In an editorial in the current issue of the Journal
of the American Medical Association, Johns
Hopkins pediatric experts are calling on pediatricians,
policy-makers and medical educators to begin
planning "yesterday" for integrating genetics, genomics and
genetic testing into the everyday
practices of primary care and routine pediatrics.
"The thinking period is over, and we're sounding the
alarm not only for pediatricians and
physicians but for scientists, educators and
policy-makers," said Tina Cheng, an author of the
commentary and director of General Pediatrics and
Adolescent Medicine at the Johns
Hopkins Children's Center. "The only way to move ahead
is [with] coordination among and between all the groups
"There needs to be a shift in the mindset and in the
way primary-care pediatricians view
themselves," said George Dover, director of the center. "We
should take genetics out of the realm of
the rare and exotic and put it right where it can have the
most impact: in primary care pediatrics."
Among the group's recommendations are development of
universal guidelines for use of genetic
testing in primary-care practice and a federal law that
would make it illegal for insurance companies to
use genetic test results as grounds for denying coverage
As big business is already moving into the arena of
genetic testing and starting to target
consumers, it is critical that policy-makers, physicians
and educators get together to devise
strategies to harness the genetic revolution, the Johns
Hopkins team says.
Medicine and, indeed, society as a whole cannot remain
in reactive mode, the authors say, but
instead it needs to figure out ways to streamline and
regulate what is happening before it mushrooms
out of control.
"This is not a molecule-to-man fantasy or science
fiction; this is happening now. We need to be
on the forefront of implementing these changes," said
Ronald Cohn, of Johns Hopkins'
McKusick-Nathans Institute of Genetic Medicine.