What the Ease of Genetic Testing Means for Physicians

The increased availability for genetic testing, including those that are being direct-marketed to consumers, raises concerns for physicians. A November 10th article in American Medical News brings to light issues of liability, regulation and oversight. With the rapid advances in genetic testing, doctors need to be aware of the impact genetic testing will have on their practices. If a physician does not recommend a genetic profile, for instance, for the diagnosis of some condition that therefore goes undetected, what issues of liability is the physician going to be facing?

An April study by the Dept. of Health & Human Services Secretary's Advisory Committee suggests that most physicians are not up to date with the information necessary to properly interpret such tests. And while there are regulations in place and oversight for the labs performing some types of genetic testing, such as newborn screenings and cancer detection, both well-established tools used by physicians for some time now, the use of genetic profiles to predict a patient's level of risk for certain diseases based on genetic markers is less standardized. An August 2008 Discover Magazine article, for instance, where a reporter had her genes mapped by three separate direct-to-consumer laboratories, revealed differing interpretations of the genetic markers.

Consumers are going to be increasingly armed with this information, however, and doctors need to be prepared to incorporate a discussion of genetics into their standard practice and interaction with their patients. Expanding current screening practices to include genetic testing, in some cases, is going to be necessary, as well.

There are currently clinical genetic tests available for more than 1,300 diseases.

Ginkgo Biloba Memory Benefit Doesn't Pass Test

Consumers spend millions of dollars per year on alternative medical treatments. An estimated $100 million is spent on Ginkgo Biloba; the leaves and extracts are widely marketed over-the-counter products in the US and in other countries. G. Biloba is generally touted as a "memory aid" or as a supplement to prevent memory loss. A study published in the November 19 issue of JAMA finds these claims to be unsubstantiated.

The study followed more than 3,000 volunteers (over the age of 75) who took 120 mg of G. Biloba or a placebo twice daily. The goal of the study was to determine the effectiveness of reducing the incidence of dementia and Alzheimer's Disease in elderly who had normal cognition or mild cognition impairment at the beginning of the study. Participants were evaluated every 6 months.

523 of the participants developed dementia by the end of the study. Of these, 246 received the placebo and 277 received G. Biloba with 92% diagnosed as having possible or probable Alzheimer's Disease. The overall conclusion was that G. Biloba had no effect on the reduction of memory loss in the elderly.

Commentary by Jonathan Silver, M.D., in the November 18th issue of Journal Watch Psychiatry concludes, "In the present economy, people can put the $100 million to better use."

I welcome your questions, comments and feedback relating to these issue; please do so by emailing me at baileyriskmanagement@medicusins.com.