Steve at Gene Sherpas reports systemic medical insurance fraud in many top institutions providing genetic health care. Clinics are billing as if doctors are seeing patients, but only genetic councilors ever see the patient. “But I have a solution,” Steve exclaims. “The answer: Nurse Geneticists.” He continues, “Call your insurer. Demand to be seen by a physician or physician extender… Why should you demand this service? It will put stress on the broken system. To repair that system, we must first rebuild the foundation.”

Be careful what you wish for, Steve. Systemic abuses like this that risk high liability for meager reimbursements suggest a deeper problem than petty greed. Either the system has collectively concluded that genetic councilors are sufficient to perform the service and that they are following procedure “in spirit,” or they are desperate to keep unsustainably high margins and must resort to abuse to protect them. I suspect some of both.

The problem genetic councilors is political. Genetics used to be called “eugenics,” literally, “the science of the well born.” After World War 2 and the civil rights movement, it became taboo to socially direct population growth and the practice of human genetics was legally and institutionally castrated. Today’s “non-directive” genetic councilors are the progeny of this purposefully impotent profession.

However, scientific progressed. We discovered DNA. We learned molecular biology. We sequenced the human genome. Suddenly, the members of this small, marginalized profession were both keepers of the hereditary taboo and keepers of the code of life.

So, that’s what genetic councilors are: specialized nurses who aren’t supposed to touch you or tell you to do anything, but who have become the hands, eyes, voices, and smiles of this newest, most vital paradigm of medicine. So long as people need a warm consult and an authoritative opinion, there will be a place for you.

That’s probably the nicest thing I’ve ever said on this website.

Old medicine was dead the day you adopted “evidence-based medicine.”

There, I feel better.

What medicine? Scientific medicine. Mathematical medicine. Mechanized medicine. Terabytes of cited hyper-linked studies compiled into statistically weighted results medicine. Input symptoms and test results, output diagnosis and CPT medical billing code medicine.

Beep-bop-boop you’re dead, have a nice day. (the industry, the not patient, who of this ethnicity and phenotypic profile can expect 55.2% efficacy and 82.1% efficiency over control who received traditional care)

And no other medicinal discipline is as scientific mechanical as genetics. How mechanized? Watch, I’ll make a free clinical diagnosis machine prototype right here on my blog. Yes, not a risk report, a real diagnosis. Just input your genome sequence service account login, and my machine download your genome securely from your sequence service and practice medicine.

Your Sequence Account OpenID URL:

Your Password:

#!/usr/bin/env python
import genome
HTT = genome.autosome[4][3046205:3215485]
if genome.search('(CAG){27,35}', HTT)):
    print "mutable"
elif genome.search('(CAG){36,40}', HTT)):
    print "reduced penetrance"
elif genome.search('(CAG){41,}', HTT)):
    print "positive"
else:
    print "negative"

Would you like to subscribe to our genetic counseling service? Now, only $89.95 a month!
Don’t have a sequence? Sequence with us! Now only $999.
Enter your credit card and you gmail account and password below.

The real question is: are you dead like “mama bell” AT&T, the century-old institution that suddenly crumbled and consolidated. Or, are you dead like the newspaper, a slow and humiliating decline of consolation and standards of with only a few prestigious survivors?

So, OK, some genetic councilors will go back to school for additional nursing or physician assistant credentials, and some genetic centers may begin staffing appropriately if they can afford to despite the gross waste in health care already. But realistically, I’m supposed to believe that genetically-trained nurses are the solution? A new, more expensive kind of medical profession for which academic and institutional support will take decades to mature? When America is straining under grossly inflated health care costs during an economic depression? Meanwhile, I can hypothetically write a Python script to practice medicine and hire a perky and well-educated Indian genetic councilor to answer phones now for cheap?

Have fun breaking the system, Dr. Murphy. It needs to be broken, sure, but I’ll meet you down here at the bottom.