tag:blogger.com,1999:blog-4519234397783312626.post3406694795328215793..comments2023-10-09T11:42:57.305-04:00Comments on Healthcare, etc.: Evidence and profit: An unhealthy allianceMarya Zilberberghttp://www.blogger.com/profile/16080475886113209344noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4519234397783312626.post-53682617028656965772011-02-13T20:21:26.191-05:002011-02-13T20:21:26.191-05:00Hi, Paul, great to see you here! Hope you are doin...Hi, Paul, great to see you here! Hope you are doing well. <br /><br />Yes, genetics holds such hope, but it is unclear when we will reap its full rewards. For over a decade there has been money thrown at genome-wide associations studies, which have yielded a lot of information, but not much knowledge that is usable so far. There is a move afoot to go in the direction of genome-wide interaction studies next. We will see what those yield. For the moment, we will have to be content with our usual clinical research tools, but learn to use them a lot better, more effectively and efficiently. <br /><br />Thanks for your comment. Hope to see you here again soon.<br /><br />MaryaMarya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-50428041730635491172011-02-13T19:01:33.044-05:002011-02-13T19:01:33.044-05:00Dr. Zilberberg,
I just read this week's JAMA ...Dr. Zilberberg,<br /><br />I just read this week's JAMA and I enjoyed your commentary. I am a family physician (and former student of yours) and remain optimistic about the future of primary care medicine. I agree with you that change is needed and I am intrigued with your heterogeneous treatment effect discussion. You also note that "...progress will be better understanding of genetics." One vision of the future is an electronic medical record system with the patient's genetic code stored on the server which will allow the physician to provide personalized medical care. For example, a physician will be able to avoid prescribing a statin to a patient who is genetically predisposed to myopathy. Time will tell how genetic research will play out.<br /><br />Paul Kruszka, MDPaul Kruszka, MDnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-37965537485292106622011-02-10T17:40:54.885-05:002011-02-10T17:40:54.885-05:00Dr. S, it breaks my heart that dedicated physician...Dr. S, it breaks my heart that dedicated physicians like you are that demoralized...Marya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-72609561840081418662011-02-10T16:47:32.126-05:002011-02-10T16:47:32.126-05:00Beautifully written.Beautifully written.Joseph P Arpaia, MDhttp://www.jparpaiamd.comnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-47387775119379752592011-02-09T12:04:27.452-05:002011-02-09T12:04:27.452-05:00MZ, another insightful commentary on our downward ...MZ, another insightful commentary on our downward spiral in which we accidentally collude with the medical industrial complex (MIC) to accidentally bankrupt America and Americans. As a Family Physician at the bottom of the funnel, I see no way out of the muck. The "guideline-itis" driven by the research to which you refer is slowly crushing the humanity of family doctors who wish more to connect to the patients reality than that of shareholders of the MIC. The clinical encounter in FM doesn't really start until the pt-dr dyad gets to "the fourth paragraph" of the pts story. Budget crunches cause many drs to stop in the 1st paragraph and just give mechanical responses to pt (unexpressed) need. <br />Your voice of truth about uncertainty, safety, public health, etc. may go viral enough to help create the next reality (I hope) but I'm worried/stuck in the muck at the bottom. (?no where to go but up?). Thanks- BLOG ON!A. Patrick Jonas, MDhttps://www.blogger.com/profile/15935504320560038973noreply@blogger.com