Editor ’ s Corner
Making a Hematology Wishlist , and Checking it Twice
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The content of the Editor ’ s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated .
Have a comment about this editorial ? Let us know what you think ; we welcome your feedback . Email the editor at ACNEditor @ hematology . org . appy New Year ! Can you believe it ’ s 2017 already ? Another holiday season passed , another calendar page flipped , another year gone by .
I thought that I was pretty good this year , earning a spot on the “ nice ” list , but Santa still didn ’ t leave all the presents I wanted under the tree . Here ’ s a sampling of gifts I asked Santa for this year ( and didn ’ t get ):
1 . An empty Epic in-basket . Who wouldn ’ t want a squeaky-clean Epic in-basket ? But nope , I woke up on Christmas morning to find it full of messages from nurses , pharmacists , patients , and other providers , and much of the content in those messages had nothing to do with me or the hematologic issues of the patient I was being messaged about . Yes , it is nice to know that my patient who was treated for iron deficiency has a normal cholesterol level , but the notice is now something that I need to read and answer to clear out my in-basket . I ’ m starting to believe that I ’ ll never set eyes on that mythical “ empty ” in-basket .
2 . A clinic day without a referral for a nearly normal blood count . It ’ s not too taxing on the overstrained brain cells , and it can be a nice break from the complicated cases in which patients simultaneously bleed and clot . However , I contend that a nonagenarian with a platelet count of 148,000 doesn ’ t really require a hematology consult , especially when the patient is in a nursing home with terrible dementia and a broken hip .
3 . A medical school class that doesn ’ t complain about small-group sessions at 8:00 a . m . I ’ m the course director for the hematologic block at the University of North Carolina , which is now taught in the first year of medical school . Every year , our faculty receives multiple complaints about the unbearably early start time for our mandatory small-group sessions . Apparently , an 8:00 a . m . start time is a violation of the Geneva Conventions . Think I ’ m being hyperbolic ? Here are a few of the comments I ’ ve received regarding the timing of these discussions :
• “ If she thinks small groups are important enough to be mandatory , then she should hold them in the afternoon when we ’ re awake .”
• “ There really is no need for small group to start at 8:00 a . m . every day . Many of us are still trying to adjust to waking up early and are still in that early adulthood sleep rhythm of studying late and waking up late .”
Really ? I love it when I see these same folks as third-year students on their surgery rotations .
4 . The complement cascade to be magically implanted into my cerebral cortex . I know I make a New Year ’ s resolution to learn this set of pathways every year , and I really did try – several times , in fact . Yet , every time I get to “ classical , alternative , and
Alice Ma , MD , is professor of medicine in the Division of Hematology and Oncology at the University of North Carolina School of Medicine in Chapel Hill .
lectin ,” my brain automatically shuts off . And how could it not ? I read “ lectins ” and my brain gets confused and sees “ lentils ,” then I start thinking about black bean soup and … yup , another attempt to learn about complement is derailed . Maybe next year !
5 . Not having to take the American Board of Internal Medicine ( ABIM ) Maintenance of Certification ( MOC ) exam ever again . I didn ’ t get this present this year and had to take the recertification exam in hematology in October , but , given the recent MOC shakeup , it might actually be waiting for me under the tree next year .
Assuming that I passed this year ’ s exam , then recertifying in the future might look really different : exams every two or five years , an open-book option , etc . Also , though I appreciate the attempts to test all of our knowledge , as a non-malignant hematologist , if I am ever placed in the position of having to choose a conditioning regimen for a patient undergoing a bone marrow transplant , then multiple things have gone wrong with our profession . I would welcome some of the proposed changes that would make the ABIM MOC process more relevant to our individual practice .
One thing I did get this year : a great group of colleagues and trainees at ASH and at my university . This is a present I get every year ; it ’ s the gift that keeps on giving .
I hope you received a couple of items from your 2016 wish list , and I hope you have a great 2017 ! Time to start making the list for next year !
Alice Ma , MD
6 ASH Clinical News January 2017