The genomics revolution, in which Dr. Snyderman had participated at Genentech with the sequencing of the human genome was going to transform medicine by allowing it to be more personalized and preventative. Dr. Snyderman envisioned a bold new approach termed personalized health care. Duke foresaw this and pioneered programs in personalized medicine. Perverse reimbursement incentives made broad application untenable. However, Duke’s efforts were nationally noted and spurred health care reform.