Precision Medicine is a new medical approach where doctors tailor care to each patient’s unique genetic makeup, environment, and lifestyle. Precision Medicine and its heavy focus on human genetics is now integrated into my practice, which gives us important tools to prevent, diagnose, and treat a wide range of diseases. I am personally very excited about bringing this approach to my patients, as I believe it represents both the present and future of healthcare.
The science behind genomic or genetic medicine is rapidly evolving. Each of us is made up of trillions of cells that are defined by 3.2 billion DNA base pairs. Until recently, this information that is so important to our health remained a mystery. Only a few could afford the high costs associated with genetic sequencing, and insurance would only cover the cost if you already had serious disease like cancer. And if you were healthy, predictive testing was simply not feasible. However, that situation has changed with recent technological advances and new studies showing the tremendous value of genetic testing in general health care. After much research, I now recommend all of my patients consider these new testing options. The cost is less than a couple months of a gym membership, or in many cases it is even free.
A Level Above Mass Market Genetic Testing
You have probably heard about consumer genetic testing from heavily marketed companies like 23andMe or Ancestry. While these tests are great for determining ethnic heritage, they do not rise to the standard I feel is necessary to make important medical decisions. We are working exclusively with high quality, FDA-approved labs that I have personally vetted. They use advanced sequencing techniques that are scientifically proven, and provide clear results with actionable information. If you decide to participate, we have lab kits available at the office for you to use. All genetic reports are delivered with genetic counseling from both myself and a genetics counselor, and will be available for your ongoing reference via a portal.
Please review the information below and reach out if you are interested.
Level 1. Family History
We are encouraging all patients to participate in Level 1 of the program at a minimum, which is included in your concierge service. The primary data that we need is your detailed family health history. You have probably already given us some basic information about your parents and siblings, but the current best practice is to go beyond this and collect detailed health information about your aunts and uncles, children, and other relatives.
We are using My Family Health Portrait, a free website tool provided by the CDC.
We will use this information in your annual wellness exam, and to determine if there are any disease-specific gene tests are recommended. If your family history indicates problem areas, your genetic testing could be covered by your insurance. I will advocate for any insurance coverage on your behalf.
Level 2. Pharmacogenetic Drug Response Testing
If you are taking any medications, then Pharmacogenetic Drug Response testing is important for you. If you are over age 65, on average you are taking over 4 different medications. And in this age group, the chances of a hospitalization due to adverse drug reactions is a shockingly high 10-30%. Even if you are under 65, 7% of all hospitalizations are due to an adverse reaction. 99% of all people will have some important drug response information on their testing report, and if you are in the fortunate 1% you will at least get peace of mind. Although pharmacogenetic testing is generally not covered by insurance, the cost is low enough that I feel that every patient taking a prescription medication should consider it.
I will use the results of this test in prescribing your medications, and will coordinate the results with any specialists that you are seeing. In the event you are hospitalized, I will work with your care team at the hospital.
Level 3. Comprehensive Genetic Testing
A comprehensive predictive test is the best option for the patient that wants to know all the details about their health. This level of test adds Health Risk and Wellness genetics to the equation. You may not be aware of this, but over 10% of us have genetics that may one day lead to a genetic-based disease. We will test for genetic markers for cancer, heart disease, vision loss, and hearing loss, infertility, dementia and more. If you do have a predisposition to a disease, we will take steps to prevent or minimize the impact as possible. Additionally, the Wellness test adds information that we can use to personalize your diet, exercise, and sleep habits. This Comprehensive predictive testing is currently not covered by mainstream insurance. In the past, comprehensive DNA sequencing tests have cost well over $10,000 and were therefore unaffordable for most patients. Recently the cost has dropped to a point where it is affordable for many and should be considered by everyone, as your family history may not be sufficient by itself to predict genetic health problems.
I will use the results of this test in developing your wellness plan. If genetic disease predisposition is indicated, I will work with you and any specialists on that as well.
If you are interested in more details about our Precision Medicine approach, please reach out to us. Also, for patients that want to understand the scientific detail behind this new approach, we will be holding two patient information sessions in May, posted with signup links up on the right column of this page (or scroll down if you’re on mobile). I will also post a video of the session on our web site for those that cannot attend.
I hope you are as excited as I am about Precision Medicine!
– Roxana Rhodes, MD