SCABB Blog

Blood Bank Guy SCABB Interview 2014 Repost

Joe Chaffin, MD, Trendsetter, November/December/January 2014 Pulse Newsletter.

  1. Tell us a little bit about your facility and current position.

      I am a Senior Consultant in Transfusion Medicine at Cedars-Sinai Medical Center in Los Angeles, Calif. Cedars is a remarkable facility, serving patients with incredibly high and complex transfusion and therapeutic apheresis needs. Our cardiac service has performed more heart transplants than any other US hospital for the last two years. Active level 1 trauma, liver transplantation, and autologous stem cell transplant programs result in transfusion of more than 50,000 units of red blood cells each year in this hospital. In addition, my colleagues and I directly oversee over 200 therapeutic apheresis procedures per month. I am fortunate to work with three outstanding physicians: Ellen Klapper, MD (Director, Transfusion Medicine), Holli Mason, MD, and Heidi Shafi, MD. Together, we cover the varied transfusion medicine needs at Cedars, interacting personally and directly with patients and caregivers to provide active consultation and care.

 

  1. What do you enjoy most about what you do?

      The best part of my professional life is being a teacher to pathology residents and Transfusion Medicine fellows. My physician colleagues have graciously allowed me the opportunity to be the primary formal instructor for rotating residents, and I have educational sessions with them every working day. Over the years, I have realized that I am truly in my “sweet spot” when I am teaching someone something about transfusion medicine. The time passes almost unnoticed for me when I am with my residents! I love to figure out creative ways to make a complex topic more clear, and seeing a confused expression change into an “ah-HA” is about as good as it gets for a teacher.

 

  1. What is an accomplishment about which you are most proud?

      If anyone in the world of blood banking has heard my name, it is very likely a result of my educational website, where I am known as the “Blood Bank Guy” (www.bbguy.org). I am honored and humbled that many students and potential students of blood banking around the world have found my site useful. I have been asked many times to share the story of how I came up with the idea to create the site, so I will share it with your readers.

 

In 1996, while I was a young attending Transfusion Medicine physician at Walter Reed Army Medical Center in Washington DC, I was given the opportunity to lecture on transfusion medicine to about 250 pathology residents and practicing pathologists at a session of a nationally known pathology review course. As I talked with some of the attendees after the lecture, it became clear from their comments that there was a “knowledge deficit” in our field among residents who were at or near the end of their training. I came up with the idea of developing an educational web site to attempt to fill that deficit. After eighteen months of developing content and learning how to write code for the Internet, I was ready to launch, but I had a big problem: I didn’t have a NAME for the site! After fruitlessly racking my brain for months, the answer came to me fortuitously at another session of the pathology review course. While in an elevator with two students who didn’t recognize me or remember my name, I overheard them discuss (in slightly annoyed tones) how they were heading down to listen to “that blood bank guy” speak. I knew immediately that I had found the right name for my new site. Blood Bank Guy launched in 1998, and fifteen years later, over 10,000 visitors from around the world every month use the podcasts, quizzes, educational modules, and glossary available there to further their education. Pathology residents, pathologists, nurses, SBB and CLS students, as well as those in practice, and a variety of clinically focused physicians have e-mailed me with kind words. I truly never anticipated that Blood Bank Guy would be viewed by anyone other than a few pathology residents, so I am deeply grateful to anyone who visits. I feel so fortunate and blessed to play a small part in increasing the knowledge of Transfusion Medicine!

 

  1. What do you see as the most important change to the industry in the next 5 years?

      I’m not sure that it is possible to pinpoint just one! I see several important trends. First, the concept of “Patient Blood Management” (PBM) is with us to stay. There is too much data available showing substantial reductions in blood costs in facilities that are “all in” with PBM to ignore, and hospital administrators everywhere are seeing that data and screaming, “Me, too!” Unfortunately, there is a misperception that PBM is just a message saying, “Transfuse less product, you dummy” to clinicians, when the reality of a solid PBM program is so much more! PBM involves optimization of transfusion therapy and improvement of patient outcomes through management of the entire period from before hospitalization through discharge. The decision of whether or not to transfuse at a particular moment is only part of the entire process. PBM is evidence-based, rigorous, and requires commitment of time and resources. I fear that if PBM programs are done in a haphazard way (with a focus solely on reduction of transfusion), patients may suffer adverse consequences that will confound our administrator colleagues.

 

      Second, cellular therapy is a burgeoning field, with advances coming in with stem cell and mononuclear therapies that will amaze us. They may not be quite “ready for prime time,” but blood centers must be prepared to move forward on the cutting edge of these therapies, or we will find ourselves bypassed by other parts of the biotechnology industry.

 

      Finally, the integration of molecular techniques into the care of our patients, far beyond even the limited genotyping options currently available to predict donor and patient red blood cell phenotype, is just at the “ramp-up” stage, in my view. Transfusion Medicine professionals will soon have to understand molecular testing to a much greater extent, as I believe these techniques will see an explosion in new applications in therapeutic and diagnostic settings in the very near future (indeed, this revolution is already upon us).

 

  1. What is your best career advice?

      When I sit with my residents to help them work through what they want to do with their professional futures, I tell them something that sounds like this: “When you don’t even notice that huge chunks of time have passed when you’re doing something, figure out a way to spend your life doing THAT!” During my time alternating between surgical pathology and Transfusion Medicine, I realized that I couldn’t wait to finish reading the mountain of glass slides on my desk and dive into a challenging immunohematology or blood donor issue. I came to a hard-earned conclusion: It is a mistake to pursue or stay in a job solely because of the size of a paycheck. I believe that such a life ultimately leads to unhappiness and not to fulfillment. Instead, I urge my residents (and anyone that will listen) to understand that life is truly short, and it is much more important to have passion and (gasp) FUN in your career than to pursue financial rewards and live an unhappy life.

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