March 26, 1997

Medical Conservatism and Molecular Genetics

Author Affiliations

University of Kansas Medical School Kansas City

JAMA. 1997;277(12):962-963. doi:10.1001/jama.1997.03540360030017-a

To the Editor.  —Dr Theodoropoulos makes several interesting points in response to my article. First, he characterizes clinicians as being "always... the final receiver of [scientific] information." I think the situation has been more complex. Learned Western medicine from the Hippocratics to the present has been more pluralistic in its outlook than Theodoropoulos' statement suggests. Vernacular knowledge, particularly therapeutic knowledge, has been absorbed readily into learned Western practice even when the theoretical premises of that knowledge have been ignored or rejected. Also, many patients have gone to a variety of healers and information sources, not just the orthodox, from the Hippocratics forward.Theodoropoulos is quite right to emphasize the potential of genetic testing. Concerning molecular medicine, I think it is important to distinguish between 2 phases in its evolution, for they have quite different implications for medicine. The first was of limited medical impact, for it consisted of creating technical means for making