Conversations Francis S. Collins

Conversations: NIH Director Francis S. Collins

Wednesday, March 24, 2010

Last week, before the health-care bill passed the House, Francis S. Collins, director of the National Institutes of Health, met with The Washington Post's editorial board and a group of newsroom reporters and editors. Collins, 59, is a physician and scientist who helped guide the Human Genome Project to completio n. He has led the NIH since last summer and oversees its 27 institutions and centers, 18,000 employees and budget of $36 billion (including stimulus funds).

Collins is also known for his 2007 book, "The Language of God: A Scientist Presents Evidence for Belief." He responded to questions about his Christian faith, health-care reform and genetic testing. Here are excerpts from that interview.

-- Rachel Saslow

Q What are you glad to see in the health-care bill?

The most significant thing is comparative effectiveness research. We've been doing a lot of that for many years, although it wasn't necessarily called that. We've certainly been comparing treatment A with treatment B to see what works best. An example is the diabetes prevention program, which taught us that if you're tipping over into diabetes, you're better off with diet and exercise than you are with medication.

What do you think are missed opportunities?

It could be a long list. I suppose we all hoped to see more of an emphasis on understanding how incentives for providers play a role in the cost of health care. That seems like the big area where we could have seen a lot of potential cost savings, and perhaps we will yet.

After you got your genome analyzed, what lifestyle changes did you make?

Diabetes turned out to be high for me. My lifetime risk, by this test, is in the neighborhood of 30 percent. . . . I got this information nine months ago and realized I'm not that lean or athletic, so I finally got involved in taking care of myself. I work out three times a week, and I've lost 22 pounds since last summer. I'm glad. It makes me feel better.

Now you might say, "Collins, you should have done that anyway. Did it really take a DNA test to get you to pay attention to good health practices?" Well, maybe it shouldn't have, but in my little anecdote here, it did get my attention. It's a reminder that we are all flawed at the DNA level and have the risk of some disease lurking in the future, and if we can do something about it, maybe we should.

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