Letter from the President and Medical Directors - Spring 2018


Genetic medicine is an evolving area of research, knowledge, and, most importantly, for the majority of you reading this newsletter, clinical applications.  At Insight, we’ve taken the position that we can add value to the work of physicians and health care providers by persistently surveying the landscape of this evolution and making the best judgments we can regarding both standards of care and leading edge developments both in discussion with you and on behalf of your patients. 
This month’s newsletter brings commentary on two of those areas – selection of specific genes vs expansive panels for patients seeking an assessment of their risks for hereditary cancer; and, the technology choices underlying the increasingly important and expansive arena of genetic carrier screening.  For neither of these areas are there yet clear-cut guidelines or easy answers to the basic question of “what’s best.” These pieces offer, hopefully, useful information and perspective that expresses the basis for Insight’s choices.
In a third piece, we provide an update on another evolving area – the policies and practices of health insurers.  In this instance, a significant change in the practice of United HealthCare that affects a significant number of patients in the Chicagoland area – and thus your practice – was certainly worth space in this newsletter along with how we continue to expand our ongoing efforts to alleviate the demands of insurance billing for genetics off of both your office and your patients.   
And, Insight continues to grow.  We’ve added genetic counselors – whom you will meet here if you haven’t already in person.  And with a renewed ‘tagline’ -- Your future. Our insight – Insight and 2018 are your ‘partners in evolution’ with our purpose to work with you in the ways that best fit your practice’s efforts to better your delivery of medicine to your patients.
A note added as we ‘go to press’ – the FDA approved a direct-to-consumer (DTC) test from the biotech company 23andMe for the pathogenic variants. The test reports on the BRCA genes that are most common among Ashkenazi Jews as risk factors for breast and ovarian cancer. The continued expansion of DTC testing is having a considerable impact on both the population at large and providers’ interactions with patients. Our next newsletter will be looking at this topic and its ramifications.

At present, 23andMe is not yet accepting samples, and cost is unknown. The FDA, in its press release, stated that "consumers and health professionals would not use the test results to determine any treatment." It states further that "the test carries significant risks if individuals use the test results without consulting a physician or genetic counselor." We will provide updates as to how IMG can assist you if or when your patients decide to pursue this testing without consulting you or other providers. 
As always, please do let us know what you would find interesting and valuable in these newsletters

Thank you,

Morry Fiddler PhD, ASACMG
Jeffrey Dungan MD, FACOG, FACMG  
Lee Shulman MD, FACOG, FACMG  
Andrew Wagner MD, FACMG, FACOG