Dr. Tommy Cawthon, M.D., Cardiology, describes how integrating precision medicine through medication management and pharmacogenomics has made a difference in how he practices medicine. For more information on how this capability could enhance your practice, please see this “Case for Practice Integration,” or contact us.
Dr. Tommy Cawthon, M.D.
Good morning. I’m Tommy Cawthon. I’ve been in private practice a little over 11 years. I do general cardiology, and I do interventional cardiology as well. I pretty much run the gamut when it comes to cardiology problems.
How did you first hear about GenoPATH and this type of personalized medicine?
I first heard about GenoPATH – I guess it’s been about two years now – but I originally got interested in the whole field when I read an article that Eric Topol authored on personalized medicine and pharmacogenomics. From that, then I gradually got more interested in this area.
Has anything about your practice changed since you introduced GenoPATH?
Absolutely. I started to integrate them into my practice approximately three years ago. It took a little time for it to change how I practice, because, just like anything, I had to get used to using it on a daily basis, but once I started to do that, I saw the value of it and how it really changed how I would treat the patients, and then how they would feel. When I first looked at it, I didn’t really understand Cytochrome P450 at all. Not in the way I needed to. So, by integrating that in a patient’s chart, now especially with the electronic medical records, it’s so simple [not only can] we interface easily, but [also] it allowed for me to do a much better job from a comprehensive standpoint about how to manage their problems with the right medicine.
Do you have any particular situations where patients experienced better outcomes as a result of integrating this personalized medicine approach?
There’s one particular guy that we were having so much trouble with. He needed to be on a beta-blocker because of his underlying chronic coronary disease and I just remember him having so much trouble with so many medications. This was in its infancy when I started to use it and I did the swab and found him to be a poor metabolizer to 2D6 and we changed him from a Toprol to Atenolol, which doesn’t go down the 2D6 pathway, and within about a month he was calling and saying he “felt like a new man.” It wasn’t even manifest in his blood pressure or his pulse, it was just purely on his overall general well-being and how much better he felt. That was really an impactful moment when that happened.
Has the GenoPATH team been able to help you with the integration into your practice?
Definitely, and they were reassuring and they really kind of got rid of a lot of the fears, particularly about the insurance. They had someone in our office originally that did all of the swabs and was good about teaching the staff how to do that. Now it’s a seamless process after three years. I can order and keep going on to the next patient. The turnover time is so much faster now than it used to be, and that allows for us to do a better job of taking care of patients. As far as the future goes in this landscape, I think there’s so much potential, but just like anything, it takes a little time to try and get people interested in it and realize the true value of it. In the grand scheme of it, I see this being a mainstream task because of it’s impact on how it can affect patient’s lives in the morbidity and mortality on a daily basis.