Post-genome integrative biology: So that's what they call clinical science

Abstract

Medical science is increasingly dominated by slogans, a characteristic reflecting its growing bureaucratic and corporate structure. Chief amongst these slogans is the idea that genomics will transform the public health. I believe this view is mistaken. Using studies of the genetics of skin cancer and the genetics of skin pigmentation, I describe how recent discoveries have contributed to our understanding of these topics and of human evolution. I contrast these discoveries with insights gained from other approaches, particularly those based on clinical studies. The 'IKEA model of medical advance' - you just do the basic science in the laboratory and self-assemble in the clinic - is not only damaging to clinical advance, but reflects a widespread ignorance about the nature of disease and how clinical discovery arises. We need to think more about disease and less about genes; more in the clinic and less in the laboratory.