“I want to make primary care doctors rich” – the potential of genetic science to reshape medical care

The statement in the title of the post was made in jest by Navigenics Co-Founder and Chief Scientific Officer Dietrich Stephan, Ph.D. to me recently. Dietrich was in DC, along with colleague Phil Marshall, MD sharing views on the future of medicine and health at the renown Lauriol Plaza in my neighborhood. In the context of our conversation, Dietrich was speaking to the current imbalance in our health system that prioritizes procedures and specialty care over primary care in our resource allocation.

The statement made an impact on me because it triggered visions of a different world, where medical students might choose primary care and community as the lucrative specialty instead of the ones they choose today with this idea in mind.

With that as a starting point (instead of “we want to make primary care less disenfranchised”) Dietrich laid out a vision for primary care providers as stewards of genetic science, leveraged to help patients stay healthy, whether by suggesting lifestyle modification, alternate therapies for common conditions, or mitigating risks later in life. Right now, our instruments are very blunt when it comes to predicting risk even for things where we have lots of data, like heart disease.

What would it be like for primary care providers to work with patients to plan a healthy life by wielding the best genetic science, and how would society value that relative to procedures? The path of primary care might change, from managing and directing goals and processes in the management of chronic illness to a new role of predictive science and planning, for a person, a family, a community.

I went to medical school hoping to become a family physician and left medical school hoping to become one, because I was most interested in what I would do as a physician. Even though I was a molecular biology major in college, I haven’t really considered how genetics would integrate into medical practice. Now I am. See what you think, comments welcome.

Ted Eytan, MD