Despite current excitement, the truth is that medicine has always been “personalized.” However, traditional personalized medicine has been based on both an extremely limited knowledge of presenting phenotype and an even more limited number of effective therapeutic possibilities.
The current interest in a new kind of personalized medicine comes as emerging technologies are pushing back the frontier of phenotype, while at the same time opening up new therapeutic and diagnostic possibilities. However, the current public understanding of personalized medicine often relies heavily – if not exclusively – on knowledge emerging from genomics.
Although highly promising, genomics is unlikely to deliver true personalized medicine in the sense it has always been practiced: With a few exceptions (e.g., at least some cancers) it tends to lack the immediacy of the diagnostic and therapeutic expectations of patients and their physicians. Genomics is a powerful way into understanding complex biology and disease, and perhaps can even deliver preventive possibilities in some cases, but the very real promise of a new molecular based personalized medicine will not be realized until actual “in the moment” phenotypes can be readily assessed and effectively addressed.