In todays issue of Science Horwitz et al. correctly point out that the promises of personalized medicine will not be delivered without the integration of the -omic data with individual clinical, social, and environmental information. One of the examples they use to make their point is to ask what would have happened if the -omics based personalized treatment approach would have been applied to native American indians (who have a genetic predisposition to diabetes) at the time before they switched to a Western diet – exagerated risk assessment and overtreatment. It sounds trivial, but it is indeed important to stress the relevance of gene-environment interactions. Horwitz et al argue that in most common diseases environmental factors dominate genetic ones. Unfortunately, the article does not tell us how to implement the ‘enriched approach’ to personalized medicine they suggest.