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Howard J. Federoff, MD, PhD, executive vice president for health sciences at Georgetown University Medical Center, is acutely aware of the hurdles facing the introduction of a sweeping new vision for health care, systems medicine. Federoff sees this approach impacting, not only how patient care is delivered, but perhaps even more importantly, how GUMC teaches, conducts research and engages with the community. As a concept, systems medicine is at once complex and straightforward. Federoff describes it as an approach that will allow health care providers to understand the interplay between genetics and the environment in such a way that they will be able to predict who is at greatest risk for disease, rather than simply reacting to symptoms.