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Impeachment, Marlboro College, and DNA in Medicine

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The from Radio Vermont. It's the Dave Graham show on. WD It's your show about the people places and the issues that matter the the most of you. Now here's your host Dave Graham Good morning reminded is Friday November the eight thousand and in nineteen and so glad to have you with us this this morning. We're going to be Having an interesting show we try to vary up the topics ear and sure enough. We've got three good ones on the docket today in the latter our our the program. We are going to be joined by Dr Bob. I believe it's Wildman. He is with the University of Vermont Medical Center which this week made a really interesting announcement that they are going to start offering patients. DNA testing is sort of part of routine medical care and DNA. Testing can be used to find out whether a patient might I have a genetic predisposition to numerous diseases. I guess they're going to be checking for a hundred and fifty four different diseases from what I understand and under and this is obviously a brave new world in medicine we're going to be talking with With Dr Wildman about what it all means and what patients ought to be thinking about this kind of stuff so in the latter part of this hour we're going to be Have a visit with Dick. Sonic Richard Sonic the chair of the board of trustees. He's a Marlboro College. Much loved little college down in the southern part of the state which had been looking for a suitor. Three Vermont colleges have closed this year this this year in an era of the real struggles for small liberal arts colleges as enrollments declined. The demographics just aren't as many young people as has the war years ago coming through that age bracket that typically goes to college and so many colleges are are really struggling to attract students Marlboro has about two hundred students. They're going to be absorbed into Emerson College in Boston and We're GonNa talk to you a dick. About what all that means. How the Maral Marlboro legacy will be maintained to any extent that it will and also GonNa ask them? What's going to happen with the Marlboro Music Festival? WE'LL world-class famous classical music festival that occurs on that campus in the summertime. So we'll find out a lot about that. But I I wanted to bring in our guest of Peter Galbraith. Peter is has worn numerous hats in his long career. He is a former Vermont. A state senator. I think he's known in this state in part for that role Outside of Vermont. He has been involved in the in the diplomatic core for in the United States for a time he was doing some sort of freelance diplomacy over in the Middle East involving the Kurds for awhile. He's been in the oil business some and he he has A real interesting. I think perspective on the overlap between politics and diplomacy and why we would be interested in the overlap between politics and diplomacy right now. Well and there's one word that would sum up the answer to that and that is Ukraine. Maybe maybe two words Ukraine and trump anyway. My first guest. I believe Peter. Galbraith is on the phone with us this morning. Good Morning Peter. Good Morning Dave how are you doing well. I'm I'm doing fine Looking at the flurries outside but otherwise tonight's day that's all coming. We're going to get more of those. Little White Particle will slow down from the sky in the coming months. So you're ready for it and anyway I wanted to check in with you this morning because there's been so much going on with the impeachment inquiry in Washington and and I just thought you know you might have an interesting perspective on on all of this Tell me first off. This idea that that a president isn't into the United States would go to a foreign country and ask before country for To do something in exchange for. US aid is is not particularly new. I mean Bernie. Sanders is campaigning now on saying that. US aid to Israel ought to be conditioned on better treatment of the Palestinians I mean you could do and I've heard I've actually read a call by Republican columnist. who calls adequate bro quote outraged about that But this this is the the trump Ukraine matter is a little bit different in the sense. That you know Bernie. Sanders is not doesn't really have a personal stake. He has he has an maybe maybe idiological purpose or a political purpose in trying to change is really behavior regarding Palestinians but he He doesn't stand to win or lose election. I don't think based on On on what happens on what the country does. Is this unprecedented in your restoration. Well certainly what. Trump did is unprecedented but it has to be distinguished from Conditions that are placed on foreign assistance. which happens all the time I worked for fourteen years for the Senate Foreign Relations Committee and I handled the committee's main legislation including of foreign assistance and conditions? And I were to attach conditions for example in nineteen eighty one when Reagan administration wanted to send assistance to Pakistan Attached conditions on human rights and restoration of democracy on nuclear non-proliferation And and so it goes does Assistance is often conditioned on policy. But that's done actually by the Congress Now the Congress Chris may delegate some discretion to the president about the use of appropriated funds and in fact You know the president. Ah Ken withhold funds if they find for example they're being used corruptly or countries violating human rights standards and all sorts of things but what trump did of course was to condition the assistance which had been appropriated and which was for the purpose of aiding the Ukrainians against the the Russians who had invaded Ukraine are fighting there on a political Investigation negation of of a political opponent and an investigation under Ukrainian law not under US law. I mean there's no allegation in any any of this any suggestion that that there was anything done wrong under US law. He was trying to gin up a Ukrainian investigation of of Burris. SMA The company neither one hundred hundred Biden under Ukrainian law no allegation there either. But that's not the job of the president of the United States because there been any credible credible allegation out there that there was anything untoward about I mean you know other than somebody getting a seat unaccompanied board because of their. They're big name. I think that has happened before. I'm sorry all the time. Well okay so one hundred Biden gets a seat on this Barista board because I'm sure somebody had Barista thought boy. It sure would be cool to have this guy who is the son of the vice president of the United States on our board Just kind of as a as nothing beyond that really but was there. It was already allegation that once having gotten this this seat in a fairly a common method for doing so which is having a big name any allegation that Biden had done anything wrong after after that None whatsoever certainly not and not under. US law or on under Ukrainian law and instantly I don't think the company was likely looking for Hunter Biden to influence. US policy or influences spot. There I think probably they were trying to send a message to the Ukrainians that they had You know that they had connections but not that they were connections. They wanted that they really could use it was it was related to Ukraine rather than to the US. Yeah I mean. There's many many times I I look around and I say why are people famous and and it does seem to be in many cases that they're famous because they They have it name. I'm thinking these car tat. Car Dash Sheen's Robert Dash and of course was the famous L. A. lawyer involved in the Oj Simpson case. And so on. And and and now I guess his daughters are celebrities. And you kind of go. Why I mean what's what is there? Were other their special talents. Or whatever I don't know I a.. And so a lot of times the celebrity is. I've never understood it. Which is why I've never even approach being a celebrity myself but But you know I used to say even during the Oj Simpson case. Is that You know it was a big deal just because he was famous and I mean unfortunately these kinds of domestic violence cases happen all over the country All the time and but the country became obsessed with the trial of the century. OJ Simpson allegedly committed Domestic violence in ended in death. And so anyway I started that grass here but I do think that a lot of times there is just this big name culture out there that is probably what got hundred Biden. That seat on that board. Yeah I'm I'm I'm sure that that's the case and As the point happens all the time Condoleeza Rice who was George Bush's secretary of state in in his second term She went onto the board of Exxon Mobil and and it was because she was on the board. I obviously she knows. Nothing has no expertise in oil But she was on the board and that was how rex Tillerson The CEO ended up being the secretary of state was on her recommendation. That's really interesting. And so again. The connections big names in there you go. That's how that's how things get done. Folks I and and I guess Well let me let me ask you about the democratic inquiry here because I was reading something on. CNN this morning where just talking about their overall strategy Do you feel that the case is getting to the point. CNN was SORTA describing it as overwhelming overwhelming evidence. Now I think I think the case is completely airtight. that in fact of trump held up Duly appropriated assistance for an illegal and improper purpose namely to get The president of Ukraine to announce an an investigation of Joe Biden and Hundred Biden as well as to investigate the surf fantastic Conspiracy story that That wasn't it wasn't Russia that interfered in the US elections but it was Ukraine So yeah I I I think that That case is airtight tight and and it's told By career professionals in the US government not not by political people Bill A Bill Taylor the acting ambassador in Ukraine who is a career foreign service officer a veteran And and and along along Can't who was testifying yesterday. George can't Jennifer Williams who was a foreign service officer Sir. Who listened in on the call? I mean to some degree. You have to think For a president engaged in probably criminal conduct wasn't very clever. I mean you don't I am perhaps not really aware of. Ah that what he was doing was criminal because obviously isn't wise to You know all Gaijin extortion in our bribery With lots of different witnesses especially witnesses who are professionals and not not your political associates. Extortion sure bribery identical the Assad Eugene Robinson the Pulitzer Prize. When he call him was the Washington? Post had a very interesting column this morning where I think the headline was something like. Let's drop the Latin. Then call it what it is. which is he said? Bribery his theory of the case. Is that basically. The the president is is Asking a public official in this case basically the president of Ukraine to do a specific act in this case reopen an investigation in exchange for something of value. which is this this Military aid and visit to the White House and so That all that those those are the pieces that fit that a fact pattern pattern Best described as bribery. According to Eugene Robinson do you buy that well I think the the White House visit certainly would be something of value of being offered which and that would therefore constitute Bribery I I would argue a and I think this is not a almost a distinction without a great difference that in the case of the military aid it was extortion because the military aid was something that was already due to go to Ukraine. It had been appropriated aided Ukraine there were no conditions on it And the president was holding up. That aid extorting An announcement of a an investigation. Yeah I mean I guess there's I guess there's other reasons for that. Maybe it was both at once in the sense. Short happens all the time I mean Eh. These are these are very much related crimes. Yeah Kinda almost two sides of the same crime in in bribery. It's if you do something something good's going to happen and and extortion is more like if you don't do something something bad's going to happen so we have a couple of callers online. Let's go to Tom Ismailia. Good Morning Tom. Tommy there This is from starts Bro. Richard Snacks. Okay let's go to tax pro then. Good Morning I I read her morning. this is kind of addressed to Dave Couple of weeks. We talked about the The media's use use the terminology to enhance the political division of I just want to point out that Used for those terms that you call. That's the democratic investigation about five minutes ago and really we talked about it. It's really a health investigation or congressional investigation not a democratic. Ah Well of course I recall this phone call now a couple of weeks ago Do you think that if Democrats weren't in control of the house it would be happening the Jim Jordan. We're speaker of the House. It'd be happening the legal body. That's doing an investigation. What is the name of the illegal body during the investigation? Well it is several house committee so yeah there you go okay thanks thanks for the call I appreciate it. Let's He's Tom Tom let me just chime and I must say I agree with rich because I you know I it. This is how representatives is a duly elected Institution this Article One. I mean I you know we could of course referred to partisanship all the time. Instead of Calling Governor Opener Phil Scott. We call them Republican Governor Phil Scott or you know the Republicans Supreme Court but You know we. These are elected did institutions and houses fulfilling constitutional responsibility. Is I understand what you're saying I I also think though that Kind of the in Brielle politic world As I said if Jim Jordan were speaker of the House this this investigation would not be happening. L. Hillary Clinton who got the most votes president. This investigation wouldn't be happening because she wouldn't have done it. Well lots of there were lots of investigations of Hillary Certin Just finally closed the email investigation about three weeks ago. So just we as you didn't do something doesn't mean she wasn't going to get investigated or in the case of Benghazi over and over again a and So I mean I I hear what you guys are saying both rich. And and you and you Peter and I. I agree as a matter of of consort of formal government functional whatever it is the House of Representatives it will It looks like very very likely. Bring articles of impeachment run against the president and it is that the Senate will adjudicate his his guilt or innocence or not guilty verdict and and in decide his whether he will be removed from office or not I do I do think though that in there is a sort of news media shorthand happens opens quite a bit and I agree with that that it is the house. Democrats who are carrying the mall on this investing majority. Yeah I mean we also house we can refer to them instead of president trouble con Republican trump. That's okay I wouldn't be bothered by that very much and actually that raises an interesting question. I mean you've been around politics for a long time. I saw some statistics recently indicating that there there've been one hundred fourteen criminal convictions connected active with presidential administrations in the last fifty years. What number of those hundred and fourteen do you think we're connected with Republican administrations versus Democratic Administrations? Aw I think it's well over a hundred with Republicans if you do Nixon And who had about about eighty and who who's about twenty Twenty four twenty four and You know and then you had I think Iran Contra two and in Clinton was leading to one conviction in eight years Well you know. That's actually I. It's a lovely statistic. But there was one David portray us who is the director actor of the CIA was convicted of Of a crime of sharing classified information with his biographer who also happen to be a mistress. Oh right I'd forgotten about it. I don't know why it's left off. Course he wasn't a political appointee a four star general but he. He was convicted of crime. But still in eight years one crime and of course it was not a crime of of greed Well as so many of the others but what are you. Did you see some continuity here a lot of people SORTA regard trump is sweet generis Harris or something. He's one of a kind never before. Never never again or something. But is there continuity here. There's some continuity between Nixon and trump I sometimes with them. I think of. What Carl Marx said about the Coup of that made Napoleon's the polling the third. The temporary said Thinking back to the first Napoleon history repeats itself the first time tragedy the second time farce and there's some helmet between Nixon and and and trump of that But you know in many ways they I I I I would say that the Nixon Watergate was was more serious in the sense that you had smart. Ruthless people engaged in a Very systematic subversion of the constitution and corruption of the political process as well as You know waging enlarging the Vietnam Vietnam War into Cambodia illegally whereas a lot of out of of trump is is so incompetent impulsive impulsive I mean the the real issue. It seems that he you know he's really mentally fit for the job that he has And so it's a it's different. It's so obvious what he's doing. I I think the other difference. Though between the the Nixon era and this era is the unfortunately the Republican Party which clearly sees everything that all the rest of us e and yet is is so intent on power in so divorced from any ideology that call all they want to do is keep the Guy Office. I mean it's quite extraordinary right to think of the Republican Party. Which is the party of what a fiscal responsibility of family values and of national security which means standing up to the Soviets now the Russians? And you have a guy who cozying up to Putin Who Mayo is election to Russian interference who is thrice-married And you know makes payments to porn stars cheating on his wife and who. We'll put up the largest deficits in American history. I and nobody seems to mind. We've gone through the looking glass. Do we have tom on the line. Still Yeah can you hear me Yup. Good Morning Yeah Warning Guys I. I guess I'm surprised at Dave. You are sort of seemingly smearing the entire Republican Tardy based on nist. This crazy guy. We have in the way Peter you too. I mean gene. The Republicans are the Party of Abraham Lincoln and in our neck of the woods. Dean Davis George Ache and they'll Scott. That's not a it's not a bad shouldn't be equated with with Scandals and negative evil people. We have this. Yeah I mean I sorta Soda. I WANNA go there Tom I I really. That's my instinct is to is to have that image of the Republican Party and yet if you look at the statistics the last fifty years fifty years is a pretty good sample size. I'd say in the last fifty years of of American politics. We've had a hundred and fourteen hundred fifteen convictions. apparently if we add per portrays hundred and fifteen convictions of people connected with presidential administrations and and the vast majority You know one hundred it looks like a hundred and thirteen of them. are connected with Republican administrations. And you kind of have to look at the the numbers and say what is going on here. Don't you look at look at Bill Clinton look at you know. There's been a lot of lot of examples of scandals on the other side. Well there were one or two who in Clinton I mean you could look at the stats. That song pedia look up. Look look up about convictions connected with presidential administrations and. That's what that's what it will be over when I did that and I you know yeah. I keep in mind. old-fashioned New England moderate Republicans. How are they doing in their influence in national politics these days? Yeah I mean I listen. I'm sympathetic then. What you're saying Tom I also I think we need to look at the reality of the situation and and you know the numbers? Don't lie so I appreciate the call though I mean you. You know I can do it with with Tom here. Having served in the in the Vermont Senate You Know I. I worked very closely with my Republican and colleagues Have sometimes to the annoyance of My of the Democratic leadership in fact. I think it's fair to say Dave you covered it often to the annoyance of the Democratic leadership But you know they Vermont's different kind of place their sensible people how we have a moderate intelligent capable April bowl normal governor with whom I agree on on on many issues but and and when he campaigned he for governor because I was running for governor that year as well we were often in forums and he constantly kept saying that he was a against trump. Wasn't gonNA vote for him. Didn't vote for him So that it is I think in Vermont. We have at least in the elected part of the Republican Party. We have people who who put country first but unfortunately unfortunately it's not just the record of Republican Presidents And and and corruption their administration. It is the fact that the Congress the Republican Congress when it was in control was not prepared to do anything about any of that and they continue in lockstep support of trump Through in all of this stuff through the Muller report through the Ukraine business and and just through through ordinary business interests. And that's all you have Peter Galbraith. I really appreciate you joining me this morning. Running out of time here but I I I thank you very much for. Forget on the phone with us. David Lloyd. Already we will be back with more than eight Rancho pouting little laws and words from CBS News. In a couple of weeks sponsors Marlboro. College Trustees Chair Richard. Aw We'll be back folks. Take the stress out of holiday shopping. At the almost world-famous Warren store. We have something for everyone on your list from toys to beer jewelry. Three to wind clothing to your walks we have a wide selection of outerwear for men and women all twenty five percent off from some of your favorite brands. Such as cool Royal Robbins Rana saved the duck and more your holiday cards rap candles pottery Snow Globes always friendly knowledgeable customer service and Free Gift Wrapping. Come for lunch at Rockin Deli than head upstairs to Shopping Heaven Fun Funky Okay and Friendly the Warren Store mainstream Warren Village newsradio. WD FM and am now back to the day. Bram show what one of the things we've been following on the Dave Ramsey show here in recent months has been the trials and tribulations of Marlboro College much loved a small school down in the southern in part of Vermont Vermont as seen three small liberal arts colleges closed this year Green Mountain College in Poland Ecologist Saint Joseph in Rutland southern a college in Benetton Southern Vermont Colleges announced. I think the other day. They're looking at selling Their campus to a private. Prep School from New Hampshire. So we'll have to follow Figure out whether the that private prep school from New Hampshire is moving lot lock stock and barrel to to Bennington. Or what's what's going on there but We want to focus on Marlborough today in particular because we have a guest. Who's been on the show now? This is the third time third. Time's The charm. Maybe Dick Sonic Richard. Sonic is the he has been around to Vermont public life for a long time. Of course he was the Commissioner of the Department of Public Service. I believe at one point. He was longtime chair of the Vermont. Vermont Public Service Board So knows a lot about deregulation and Then it's been in a private law practice in my period for a number of years and also so is the chair of the Marlborough College Board of Trustees and He's GonNa Phyllis in on the latest doings at that. Campus down in down near Brattleboro just west of Brattleboro up in the hills there Good morning addict saw. Thanks for coming in good morning. Thank you excuse. Me and Wanted to check in with you. Just fill us in the big news from Marmer. This week is what it's very big news. Marlboro will change. It will move off. Its campus and become the Marlboro Institute of Liberal Arts and Interdisciplinary Studies at Emerson College College in Boston in Boston. Yes Emerson is known for for its are sand communications and so on in that area but it also has an end to pendant institute which teaches Liberal Arts and interdisciplinary studies that exists now. But it's a small part of Persson. We will make it a a big part because our faculty are tenured faculty and our Tenure Track Faculty will all be calm faculty at Emerson if they wished to and our students will move over also to Emerson. And we're we're delighted in this way out of what was a tough situation financially for US similar blur to the colleges that you were reciting had folded already From what I recall Marlboro has stronger down at than other colleges didn't it. Yes yes. We had an endowment have an endowment But we were about to get have to slice way into it closed close to twenty percent We were going to have to apply toward this year's budget and it would decrease the endowment down pretty fast asked like over probably two years. We probably only have enough left to close out the campus. Teach the students who were there and Grant severed staff everybody and it just was a it was a bad prospect so the future projections were not good and you decided to get ahead of it. And and work out this deal with Marlboro Co with Emerson College Emerson College actually Interesting School It's in the Back Bay in Boston right. If I recall correctly we had somebody actually graduated alumnus ever college as a guest on the show earlier this week. The comedian Steven Wright Join me for a while. And he's a very funny guy and was actually telling me stories about when he was painting the dorms. I guess. He had a job painting the dormitories at At Emerson College and they may have been enough a fuel for his later joke about when he would say It's a small world but I wouldn't want to paint it and He I asked Evita had some practical learning experience with a paintbrush. And sure enough. That's that's where he got it. Apparently and so that was A humorous little exchanged by the way Stephen Rate of course has got to be appearing at the flame. The're next Friday evening up in Burlington in and I'm sure that'll be a terrific show is very funny. Clever gentleman and has been Around the national comedy scene for a long time Emerson is produced a number of a number of folks here in Vermont and the media in the broadcast field especially and And not just all over the country so they do have quite a name in as a as a school for the arts for for Media Studies and communications as as you mentioned and now they would expand their into a more Stronger traditional liberal arts program a gathering in things like what English and history and et Cetera. Yes l. sure Emerson Emerson's well known in a particularly in the arts and it is a dynamic place with a wonderful president event who is mainly Pelton who has expanded it. It is very popular school. It has sound financials and We and is much larger than Marlboro. So we felt that it would. It made a lot of sense once. The opportunity came up to do this rather than just kind of ride our own situation down Actually that's an interesting question. Marvel has about two hundred students at home and what the student bodies like it Everson. So we're three thousand. Wow Okay so that is that is a much larger institution institution Of course Mar is still three thousand even small by Higher Ed Standards Having of course I went to Umass amherst for Undergrad. Averages was something like twenty eight thousand at the time and and And then know Ohio State for a master's degree and that was I think the largest single university campus in in the country. So I kinda stuck with the big places I don't know why exactly but anyway The but these these schools are they have played an important role in the overall fabric of of higher education. In New England and I do want to go back to the Music Festival because I'm so glad to hear you. You say that you told me dictated that would That would continue What is the likely impact on the music festival? If any from this announcement that's hard to say. We are looking into uses of the campus. In general there's some beautiful buildings on the campus and the campus in a beautiful spot up on on a hill in Marlborough side Brattleboro but the music festival has a ninety. Nine year lease We you had signed up for the music festival to be a permanent tenant and that lease will be honored. That's part of this deal and The Music Festival feels that the Marlboro campus is definitely their home now. As the festival they really are only there for about seven or eight weeks in the summer So we're going to have to work this all out. We're we're hoping to figure out other uses for the campus We're we're enlisting a number of people involved in the college now and and Alumni and various groups. I think if I might the the heart of Marlboro has been its faculty and it has an an and the its particular niche has been its curriculum at self determination in subjects and studies indepth study of chosen subjects and self governance and then it also ends with a very large large academic project call which we call the plan and that goes for the last two years and ah of the four that each student is there and it's it's like a kind of a super thesis a super master's thesis I the study. Will that continue emerson. Will they be expected. It will continue in some forms and may not form. It may not be the last two years maybe the last last year but we expect that to continue. We expect our faculty actually to have a great deal of influence in the way Education is delivered in this Institute because they may very well a lot of them choose to go they may very well be in in a majority and have a lot of controller. Yeah I was GONNA ask about the general read of the Faculty I mean is your understanding and most of the faculty marvel or it's a way different environment Emmett working in Marlboro Vermont. That it is comedian and out of Boston every day. And are they okay. I mean most of them going to go. We don't know yet I will say that the Faculty of my read the Faculty having discussed it with the entire Mahbubur community ready Two days ago was their initial reaction was to To be interested in it and not to be negative about it in general now there you know it runs the spectrum. Everything at Marlborough runs the spectrum and this one does too yeah. I think the faculty was intrigued with the idea and the idea that they would get their tenure would be transferred to Emerson Jason and They would become faculty members there. So this'll be this institute at at Emerson College will be the Marlboro Borough Institute Give me the full name. Here has a great day Marlboro Institute of Liberal Arts and Interdisciplinary Studies at Emerson. Okay that's quite a mouthful and one of the intriguing things about Marlboro to me over. The years has been it's town meeting governance where I've been to a couple of town meetings. There where students faculty staff are all welcome to come to One of the larger meeting places on the campus and vote on Various decisions about whether to build a new building or or start a new program or whatever and Will that continue in any form. I don't know I honestly don't know it wouldn't surprise me if it did. It really is part of the Marlborough. DNA and and our goal in looking for a partner here had been to perpetuate that tradition these these traditions of Marlborough. In the way they teach and the way and the self-governance will will be literally like the town meetings that they're having my guess would be that there will be a lot of students control and a lot of self-governance. They'll be able to pull off the kind of town meeting style but I think it will be good in. All of our students incidentally are automatically accepted with Emerson at the tuition rates that they're paying now and So we were. That was another important aspect of this deal. How do the how do those rates compare? I'm just I'm just wondering. Is that a good deal to get to it is and that's my understanding And they get whatever grants-in-aid scholarship and so on that they they have now at Marlborough. So it's not going to be a big sticker shock for them so the idea here is it. Students Held harmless effectively. Yes and Again you know big change in environment. I mean you think about going to a small school in a very very rural setting in the hills west Brattleboro Vermont versus you know versus a place Walking distance to a couple of subway stops. Oh aw that's that's a big difference How how are the students reacting? Well you know hard for me to gauge age. My sense was that their emotions were kind of all over the place when it was it was announced and their immediate reactions. A it just were hard to read I. I would say that they kind of ran the gamut and We'll see after they've reflected on it for for a while is it. Is it fair to say I mean. I think one reaction might be sadness because as gracefully Marlboros doing it and you would expect Maher Mar do do something like this more gracefully than average perhaps It's closing isn't it. Yes yeah and it's I I would say that three action is is a strong sense of sentiment and and at Ta And and among many people alumni former faculty members and staff staff is anxious of course because they would transfer to Emerson and the other groups that I've just mentioned you know now are extremely concerned about this and extremely concerned about the campus there is. It's a beautiful campus when wonderful buildings and And they are and of course. There was the educational tradition and is the educational tradition which they All relate to in a very positive way. Yeah I my impression you know I. I made A number of trips down to Marlborough College over the years during my work as a reporter for the Associated Press different things happening down there from time to time there would attract some media attention and so I'd had down there and and I always I always had the impression of the place that The folks who were there. We're kind of up against some tough odds and way in some ways but on your hand they really loved it and and it was. It was kind of a challenge very it was set up as a challenging educational environment. You know this plan. You talked about the Very a high level ex- expectations by the Faculty of the students And then just Some sort of rustic aspects of being being in such a rural place and so on and so forth Really not a not a standard university or whatever college college setting the you'd get in a lot of places but folks who were who were diving into that in that scene Marlboro Seemed to really love it. Yeah there are those who just feel so sentimental about their days there it It it. There's no question it's a challenging rural setting and anybody from Vermont knows what that means it means power outages. It means you. You Know Sketchy Seltzer source or even Internet service is it is You know it's a challenge. He says no question and people look back. Many people look back on their days at Marlborough with great strong sentiments about that aspect of it we also put aside one hundred twenty five acres of woodland preserve to study the woods. saw in in the science classes yourself did your undergraduate work at Harvard and then went to law school. Where University of Michigan? Oh Okay and So so you've been do you went to big places to Marlborough which two hundred students but Michigan Stadium watching a ballgame with one hundred in one thousand fans. Yeah that is that is just an amazing scene out there. Of course I might graduate school was at Ohio state similar environment there and and obviously big football rivals and so but Go into Ohio Stadium on a Saturday afternoon and it was pretty crazy just a while so anyway. We digress I I did want to ask in as far as Marlboro goes a college would have a lot of stuff I duNno lab equipment and books and in all sorts of materials that go with Running a course of higher education and Any any thoughts some what happens with all the all that at Marlboro does it. All just get packed up the moving van and sent down to Boston. Well what we have. What we have signed is is called a term sheet and it it gives the basic terms of this deal? We it includes groups To look into that sort of thing groups on the use of the campus group on the on the on the library group on You know various various aspects of this and so it's too early to tell the calendar perhaps of of this term sheet might be of interest we will be Probably deciding in May weather after we've we've we've vetted all these issues whether to go ahead with a final decision whether to go ahead with this and if we do the merger would take place as of July. Yeah now that's that's an interesting point here. I mean and one that needs to be made isn't it isn't a deal as of today it's a it is as a A tentative deal I gather the way best way to describe it or it's called the non binding term sheet. It is I think a pretty strong on commitment that We'll go ahead with it and we were all kind of gearing up for for it to happen. Yeah okay And so the the the broad terms of it Emerson would actually own the CA- Miro property. Well it would be transferred to them now. Now whether they have any particular interest in continuing to own it is some question I think. Probably they don't. And then the dominance large ruffling dominance thirty five million okay. So that's the is that the big prices fair way to describe it Emmerson some I suppose that is what in effect sets up this institute and Finances bringing that our faculty over these these other enclosing our campus severance and all that sort of thing already well we are As it happens just about out of time here for this segment of the day Graham. Show Richardson. I really appreciate you coming by giving us the latest news on Marlborough College and I wish all the folks down there. Good luck in this transition. I'm sure it's it's GonNa be Kinda hard in some ways but Best of luck with it. So thank you We are going to be going to. CBS News of the nominee our sponsors more. The road shoulder fallen. We hear a lot about shopping local in here in the mad river valley. We put our money where our mouths are. Make your holiday shopping of joyful adventure. Far from the present stress of the big box stores come to the mad river valley inexperienced the joys and charms of quintessential the central New England holiday stores bars and restaurants to fill a day trip or take a few ski runs before heading into Warriner Wakefield for lunch snack. While checking off the items on Your List at the Warren store away you'll find something for everyone best one. Stop shopping in Vermont where we're fun. Funky in friendly mainstreet Warren Village Graham am shown on Wbz FM and am. We are back and The University of Vermont Medical Center this week made an important announcement. Osman it's about DNA testing they're going to offer that to patients There are a lot of diseases these days it can be detected or predicted through DNA. Testing and. I'm a complete novice at this entire topics. I'm here to learn as much as I hope. Our listeners are in the next In the coming hour Dave Graham. I'm show it's a it's a I I love this aspect of the program actually that It's frequently feels like going back to school myself. And so Today it's going that'd be a little bit of medical school maybe but anyway you've EMC was kindly Able to spare US this morning. A couple of people who are involved in this project could come down one. One came down through the winter weather to talk to us. That's Dr Bob Wilton Dr Walden thanks so much for coming in here very welcome. I'm happy to be here on the phone. I believe we have Christine is Jim. Oh yes and you are a genetic counselor in the Genomic Medicine Laboratory. Yes walk all right. Well this is to folks I'm very glad to have with me this morning to talk about this because I saw this news release out of the university I immediately eighty Lee said to myself. Wow that's a big deal and and So first off. Let's go to the basics here What is Genomic medicine who wants to take swing at that shirl. I'll do that. So Genomic. Medicine is the application of the science I aunts and understanding of The variations in our genes are inherited material and applying that to Medicine and so you can actually do a DNA test on someone and What are you looking for? And what might show so the tests that were introducing adducing is somewhat different than the traditional genetic testing if you come in with Signs or symptoms of that might be a genetic condition Or a strong family history than we target that testing for the conditions. That are You know that sound like what you might have and and in this case we're Doing more of a screen for multiple conditions that are anywhere from a relatively common into uncommon but not extremely wear and we're looking for them and individuals who may or may not have any symptoms and Do I see a number of a hundred and fifty four. So there's one hundred forty seven so the the. The test has two components there's one component is a hundred and forty seven jeans That are are helpful in predicting health risks for the individuals who take the test and then the second component is a carrier screen With another about three hundred genes that looks for Variations in the genome. which if passed along to your children while your partner also passes along a variation in the same gene can result in a condition? So you health self don't aren't affected by that By your children could be if your partner also has a very in the same gene is a fascinating thing to think about. And I think we've only really become aware I mean after all DNA was just The whole uh fact in theory behind DNA was developed. What in the Nineteen Fifties Watson and Crick and all sure? Yeah so it's it's been a fairly recent development went and The the discovery of the structure of DNA was one of the big steps forward to understand how DNA works and there have been many other. You know sort of quantum leap since then And so you can actually look at someone's DNA and say what this person is more likely than other folks than the average person whatever to To develop heart disease or diabetes are kind of cer- certain so this this particular test is looking at Disorders orders in primarily two categories one is cardiovascular disease and these are conditions which are inherited within families Although they may appear new in a family in an individual and that affect the structural integrity of the heart and its vessels The ability of the heart continue pumping in a normal rhythm and things like that. I remember. Yeah this is really interesting. I mean I've had many doctors appointments in my life. Where a basic question you get asked is Tell us about your family. History of heart disease your family. Do you have diabetes in your family. Do you have this or that. Added and And clearly I think even even before it's become as readily apparent from testing with DNA People knew about heredity knew about Tells a little of the history of this. When did I become a habit a in medicine? Say Tell us about your family and we history. Yeah I think I think it's been known since since before The discovery of DNA even that at certain disorders were passed down in families or that certain families had a high incidence of certain rare conditions in their children for example and So their medical papers going back into the eighteen hundreds that describe families like that so we knew that things were going on and it really wasn't until The nineteen nineties late nineteen ninety s that we begin to really get a handle on What was underlying those the genetic changes that were underlying those does and so now? We're sort of jump forward to Saying okay we understand those and we understand what that means for many of them were still discovering new gene disease Z's associations but for the ones that we have understood for some time We want to take advantage of that information and apply it To healthcare so that people can and their providers can discuss what their risks are. No Christine Jim. Oh my other guests on the phone. This morning I don't want to ignore you in fact I want to ask you Are you taking this information from that. You would get results from the DNA test and then by your job title genetic counselor. It sounds like you meet with patients and talk to them about About what these tests might show exactly so we're available in the Genomic Medicine Resource Center to answer questions for patients either other before they begin the testing process to answer questions about the test. What it might tell you but then we are available after the test to discuss specific results and what it might mean for an individual and their family members? Wow and and so I are Ah some of these conversations pretty difficult I mean if you tell somebody you you are a very strong candidate for There's a in fact there's a particular kind of breast cancer. I understand which is strongly connected with with a certain gene is that right. There are a few different genes involved And hereditary breast cancer and and those conversations can be difficult but at the same time we would be offering individuals follow up with specialists. We would be discussing different surveillance. They may take which may prevent cancer and their family or in themselves. And that's obvious I would think the goal is to say We we think the We think the storm might becoming less batten down the hatches and try to prevent as damage to the extent possible. Exactly we want to arm and people with the information that How they can prevent it? And what screening. They may take to prevent any storm as you say it. And is there Do you end up with. I don't know dietary recommendations or or actual medicines. You'RE GONNA put people on as preventative. There may be it depending on the genes involved And we would be referring individuals to either a cancer specialist or a cardiac specialist depending on what we refined. It's kind of funny but I mean I I had My own genetic experiment. Perhaps my life because I have something called horizontal next Agnes switches visual disorder and From birth it and And when I was a kid I came across an old portrait painted portrait. Richard of great great grandfather. I think in my mom's attic or something and And the and the portrait painter apparently did quite an accurate in good job. Because this guy is is looked exactly like mine and And I remember thinking so. Does this skip a couple of generations or or You know exactly how does how does Because my parents neither of them I had horizontally stagnates and actually my kids don't either but you sons and and and So I sort of wondered about that if if there's is there any and all done on this particular thing I'm sure that's it's a phenomenon that we know well about and is called Decreased penetrates and what that means or or incomplete penetration. What that means? Is that even though you may have inherited a gene that predisposes you to condition You don't always express that can you don't always show the signs of that condition So that's that's A common FEM- an in a number of the genes particularly in some other cardiovascular genes. We're looking at. That's going to be an important message that will get as just because has you have this genetic change. It raises your risk for having this condition but you may or may not get it. Yeah that that the idea of of Of having a certain gene does not automatically dispose you to something in fact it it. There's some other honor offs which which I'm going to ask about it in a moment but I I have to say I remember reading a fascinating Article A couple of years ago by a science writer who lives here in Vermont Guy. The Guy by the name of David Dobbs and It it was about grasshoppers and locusts which I had never known before but are actually the same creature and they They but they have the they carry this gene that either express it. They don't if they express their locust and if they don't express it there grasshopper and certainly people like grasshoppers a lot better than we like locusts right right so I mean I I just I thought that was a really fascinating example of this kind of gene expression. I guess we're talking about right now right. Yeah I think there are factors that we don't completely understand. Some of them are environmental So for example people who have have a predisposition to The lung breaking down Get the disease more frequently when they're smoking when they're exposed to environmental irritants for example And there are also Increasing evidence that Other minor genetic influences exist. And that's why you don't always inherit all of your genes from your parent you inherit about half of them and the other half and the other parent and maybe A A second gene has is a an influence on the first one That by itself doesn't make any difference fascinating stuff to four four one seven seven. Seven is our local. Well number here in Waterbury One eight seven seven to nine one eight two five five ought to nine one. Talk if you're calling from slightly farther away that's our toll free number and My guests are Dr Bob Wilson of the University of Vermont Medical Center specialist in Genomic medicine and also Christine Jomo is On the phone with us she is a genetic counselor in the Genomic Medicine Lab and Let me let me ask you Dr Dr Wilson It tell tell us about where you. VM Is in the overall. Push in this direction. American medicine right or worldwide medicine right now we among the first here to To get into this or is this becoming widespread her we re catching up. Or How's that work. I think we're really among among the first and the some some of the things that were there are a handful of other programs around the country and around the world that are doing things that are somewhat similar. Most of them are doing this on a research basis And we're doing this as a clinical test. So basically picked out the segments of of the twenty thousand genes that that that are in our genome and That have the most value For Health at this point in time that we know of and were Testing for for those. And we're doing this as a I clinical tests There's opportunity to participate in research around that but that's optional and so I think I saw in the news. Release that that you're starting with one thousand patients who are who are in the practices of six primary care. Doctors are predicts primary care practices. Is that right. There's one one primary care practice that we're starting with which was the UVM Family Medicine Group and And they're six providers there that we're starting with okay so and patients since will be offered the tests through those providers initially in that. We're starting slow so we can make sure that the systems are working right. Our communications are working right. And that The providers and their staff Understand how to do. This were In the Genomic Medicine Resource Center standing by to help Help them Through this and I think they're going to learn very quickly the I also wanted to ask about the Are you hearing any pushback. Act from patients groups or patients individually Concerns about privacy and about Just you know is there. Is there any element that people need to worry about automatic front so It's it's something that is on people's mind Genomic Information is has the potential shoul to be a means of of discrimination There are federal laws For example the genetic information nondiscrimination the Nation Act or Gina. Ti is A law. That prohibits discrimination in the provision of Health Insurance in employment and But it does not prohibit discrimination based on a by life insurance long-term care insurance Or other types of insurance for example I just want to add that we've worked closely with the patient. Family advisors advisors for me of Em last year on in planning this project and how we would implement it as well as well as the UVM ethics specialist and and there is a Of course hip the Health Information Privacy Protection Act. I believe it is as another federal law that covers an awful lot of Medical information my wife's an rn by someone who you with some of these concepts yes so hip hip is his is so this information will be treated as the same as the rest of your medical information So it'll be secure in the medical record and non released to People who are not related to your health care Without your permission. Yeah that's I I would think that is a that is something that patients want to keep in mind and and perhaps you know ask enough of questions get yourself comfortable with is that is that if Goodwin's budget that's right because This is this is optional. You're a member of the Is it you university. She wrote Family Medicine Practice. If your primary care provider is in that UVM Family Medicine Group and That's where we're initially rolling it out. We do plan after that. Got To Expand to other primary groups within the OEM health network and then eventually to community providers viner's as well all right Let me check with my My good friend Dana Julian ask him okay. We don't need to take a break right right now. Sometimes we do and sometimes we. He just pointed at the sign he had put up earlier. Dave says break is optional. Okay Hey we have a caller on the line. Let's go to Hawaii uh-huh Judy and bury a belief. Yes good morning. Good Morning I have three questions and I'll get off the phone. Okay I WANNA know if this genetic testing acting. includes pancreatic cancer I wondered if unsure if this has to be something through your insurance and your insurance covers these these tests and is it just a regular blood test like the The breast cancer genetic testing. So so I'll go backwards It it is a regular blood test. it's ordered through your provider and the blood is drawn The same way any other blood tests is too strong and it takes them Three to four weeks for the results to come back for your provider to Have time to review them before Talking to you about it The first question was about pancreatic cancer I do believe that that is in the gene list We rely on our familial cancer program experts at Uvm to handle the those cancer predisposition genes And then the second question was question was the MO- insurances insurance cover this so actually in what we're what we're doing in the pilot is offering doing this for free so the testing and the Genetic counseling that as provided pre pre test and For many of the disorders post test will not be at additional charge. So there's no pre authorization required for insurance for this test at this time. How many do do you have an estimate After you had to present this to the hospital budget committee or something like that we we expect out of these first thousand patients. We're going to be testing that. A certain percentage adage of them will actually need Post test counseling. Yes so The the we don't actually have a really great idea How many are going to need GonNa want the counseling mom? The idea What we know about this test from Experience is that the jeans that of the disdain sat will yield about one in six individuals will have a positive result on the health risks portion and probably a higher portion portion will have a proportion will have a positive result on the carrier portion. And that's because we all carry several recessive genes for disparate disorders. That the likelihood they will meet a person and have children with them. That has the same gene changes relatively low except for certain disorders. Like cystic fibrosis and Sickle cell disease. Question sure How can you apply to be part of the Part of the testing so it's offered through the UBS family medicine group primary care providers and when they begin to enroll enroll each provider as we bring them on they will Assess the eligibility of each Individual before the The Clinic v Necks Clinic visit and offer it at the time of those clinic. Visits so some initial discussion can happen but it sounds like judy. If I have this right your question really we went to Can I ask to sign up even if I'm not a member of the VM. Family Medicine practice right now. We are part of that here in central Vermont believe so so we we may be getting here provider but we are starting With one family medicine practice and expect expect to roll it out slowly so I think it's a good question for your provider and to let them know you're interested in and when they come on board perhaps they he could keep you in mind something. Yeah so so. One of the thing about the pancreatic cancer so We want to make clear that for people who have a strong family family. History of of cancer pancreatic cancer melanoma or combination of those or breast and ovarian cancer or Colo rectal cancer especially with people getting those at an earlier age You should get referred for Direct testing of those questions. So you oh you don't need to really wait for this kind of test to come around But if you have an indication for genetic counseling and genetic testing you can get that now and insurance should pay for that. Okay thank you take your questions pretty much okay. Well thank you very much for the call I so so it sounds like just so just to make sure we're all clear on this Dr Wildman and and Christine Jim O.. the The situation right now. Is that these free tasks asser GonNa be offered at the family medicine practice me. That's up in the Burlington area right So South Burlington Is Our starting place. We'll move to Chester Chester and Milton. Okay County then And and folks in central Laurente. Maybe what a couple of years before it spreads that are what are you it depends ends on how things go. And how much funding we can do to continue offering it for free icy. Okay and Meanwhile though if you do have a concern about The presence of of a specific type of cancer in your family. You can get this kind of testing right now at by asking your doctor about it and and generally insurance will cover it. Yeah Okay Yeah so I think that that it really helps to clarify on some of the situation that we have another caller online jim from Chelsea. Good Morning Hi Jim Good Morning. It's another great Topic you have some of the most fascinating people on now. Really try thanks interesting. It's not just you know dead stuff that fills the air I think you probably just answered my questions but I'm a little confused. There's UVM and C. V. H. and a lot of 'em's visa and sees these are you out of Irwin or out of Burlington so we're out of BURLINGTON and I agree. It's all very confusing. Yeah Yeah so the the the UV medical center is partnering with several other hospitals to create the VM health network. And so it's very easy to get confused between all those pieces. Okay today which is U B. M as that. Berliner is that Erling Winton The is is the The University Medical School and Medical Center. That's associated with it. Yeah and Burlington and that's Burlington. Yes just call their office and they didn't know anything about it my GP says. I said we're we're we're we're rolling it out into certain office says okay only At the beginning to make sure that we get all the pieces running well. But if I understand you're you properly Is it something that excuse me anybody can go to any of their. GP's to ask for or or is it just through what you guys are doing. So so the the program that we're doing of offering it for free including including the genetic counseling in the referrals and that come out of it through that is only through us You can go to your primary care doc and order a similar test okay. Good but The insurance will unlikely pay for it so okay. Does this qualify for arthritis osteoarthritis or is it. Just cancer sir. In heart and so the genes are on this panel are are not strong indicators of osteoarthritis okay so if you have Something early onset osteoarthritis arthritis. Something like that. Then you may want to go through An arthritis specialist Yup yum. And then they say oh yeah. This looks genetic than they may come come to. Aren't genetics clinic. Thank you all hang up and keep listening to thank you Jim for the very good questions. you know and I do think that that is fascinating is. Is that if you go to your doctor and and and I mean leaving aside this program that was just announced this week. It sounds like a lot of this already. Goes on where you go to your doctor and say I have a strong family. History of X Y and Z DOCUMENT GONNA come down with X Y and Z and the doctor says well there's a today task for that and let's talk about your family history and I think the real question comes down to his The terminologies or the the fundamental question for the Insurance Company and Etcetera would be is it indicated you know is is it something that your your Your background your symptoms point to as as as necessary and of course then the insurance company gets a call about the prior authorization in and all that fun stuff and and Makes a decision. There is that how generally works in in the bigger world out there. Yeah and and the bigger world. That's right so you have have to have a reason to to consume you know health dollars and The health insurance companies are the gadget willy. Nilly we gotTA gotta go to a bottom of the hour break here on the Dave Ramsey show four. CBS News and a couple of words from our sponsors. We'll be back and continue our conversation with Dr Bob a Wildman and and with Christy Zumo of the University of Medical Center. Just a few minutes folks stick season is the perfect time for a road trip. It's an easy drive from anywhere to visit our perfect piece of Paradise in Warren Village. Have Lunch and are Rockin. Deli and venture upstairs to a shopper's treasure trove of toys gifts cards accessories and beautiful functional clothing for every lifestyle brands. You know and love cool. Totally Co Royal Robbins share the space with fashion forward grants like Tony Ballasts and comfy. Smart will darn tough and more upstairs at the almost world-famous Warrant Store Warren village. It's the day Graham Show WBZ FM am. We are back continuing our conversation with Dr Bob Wilson of the University of Vermont Medical Center also Christine Dean you o of the She's a genetic counselor with the Genomic Medicine Lab at the University of Vermont and Let me ask about genetic medicine Genomic Medicine Lab Christine Jimbo is is this just started up in conjunction with in in connection with this experiment. Here or or this this study. You're you've just launching or is this a existed for a while so it's been in existence for about three years and we currently are doing tumor based testing For genetic profiles in the lab and have been for the last few years airs. Let me let me get a little explanation to that. So if somebody comes in who actually has a a form of cancer and has a has a tumor they could be tested for. That is that what's going on right so certain tumors we are sent and we extract the DNA and we look for certain certain genes made guide treatment for a patient. I see and people always talk about the quote unquote elusive cure for cancer. Or whatever but how much promised promised. Would you say This whole genomic approach to medicine might have toward really trying to You radical or at least greatly reduced instances of cancer. Well I don't know about a radical but I know certainly tests like ours may indicate if someone and has an increased risk for a certain type of cancer and may be started on a specific surveillance program. Maybe offered a preventative treatments in terms of drugs. so there is that option and what sorts of drugs are generally used. If someone it comes in with a PREDISPO- predisposition toward I dunno bladder cancer. Let's say I am I that would be outside my expertise. They would refer them onto the familial cancer program or any of the other oncologists icy Dr World near thoughts on that one nurse. Yeah that's also I would be speaking a little outside of my My domain so They're they're a lot of the options that we provide to patients who learn that they have a higher risk is Kearlier screenings so for example for colon cancer. The current recommendations are to start calling us copy or other similar screening at age fifty but individuals with Lynch Syndrome will start a screening Much much earlier because they're they're onset of colon cancer may start in the twenty S. You know I I would. I would also think you could end up in a a situation where the doctors saying that. The patient listen There is a species predisposition in your genetic makeup and We generally remain. We generally do you know I'm a doctor. I'm telling my patients all day to cut down on their drinking. Let's say alcohol consumption With you you should be not drinking at all or something like that in other words it's even more important in this. Particular case is standing. There are some there are definitely some conditions that we will detect with this This test that affect deliver And for which alcohol It would be a really bad thing to do. Yeah and so that and I suppose was there a dietary risks. To in other words. You could say that pretty much. Everybody limit your intake of French. Fries for instance right because they're high in fat and salt all usually in CETERA and conducive to heart disease as we hear and and But in your case the doctor might say to the patient it's doubly so yeah. So there's there's a one of the disorders we expect to Pick up Relatively frequently something called Famille hypercholesterolemia which is a lot of syllables By you yeah you have very high cholesterol. That's that runs in the family and It can be treated with statin drugs. very successfully and you can dramatically manically change The development of for example coronary artery disease a heart attack risk Over the years every go ahead. I'm Kristie say. In addition to that it would be equally important to modify lifestyle in terms of Diet and exercise so there would be added emphasis. Yeah that that's I suppose those inputs diet exercise all of those things are going to have different impacts uh-huh on people with different Genomic makeup is that right. Yeah I think I think we know that I think we know there's a lot of Influence on I hope city and things like that in our jeans. Mom It doesn't Eliminate the value of a a reasonable diet and Getting regular exercise so I think everybody can still benefit from those a. We're not gonNA have doctors telling patients go ahead and have as many drinks as many plates of French fries is you want. Oh shucks anyway. Hey let's go to guy in Berlin. He's calling in Good Morning Guy Interesting. Show thank you dave. Better curious Well they'll be Screening our is our already but whether it be screaming for prenatal screening. We're down syndrome and that kind of thing so excellent question guy. the There this test is offered to adults who are not currently pregnant or their partners not pregnant And the reason for that exclusion is because there are different tests that are more appropriate atfer using in the prenatal setting If people choose to use them and get that information so the carrier screening they're redoing is really for people people who have are planning families or wanting to have families and trying to understand their risks and for It's been giving everybody in so even someone who isn't Having kids anymore may benefit from it by passing that information onto their kids who are each at fifty percent chance of having inherited that same change and then they're the grandkids could potentially be at risk depending on what the child's partner it carries that was a long explanation. I hope that was unclear guy. y'All set yeah that's right all right thanks to call good question I I did want to remind folks that Again there are there are some boundaries around this initial study that the university medical center is doing One is that that they've got to be at least eighteen to participate. Is that right right and and right now you pretty much need to be a patient of the give me the name of the practice account you the M. Family Medicine Group and they are based in county they have what three different clinics I guess. Oh right okay and eventually the plan is I'm told that Depending on continued funding. All the good stuff and success of this of this program that eventually you would want to extend it. Extend the offer of this free genomic screening meaning to I saw the number was amazed. I said one point. Two million P patients in the VM Network of course this is Again again a system of hospitals that extends not just in Vermont and you know to the Middlebury into Berlin and et Cetera but Also across the lake in New York state correct. Yes this is why I said one point two million twice month population so I should mention. There's what there's one more Criteria right now for which is that? The patients Insurance Policy Falls under Those that are Look so-called attributed under the Accountable Care Organization one care Vermont which is sort of an umbrella organization? That's working to help advance Patient Care Through better prevention and better cost I was GONNA ask about that you you need to be part of the one care system in order to participate as well. Yes that's the current Part of the current requirement. And that's for two. The reasons one is that One Kerr can collect information from different insurers about how effective This is What what happens to patients after after they get the test whether they take advantage of screening opportunities for example And what their a health outcomes are and what the overall cost is and the other reason is because in order to offer it for free There's a legal hurdle we we have to get over and one Vermont has the ability to issue a waiver to do that. What is the legal? Hurdle There's something called inducement and I'm not. I'm not a lawyer so I'm not going to get very much into this but when as I understand it and somebody can Nkala correct me That when Medicare and Medicaid were coming on There were concerned that Free things would be offered two people in order to capture those now insured individuals and have viability in practices And so that was Outlawed a lot. So there's a you can't do something that induces patients to come over to. Your clinic can give them something for free. Okay I see so so We we can't have a situation where we are offering a free service just to get you in the door correct and so what what what the waiver allows us to do is in this. Context have of Exploring ways to better. Preventative Care We are allowed to do this fascinating stuff and in healthcare economics. I mean I've been fascinated by the whole development of this one care accountable care organization in Vermont. And if I understand it correctly basically It's it's part of this overall goal. We've you've heard talked about for years in the whole Hel on whole healthcare scene of getting away from the fee for service system where a doctor gets paid depending on how many a shoulder surgeries they do And and if they're an orthopedic surgeon specializing shoulders say just for one example The The new system basically says we are going to give you a a number of patients and your goal is to keep them healthy over the course of a a year. And we're going to give you. We're GonNa Negotiate what we pay you based on that service as opposed to just these discreet payments for the individual healthcare operations in visits etc.. He I couldn't set a better. And it makes sense to me then This kind of Clicks Alexa my head and tell me if I'm the click eroneous but In in the one care context in the in the Care Organization context And you probably want to know if you're being given a certain population of patients to care for for and you're going to negotiate how much you get paid for carrying for these thousand patients agents or whatever it is over the course of a year You probably want to know Roughly and again that's preserve confidentiality and all that good stuff but you probably WanNa know roughly How many of them are predisposed to part disease? Let's say yeah I mean I think now and again I'm not involved in those calculations relations and I think that those are in aggregate taken taken into account because we know there's a proportion of the population that is and will be consuming You know Coal Cancer Resources Cancer Treatment sources earlier than than than most people or getting stents angioplasties. So that. That's I I can imagine That becoming a feature of uh of the system that is well tooled up in the direction of this accountable. CARE or or What do they call capitated budgeting and that kind of thing? Yeah they have a different name product. Remember at the moment but yeah it's a little bit different than the old inhabitated AL capitated model. I will say that you know I think one of the things that we WANNA Do as we were sort of Creating landscape a new opportunity for prevention and Being able to detect things earlier earlier I'm and Treat them at an earlier. Stage is not only better for the patient but presumably in the long term will save healthcare. Dollars right yeah and I I I don't i. It's a good point. I don't want to over emphasize the economics here because obviously a bottom line goal. This whole situation is to try to improve medical care in general. So that's a Christine where you're gonNA add something. I always just going to say and we also envisioned genetics. Genetic information becoming part of someone's yearly early annual visit where. It's not just something special but the genetic information is used in everybody's day to day care People are GonNA end up offering this stuff you know I find out on clear of all these different genetic predispositions would I would okay then an hour doing this if I were in the in the stage of life where I might be interested when I put that in my online dating profile I all up to you. Five ten free of heart disease forever. You know get guaranteed Ni- I A Anyway that just ran. Sometimes I have these bizarre random thoughts pop into my head and it caused me to ask questions which You Know I. I sort of asked myself lady. Why the heck did you go the Dave can I circle back to talking about going here? Let's doctor and And and Relating if you have a positive if you have a family history of early onset cancers or a a lot of clustering of cancer in your family What we've learned in the last three or four years is that That process which is not often done as well as it could be. I'm not as productive as volley but even if you go through that process You will miss at least half of the cancer predisposition families so this is not a panacea. We're saying right what I think what I'm getting to is that that's one of the reasons for doing the testing so people may not know they may not have a family history of the amount of small family. They may not know much about their family medical history and so there's a big chunk of people who are likely at increased risk. Who Won't know about it until they find their genetic variation? Yeah and and and these questions are these are issues that person probably does want to know about in the course of Of course of his life life and so this is important stuff About a year ago. One of these companies I. I don't remember whether it was ancestry. Dot Com or twenty three and me the Iran and add online where they featured a woman woman who said she had gone to work as a tailor for a day because she had found out that her great grandfather or somebody In her in her genetic history was that it was a tailor and and she found it to be really interesting and rewarding. Work for the she did it and Gee whiz maybe she had a genetic predisposition toward sewing etcetera but And I remember I looked at the ad and I said that's interesting to me because my grandfather Worked for the Associated Press back in the nineteen thirties. And of course people who've listened to the show regularly. I mentioned mentioned before that I I spent about thirty years in the associated. Press Bureau here in Mont Peel Year and And now I am radio and sure enough on the other side of the family. My Dad's uncle Was a guy named Raymond gram swing. WHO's sort of the one of the early? Edward R Murrow of the I think it was a mutual broadcast network. Back in the thirties. Also also so And I said so I am working for the AP radio and Gee. I never even had to give anybody a DNA test so lucky. He me but I wanted to spend our last few minutes talking a little bit about the the enough not to be confused with the Commercial Twenty three three and me and ancestry dot com and those companies versus This kind of genomic testing that is that the University of Vermont is launching into and Dr Wildman And tell us You mentioned on a break I asked you about it and you you said you think that that would ancestry dot com. It's doing good for entertainment value. Yeah I think I think you know the the ancestry thing is is it's interesting to people to learn you know something about their genetic heritage And his is as entertainment goes relatively inexpensive and It's it's a fun thing to do. there's a there's a categorical distinction between The what's a clinical laboratory that produces sonoma genetic information that you could use a medical care and and something that is for entertainment purposes or for your information your information only so there's a Another law that Clinical Laboratory Improvement Act clear which requires that any information Any testing information in genetics that we use in medical care ear. Be Performed in a clear certified laboratory and direct to consumer labs Most for the most part are not a clear. Certified defied and their In their sort of business model is not the same as we want to Work together with you and your healthcare providers. Yeah to ensure that you get the most and best information you can all right. I got an email here from And this may be actually a good would question for Christina. Jim Oh here. It is any concern that DNA test results may create excess unnecessary anxiety due to some small percentage percentage of possible disease or condition for patients. I'm not sure I want to worry the rest of my life that I the five percent chance of developing some condition. Christine what do you. What would you liter patient? Who said that to you? Well we would first of all say that this testing is optional. And we would not. We don't require patience to take this past and I think the second part would be that if we gave you an increased risk of a specific condition. We would also be giving you new plan of what to do next Your doctor maybe ordering some surveillance tests maybe earlier mammograms Then than you would normally have you may be referred to a specialist for monitoring and surveillance but it would be empowering someone with the information to take care. Take charge of their house. Yeah that's that's a a reasonably response. I think to the patient in your who has a lot of people. People are skeptical about everything and it sounds like there's a little bit of that going on here. People people do respond to information differently. Use it in different ways and that's perfectly normal and so you know people who feel like you know this is something that might just way on me and and that would be worse for me than knowing what it isn't having a plan to go forward thin that's fine and they. This is not a good test for them. All right We have another caller on the line pat from Randolph. Good Morning Pat. Good Morning I. I was wondering if these folks could tell me if there's a genetic predisposition to try cloudy or if that's just an anomaly so tripe triploid triploid is basically having instead of having two sets of chromosomes one you inherit from each parent You have three sets of chromosomes. It's pretty rare And in general there is not a predisposition to that Then I'm thinking back way back to my training. I haven't seen a case TRIPLOID IAN and many many years and I you know there may be a few extremely rare families where Um triploid might recur but It's it's extremely rare. They Call Pat and I just wanted to add. This test would not cast for employees And it also. I wanted to point out that it doesn't test for ancestry so that's not something that's included on this test. Okay that's a good thing to me. You're not gonNA tell somebody. Oh by the way your great grandfather was a Taylor. No in fact I. I'm not sure how they make that connection. Even in the commercial affects the I'm not sure what happens there. But there's some other steps that would have have to be involved but I think you would you would think yes. Yes triploid I'm not familiar with that at all. That manifest itself. It's it's complex. Okay Yeah I guess maybe too much complexity for the last two minutes of the Dave Ramsey here in WD ev the F. FM and am. I this has been a fascinating conversation and I think something that May may deserve another co paint in a year or so when you start to have some results and see Get get an update on how this is going. I'd love to have the two of you back and Perhaps in November of twenty assuming Some genetic disorder hasn't hasn't gotten me be by then and well. Yeah and we Because I I do think that this is does feel like a brave new frontier here and I commend the two of you as explorers. It's really really something so I wanNA thank. Thank my guests Christine Jimoh who is a genetic counselor where the Genomic Medicine Lab at the University of Vermont up in Burlington. Your University remind health network. It's a great pleasure to have you on the air with us this morning thank you. Thank you Dr Bob Wilbon gentleman and a scholar here. Here I can tell and and it's been a real pleasure to have you in the studio here. Thank you it's bench. Why and I want to mention is just in the last minute or so of the day Graham. Show here a a couple of things. We have upcoming next week on on Monday. We're going to be having an interesting discussion. Awhile thirty seconds. I'll make it quick interesting discussion with Margaret Maclean. and Dave Kelly. Are you about some of the problems with the act. Forty six School merger could school consolidation law. And that should be fascinating conversation in the second hour Monday show tune in then meanwhile stay tuned for a common sense radio. Bill Sayer and we will be back Monday. have a great weekend everybody.

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