Israel Deaconess program is hardly the first such attempt. Indeed, DTC genomics company 23andMe announced a similar strategy last month, providing discounts to doctors and encouraging “doctors to take [23andMe’s] tests themselves so they are better placed to help patients who take it and then approach them for advice.”

While both are creative approaches to a problem that many agree is indeed of immediate attention, the difference, of course, is that the Beth Israel Deaconess program is being driven by medical professionals and not by one of the DTC companies themselves. From a legal and regulatory perspective, the more closely DTC genomic services are integrated into clinical care, the more difficult it becomes to avoid categorizing—and regulating—DTC companies as clinical service providers. But from a healthcare perspective, increased integration and cooperation between these different domains is an encouraging development.