Policy & Practice


Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their health care provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing, said Michael S. Watson, Ph.D., executive director of the college, in a statement. The policy statement is available at

Women Hit Hard by Uninsured Status

Women of child-bearing age are more likely to be uninsured than are Americans in general, with potentially serious consequences for their health, according to the American College of Obstetricians and Gynecologists. About 18% of Americans younger than 65 years are uninsured, compared with 20% of women 15–44 years. Uninsured women are less likely to receive clinical breast exams and tests for cervical cancer, and are more likely to be diagnosed for diseases at more advanced stages. And since women are the health care decision makers in many families, their lack of access to the health care system has even greater consequences, according to ACOG. The problem of uninsured Americans is not going away and will require the continued attention of the medical community and elected officials, Dr. Kenneth L. Noller, ACOG president, said in a statement.

Iowa to Insurers: Cover HPV Vaccine

Iowa Gov. Chet Culver (D) recently signed legislation requiring insurers to provide coverage for vaccinations against the human papillomavirus. The new law, which will take effect Jan. 1, 2009, will require insurers that provide coverage for any vaccination or immunization to also offer coverage for the HPV vaccine. The law has a different focus from many of the legislative efforts in other states, which have considered mandatory vaccination of school-aged girls.

Coping With a Malpractice Lawsuit

Despite legal advice to keep quiet about a pending medical malpractice suit, ob.gyns. need to talk about their feelings with family members, according to a statement from ACOG. In a May opinion, the college's Committee on Professional Liability advises physicians to inform family members of the lawsuit and the potential for publicity, while keeping clinical aspects confidential. Common responses to medical liability litigation include feelings of shock, outrage, denial, anxiety, guilt, shame, and despair, the opinion stated. Coping with medical professional liability litigation is an ongoing, complex process in which physicians often must struggle to regain a sense of personal identity and professional mastery as well as control of their clinical practices.” State or local medical societies and medical liability insurers may offer support groups for physicians and their families, or physicians can turn to individual professional counseling, the committee advised.

NIH Committee Gets New Members

The director of the National Institutes of Health recently appointed three new members to the institutes' Advisory Committee on Research on Women's Health. The new members are Dr. Linda C. Giudice, Dr. Nancy H. Nielsen, and Debra Toney, Ph.D. Dr. Giudice is a gynecologist and reproductive endocrinologist and chair of the department of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco. She also recently chaired the NIH Reproductive Medicine Network and currently sits on the Institute of Medicine's health sciences policy board. Dr. Nielsen, an internist, will become president of the American Medical Association in June. She is also senior associate dean of the State University of New York at Buffalo School of Medicine and Biomedical Sciences. Dr. Toney, a registered nurse who runs a licensed home health care agency, will assume the presidency of the National Black Nurses Association in August. She has more than 28 years' experience in leadership roles in family practice management, ambulatory care, and home health care. The Advisory Committee on Research on Women's Health is charged with advising the NIH director on research activities and the inclusion of women in clinical trials.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications?” asked Consumers Union's Liz Foley in a statement.

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