United States: Clinical Adoption Of Personalized Medicine

A recent study published in the American Journal of Medical Genetics, "Barriers for Integrating Personalized Medicine into Clinical Practice:  A Qualitative Analysis" investigated physicians' perceptions about the future of personalized medicine and identified factors that would influence their decisions in using genetic testing in their practice. The study is an interesting read for any innovator in genomic testing and analysis and provides insight into what factors will facilitate adoption of genetic testing into clinical care.

Study Design

The authors of the study, Mehdi Najafzadeh, Jennifer C. Davis, Pamela Joshi and Carlo Marra, conducted three semi-structured groups of physicians currently practicing in British Columbia (BC). Two of three groups were in urban areas and the third was in a rural setting. Each group was moderated by facilitators that assured coverage of the following pre-defined topics:

  1. Physicians' general understanding of personalized medicine;
  2. Perceived advantages of personalized medicine;
  3. Effect of personalized medicine on future of clinical practice; and
  4. Perceived barriers to integration of personalized medicine into clinical practice.

Twenty-eight physicians participated in three focus groups conducted at different locations. The majority of physicians that participated were male (67.9%) and the median age among those who reported their age was 50 years old. The mean number of years practicing among physicians was 21.0 (SD=11.2). The authors note that interestingly, the majority (approximately 68%) of participants indicated their interest in using personalized medicine in their practice if they could have access to the necessary knowledge and tools. About 22% were reported to be against the idea of applying personalized medicine and 10% of the physicians were undecided.

Results and Analysis

Physicians' General Understanding of Personalized Medicine

The authors report that about 36% of physicians self-reported that they were not familiar at all with the concept of personalized medicine prior to participation in the focus groups. Some understood that personalized medicine was the application of personal genomics to tailored treatments, while others were reported to understand it to be clinical care focused on the individual (e.g., health care management for the particular patient) and did not have any relationship to the patient's genes, a patient's family history, social history or ethnic background. Yet others were reported to believe that personalized medicine related to wealthier patients having access to personalized health care.

Perceived Advantages and Disadvantages of Personalized Medicine

Perceived major advantages of personalized medicine included improved effectiveness and a reduction in adverse effects in treatments. Uncertainty in validity, equity issues and implementation were identified as perceived disadvantages.

Uncertainty around the validity of genomic tests given the complexity of gene expression was mentioned as a major concern. In addition, substantial financial incentives for private companies for excessive marketing of their services, possible mishandling of genomic information by private companies and discrimination based on genomic information (by, for example, insurance companies, private companies and the health care system), were reported disadvantages. Lack of public knowledge about genomic tests, possible harmful impacts to patients after use and reporting of results, and affordability of genetic tests, were reported implementation barriers.

Effect of Perssonalized Medicine on Future Clinical Practice

The study participants were reported to widely believe that genetic developments will directly affect their medical practice in the future; however, they also were reported to express differing viewpoints on the timing and potential influences. Some physicians reported to have already received requests from patients for interpretation of direct-to-consumer (DTC) genetic test results, and thus, advances in genomics were already influencing clinical practice. Others opined that the effect of genomics on clinical practice might take more than 10 years to be realized.

Barriers to Integrating Personalized Medicine into Clinical Practice

The reported barriers to implementation into clinical practice included lack of training about genomic tests and interpretation of results. A lack of clinical guidelines and protocols on the use of genomic tests were other key issues of concern to the physicians. The physicians also noted that the complexity of reporting and interpreting test results to patients were additional barriers to implementation.

Discussion and Notes For Innovators

In conclusion, the authors believe that despite the challenges that personalized medicine can create for the participating physicians; there was a general interest in using genetic information in their practice. The authors also believe that physicians expected to have access to training opportunities and clinical guidelines in order to use the genomic testing and interpret the results. Interesting, the authors noted that the cost of genomic testing and who would pay for the tests was one of the reported major themes raised in the focus groups.

The authors also raise the point that although many genomic tools are not currently ready for clinical practice, there was a consensus among the study participants that given the fast pace of genomic science, there is a need to be prepared for evaluating and implementing technologies upon their availability. The authors opine that creating the capacity in the health care system can be a lengthy and timely reaction to advanced medical technologies can maximize the benefits and minimize the harms associated with their use.

The authors note that many of the physicians in the study received their medical training before any of the currently available genetic tests existed. While the authors state that this highlights the responsibility of organizations that are involved with training physicians and the oversight of medical care to provide adequate training and education, innovators who develop and market such tests should also appreciate that many practicing physicians presently lack the support and training to interpret and communicate test results to patients.

Clinical application of genetic information to inform treatment decisions, a basic application of personalized medicine, must therefore understand and meet the needs of a primary consumer – the treating physician. Thus, training and on-going support to physicians and genetic counselors (that support physicians) are important to successful adoption of genomic tests that support personalized health care.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement

Mondaq.com (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of www.mondaq.com

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about Mondaq.com’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to unsubscribe@mondaq.com with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


From time to time Mondaq may send you emails promoting Mondaq services including new services. You may opt out of receiving such emails by clicking below.

*** If you do not wish to receive any future announcements of services offered by Mondaq you may opt out by clicking here .


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to webmaster@mondaq.com.

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to EditorialAdvisor@mondaq.com.

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at enquiries@mondaq.com.

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at problems@mondaq.com and we will use commercially reasonable efforts to determine and correct the problem promptly.