Genetic Future

A reader pointed me to a recent Economist article on personal genomics. There are numerous tidbits of interest, such as a passing comment about the chaotic Chinese personal genomics industry (about which I know almost nothing). Perhaps the most important quote comes in the closing paragraph:

Dr Church even argues that genome sequencing “will in effect be available free” because companies will give away sequencing to sell other services, such as genetic interpretation–much as mobile operators “give away” handsets to get customers to sign up for lucrative service plans. And when this happens, he reckons, “it will be just like the internet: once all this information is floating around, a lot of creative people with PCs will nose around and develop applications.”

The ruthless competition in sequencing technology mean that companies in the sequencing industry will spend the next few years butting up against the bottom line, struggling to cut the price of a genome by a few more dollars to match their competitors. That’s a tough way to make a living. On the other hand, companies with skills in interpreting genomes – like, say, 23andMe and deCODEme – will be in a good position to take advantage of plummeting sequencing costs to provide useful genetic information to consumers. 

And as Church notes, there will also be plenty of room for entrepreneurial individuals with a little programming skill to build their own targeted genome apps – once everyone has their sequence on file there will be plenty of potential customers.

Comments

  1. #1 Steven Murphy MD
    April 17, 2009

    What exactly is “genome interpreting”?
    1) Reporting on science which is often incorrect in the end?
    2) Telling you bogus information about your “partner type”?
    3) Telling you which Iphone app is specifically for you?

    Just Curious…..

    -Steve
    http://www.thegenesherpa.blogspot.com

  2. #2 anonymous
    April 17, 2009

    What exactly is “practicing medicine”?
    1) Reporting on cholesterol or CRP levels when the science is not fully understood?
    2) Recommending unnecessary tests in order to get reimbursed by insurance?
    3) Prescribing drugs whose molecular mechanisms are not known and whose makers give gifts to doctors?
    4) Shilling for a company you run on the side?
    5) Spending 10 minutes with a patient if you work at an HMO, or charging extra fees to the wealthy to practice personalized, “concierge medicine”?

  3. #3 Steven Murphy MD
    April 17, 2009

    @anonymous

    I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath.
    To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

    I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

    I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

    But I will preserve the purity of my life and my arts.

    I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

    In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

    All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

    If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

    That is what I do……..
    Get a grip anonynmous. Who saves you when you are sick?

    Not a web app….stop being so obtuse.

    -Steve

  4. #4 anonymous
    April 17, 2009

    Interesting how that oath doesn’t preclude any of the things I mentioned. Medical consciences everywhere are assuaged by your comment.

    *You* may be a virtuous polytheist but apparently not everyone with an MD to their name is, because every single one of the things I mentioned is done by some people in your profession. Oh, you save me when I am sick? I guess that excuses all of these other abuses.

    Yes–mine is a one-sided list, but then, so was yours, wasn’t it.

  5. #5 Steven Murphy MD
    April 17, 2009

    @Anonymous

    “What exactly is “practicing medicine”?
    1) Reporting on cholesterol or CRP levels when the science is not fully understood?
    The science on CRP has been developing for 20 years not 2. ALSO WE HAVE A CLINICALLY VALIDATED PREDICTION MODEL CALLED REYNOLD’S RISK….
    Sheesh, read before you blast assumptions.

    2) Recommending unnecessary tests in order to get reimbursed by insurance?

    A doctor doesn’t get paid if he orders a test or a drug…..it is called antikickback statutes and is illegal, despite this, Navigenics’ BizDev proposed I get a deal like this shilling their test….

    3) Prescribing drugs whose molecular mechanisms are not known and whose makers give gifts to doctors?

    Gifts? You mean like a bic pen? The days of trips to tahiti are over. Haven’t you read about that?

    4) Shilling for a company you run on the side?

    My company is my practice, it IS my profession….

    5) Spending 10 minutes with a patient if you work at an HMO, or charging extra fees to the wealthy to practice personalized, “concierge medicine”?

    The limitations of care are reality of the business of healthcare. Want to change that? Fire your lawmakers and insurer. NOT YOUR DOCTOR….

    -Steve
    http://www.thegenesherpa.blogspot.com

  6. #6 Jason Smith
    April 18, 2009

    Thanks for pointing out this article,

    Where would I go to find more information with regards to programming genome apps? I have a background in genetics (B.Sc. in biology/microbiology concentrating on genetics) but no programming skills, and I was looking to teach myself some programming this summer.

    What would be the best programming language to learn first, and how could I tailor my learning with genome application creation in mind as an end-point?

    Thanks for any advice.

    Jason

  7. #7 les garson M.D.
    April 18, 2009

    well said Steve; it is unfortunate that the ‘business’ of medicine interrupts the ‘practice ‘ of medicine. It is difficult at times to explain the vagaries of insurances, compliance issues, threats of malpractice, not to mention tough medical decisions on a daily basis, etc., etc. to those outside of the profession. It ain’t all ‘E.R.’!

  8. #8 Daniel MacArthur
    April 19, 2009

    Steven and anonymous,

    Was that good for you? It was good for me…

    Jason,

    Different bioinformaticians will give you different answers, and it depends on your goals.

    If you plan to be a biologist who also knows how to code, I’d suggesting learning either Perl or Python (both good basic scripting languages; Python is probably preferable) and the statistical language R. This is the category I’m in at the moment.

    If you plan to be an actual bioinformatician, I’d suggest starting with C++ to learn real programming, and then branch out to other languages. This is what I should have done. :-)

  9. #9 Steven Murphy MD
    April 21, 2009

    Daniel,
    It is always good to point out that physicians actually to their credit DO CARE about patients…..Despite what the press or Silicon Valley says.

    -Steve

  10. #10 Daniel MacArthur
    April 21, 2009

    Sure, a lot of doctors care about patients – but there’s nothing wrong with pointing out that they also care about their wallets (a priority not always aligned with their patient’s needs), or that they often don’t understand what is in the best interests of their patient.

  11. #11 N/A
    April 22, 2009

    Daniel,

    Do you care about your wallet as well?

  12. #12 Steven Murphy MD
    April 22, 2009

    If PMDs cared about their wallets significantly, they would have went into radiology or orthopaedics…..

    Look at it this way. In the US, primary care practices are going belly up b/c they can’t make ends meet. These aren’t the FAT CATS you think they are……Instead, you should look to SV.

    -Steve

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