One fundamental problem in our field is the lack of an integrated work flow to address clinical issues. For example, developmental models (zebrafish, xenopus, mouse, chicken), lack some genetic power (xenopus, chicken). Cell biology model systems utilize cells from dog, monkey, human, rat, mouse, possum, pig and are frequently used but findings seldom transfer to developmental systems or physiological systems (rat, mouse, dog, pig, rabbit). So from a standpoint of efficiency important findings are not being translated as rapidly as possible from genetic models, cell culture, physiology and eventually to the patient. An NIDDK sponsored meeting on translational medicine should be held with all stakeholders to work on how we can become more efficient in bringing fundamental science findings to therapy.