Reply

David and Gramling point to an important area of collaboration as geneticists and primary-care providers define ways to prepare for emerging opportunities in genomic health care: dialogue between the physicians in different health-care systems. We have much to learn from each other as we address the challenging task of integrating this new and evolving area of technology. Differences in training, patterns of service delivery and societal influences might lead to different insights or opportunities for experimentation.

The Brown–Oxford exchange represents an attractive model for encouraging the exchange of ideas and allowing rapid dissemination of successful innovation. It might profitably be expanded to include other countries in America, Europe and beyond, to allow for an increasingly rich discussion of both educational strategies and cultural responses to genetic medicine.