I think GINA is a really important aspect that needs to be fully developed, but I do think that there are already some controversies about employment and disease. One of my friends recently graduated and got hired at a company called Reynolds and Reynolds. The company provides health care, so to decrease its insurance costs, it has a gym that all employees gain membership, it also has its own health center on site for employees. The company does random drug testing for marijuana as well as nicotine. If any employee uses nicotine products, they are fired. Personally, I think that this is fine for a company to do. But, what if a company started looking at eating habits of employees and monitored their fat or caloric intake? It seems harmless to do nicotine testing but it can lead to an overuse of restrictions for employees. This shows the importance of GINA and making sure that health insurance companies and employers do not gain access to a person's genetic information.

I really believe that personalized medicine is heading in the right direction, but certain aspects are of concern. Many businesses will could use the information of their employees or future applicants as reason for letting go or not accepting someone. Also the question of who should be responsible to sit down with every patient and review their medical needs and areas that should be looked at more closely needs to be addressed more clearly. However I do believe that as time progresses these concerns will be answered. In my opinion, patients who receive this important information can benefit in terms of their health especially those who are taking many medications that could be reduced to just a few medications.

This makes me wonder how this \"well-oiled\" machine plans to work. It is always going to be difficult to gain support from regulatory agencies and money from government programs, but to try to coordinate both of those factors along with several others will be tough. Can PM ever run as smoothly as this post asserts?

So much can get so complicated when run through the government. Unfortunately, there is no other legal choice with how much the government is forcibly involved.

Aside from that, I was thinking about how all healthcare professionals have to know the implecations of genetics. I don't know which would be \"better\": to have all healthcare professionals add genetics to their workload, or to get a genetics specialist to council alongside the medical doctors, much like a nurse or pharmacists does in their prospectives roles. Is there any reason that really says that a genetics specialist cannot be in the equation without a complete overhall of how the medical specialists work?

I think that patient education is another thing that can help PM run smoothly. By educating the patient, he/she can become more involved with his/her medical care. Something as simple as learning how to interpret the results of a genetic test could help a patient in the long run.

Education for other medical professionals and GINA will be, in my opinion, the hardest to implement completely. There are already so many other medical professionals practicing now that are not aware or not educated on PM hardly at all. A lot had already graduated before PM even came out. All of these people would need to be educated on the topic in order to help the patients requesting this information. Also, GINA will be extremely difficult to accomplish. Once someone has had a genetic test showing risk of a terrible disease, there is no way to assure that an insurance company will insure that person with the known risk. It would be the right thing to do, but in the business world that is not the major concern. The major concern is making money, and the company would be a little iffy on embarking on that venture because they know they will probably lose money overall.

I just came out of a national board meeting tonight. We were deciding which grants to support and which to reject. There was one in particular that caught my eye, since we funded it only partially. The $33,000 that the grantees requested for genetic testing of ten of their patients was rejected, due to the fact that the board felt that it was \"too expensive\" and that money could have been put to better use. Unless completely educated, genetic testing is still considered to be a luxury and too many complications seem to follow the patient once his medical history is revealed. GINA should protect all patients, but does it do that for sure? Are we protected from discrimination from future employees and health insurance companies? What about life insurance? Would someone insure me if they knew that I had a terrible set of genes, loaded with mutations, like a ticking bomb?

It would be ideal if the healthcare practitioners implemented personalized medicine into their diagnosis and treatment. In reality, there would be a lot of catching up to do since many of the most experienced doctors have been out of school for so long, prior to the boom of personalized medicine. Although it is required of doctors to keep up on their studies, they can only understand the new information to an extent. That being said, it is best if a specialist gets involved in personalized medicine. There is a down side to this because the current trend in the health field is to have fewer doctors to reduce information left out that might cause issues such as drug interactions.

In the monetary side, I agree that some people will be uneasy at the though of insuring a person who has the chances of getting multiple diseases.

Genetic Testing seems to have mixed reviews in our society. Coming from a medical perspective, genetic testing makes perfect sense in that it could potentially help save lives and better the life quality of countless individuals. However, the main problem (just like it always is in our world today) is money. Everyone seems to be wanting money for something and genetic testing may seem to some people, like the same thing. Therefore, genetic testing should be supported and encouraged. Individuals should be more educated about the benefits of the testing and they may be more willing to accept it and support it financially.

I think that the genetic privacy and legal protection is one of the most important parts of PM. Privacy and legal protection is going to become increasingly important, as more people start to get their genome sequenced. The information that this sequencing provides is important, and does give insight into relative risk for certain diseases, but it will become very important to protect this data, so people are not discriminated on the basis of their genetic makeup. This is a huge issue, as people have no control over their genetic makeup. Thus, it will continue to be important that laws are put into place that protect individuals on the basis of their genetic makeup.

I think that the biggest barrier to PM currently is the lack of support by insurance companies. As we continue to advance our knowledge in this realm, it is important for insurers to be supportive and receptive towards the findings that are produced. In addition, I think it is important to consider how health insurance companies will use genetic data. While it is true that insurers should not be allowed to discriminate based on genetic information, I believe that the companies do have a right to this information just as they receive information about any current medical conditions a patient may have.

Increasing education could probably help with all of those problems. If law makers knew what needed to be legislated then they could move forward with protecting privacy and coming up with regulations. If insurance companies understood the implications of personalized medicine, I think they would be more likely to cover the test because in the long run it could save them money. From a patient perspective I think educating them could be helpful too. If people realize the benefits of the test then they're more likely to ask the their physicians for it. Physicians, of course, will play a critical role in personalized medicine so they need to know when to order tests and what to do with the results. Pharmacists can help by talking to patients and physicians and also being aware of dosing guidelines and recommending genetic tests. Once people know enough about personalized medicine to be comfortable using it, I think it will become a standard practice.

Education is perhaps the most valuable \"sprocket\" to advance in. Without the education, struggles will continue and application of PM will be staggered. The most difficult barrier to overcome, I think, will be genetic privacy and legal protection. Companies will certainly be looking for some way to peak at the genetic information of their employees. This information can be invaluable and it is understandable that they want to know the potential risks that hiring certain employees can pose, including any medical problems that could cause liability and performance issues. But the right to genetic privacy is also necessary, and as a result this conflict between both aspects will vacillate for years to come. And while the insurance companies will likely drag their feet as they do for everything, I believe that overcoming this problem will be less of a feat than the others.

GINA is an extremely important concept in this controversial topic. Just like employers and insurance companies can't discriminate because of race, they shouldn't be able to discriminate because of our genes. These are things that we have almost no control over. It's not like someone would choose to have a higher risk of heart disease or cancer, we are just born with it. Someone shouldn't be penalized for something that they didn't choose to have.

Also I agree that education is also important. If the patient knows how to interpret his/her results they can start to put things into their own hands and possibly try to change their risks.

I agree educating is very important. By educating the patient,and getting he/she more involved in what is occurring with he/she can really help out. Something as simple as learning how to interpret the results of a genetic test could help he/she out significantly.

As personalized medicine continues to be developed and more widely accepted and developed it also becomes more important. Just like you would treat a patient fairly and kindly you also need to treat them individually. Every patient is different and different things work better or worse depending on their make up and disease progression. The United States is becoming increasingly more diverse, acts like GINA are essential. Also with insurance there seems to be more difficulty and or stipulations to reimbursement and coverage, making sure people have availability and options is important.