PRACTICAL GENETICS
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which treatment and medication has the best chance of helping our patients ? The answer quite simply is yes ! Informed decisions about medication choices that are more likely to address the patient ’ s disabling symptoms with minimal side effects are a major step forward . I would submit , that the tired , old excuse of “ these tests are not ready for prime time ” is imbedded in ignorance and not in the realization that our patients have moved well beyond our defensive statement , “ We just don ’ t understand this well enough to know !” Consider our antiquated views of the impact of social media : we don ’ t have to like it , but that ’ s what our kids ( and patients ) use to decide what is right !
Can a primary care provider truly rely on a genetic test to inform the decision about which treatment and medication has the best chance of helping our patients ?
needing mental health care . It takes weeks to months to get a patient in for psychiatric care , and when they finally get in , the options are restrictive or too expensive . Patients are begging for clarity around what is wrong – and what can I do ? Are meds the only answer ? What about diet and exercise ? Can vitamins or supplements help ? Will regulating my sleep make the difference ? Genomics testing can inform your counseling of patient ’ s complaints .
The physician excuse of “ This is too new ” or “ I don ’ t understand ” is no longer reasonable when our patients spend hours on the internet reading about the elegance of personalized medicine , and their trusted providers remain skeptical . Using this technology extensively in my psychiatric practice the past four years , I can say with confidence that love it or hate it , this type of genomics information is here to stay . Our patients expect ( and deserve to believe ) that their doctors remain current and are not hesitant to discuss these issues with them . I hope to share with the reader future success stories , and treatment failures as well . This technology should not be seen as a panacea . However , the movement forward is inevitable , and it ’ s time we all abandon our antiquated prejudices and move forward , to the precision model our patients are now demanding .
Dr . Wernert , MHA , is the Executive Medical Director of Norton Medical Group and practices with Norton Behavioral Medicine .
The field of psychogenomics testing crashed on the shore of American health care a decade ago with somewhat rudimentary tests that focused on genes associated with drug metabolism and likelihood of drug-gene interactions that would cause side effects and resultant side effects . Today , consumers have options from physician ordered comprehensive genetic profiles ( retail pricing = $ 5,000 / test ) to Amazon-ordered Mental Health Maps ( retail $ 450 - $ 600 / test ). Many insurance plans are stingy and require “ high bar ” prior authorizations requirements to cover the test . Now patients can bypass the bureaucratic American health care system and get their own read on their genetic profile . Is a physician-ordered test better than one I order online ? Bottom line : you get what you pay for in terms of detail and predictive value . For example , it may be informative that based on your genetic profile , you are prone to insomnia or being over-anxious , but it is more therapeutic that you learn that only certain classes of medications would alleviate your symptoms . Patients want positive results , not scientific observations .
PROFESSIONAL ANNOUNCEMENT PACKAGE
The GLMS Professional Announcement Package provides mailings and printed announcements in the monthly publications to let your colleagues know about changes in your practice .
Outsource your next mailing to GLMS .
CONTACT Amanda Edmondson Director of Communications & Marketing 502.736.6330 amanda . edmondson @ glms . org
So where do we stand in 2021 on genetic testing for psychiatric disorders ? We have a major manpower shortage in capable mental health and psychiatric care . It falls on primary care to assess and make informed decisions on care for our growing consumer class
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