Tuesday, October 01, 2019

Both sides now (Musings on humans vs technology in transfusion medicine)

Stay tuned: Revisions are sure to occur

There's much transfusion news these days on artificial intelligence (AI), big data, drones, innovations, new technology, precision medicine. In a way this blog is a follow-up to the prior one, 'Get back' (Musings on transfusion medicine's future).

September's blog (albeit published Oct. 1) was stimulated by a weekly feature ('Workplace column') on a local radio program I heard this morning (Further Reading). Also, because as an oldster I want a record of events I've experienced in the hope they will resonate with some and influence others to do similar. Otherwise when we oldsters croak, they're gone forever.

The blog's title derives from a song by Canada's Joni Mitchell.

As you read the blog, regardless of your health profession, please consider the challenges you faced if you have held a management position and, if not, think about the strengths and weaknesses of managers you have had. Also, consider the impact you as a manager have had on colleagues and the influence your managers have had on you and your career. 

Specifically, the radio column was on moving into management, generally viewed as a promotion with a higher salary. The columnist (@sandbaryeg) gave tips on becoming a manager for the first time. Her tips made me recall when I took a giant leap from a long career as a transfusion educator of medical laboratory technologists/biomedical scientists to become a lab manager at CBS ('assman' as the centre's QA department addressed my mail). True, I'd been lab supervisor in my 13-yr job before teaching, but with none of the responsibility the 'assman' position entailed.

Indeed, as I only learned later, although I managed the patient services lab at the blood centre, the position had been downgraded to 'assistant manager' in order for the centre (and perhaps head office?) to retain more control, especially over salaries. Also, I hadn't realized (bit stunned of me) that the person who had been an assistant to the prior manager and perhaps (just a guess) had applied for the job I was recruited for, and was the acting manager when I came. She was a prior student of mine, in fact in the first Med Lab Sci class that I taught all the way through, who I was and still am exceedingly fond and proud of.

My take on the consultant's 5 tips for new managers. How to
1. Run meetings, something many dread;
2. Give effective feedback;
3. Foster a team environment;
4. Attract & recruit the staff you need vs filling an existing job;
5. Manage your own time effectively.

Promotion: First, I'll note that in my experience (historical, I know, dating from 1960s-2000) often the folks who get promoted in the lab are ace technologists. If all factors are considered more or less equal, seniority may play a role. To me, that's not an effective process, but it's likely the easiest.

How often do fabulous footie players (soccer in NA) or hockey players become great managers? Not many. Why? Because the skills needed are quite different.

Needed skills? More recently, not only med lab techs/scientists but also physicians (perhaps nurses?) tend to get Masters of Business Administration (MBAs) as lab medicine and transfusion have become more and more a business. Presumably these degrees help in a new career as a 'suit' whose prime concern is the bottom line, though patient safety is always touted, given first place in communications.

I'll discuss the 5 tips in various ways based on my experience.

Decades ago as an educator I'd experienced many ineffective meetings, including those run by MDs at the departmental (Lab Med & Path) & Faculty of Medicine levels. Some dept. meetings were info-only unneeded sessions. Few required active participation. And often the minutes were totally useless to anyone not attending.
  • My experiences motivated me to write a resource for TraQ in 2009 on running meetings (Meetings as Time Wasters, Further Reading).
On running meetings in my brief career as 'assman' I was fortunate and smart to designate my prior student to run many meetings. She was experienced in the task and did it much better than I ever could. Only time I ran meetings was when it came to getting staff on board with changing almost all pretransfusion testing methods in the lab. That came easy as it was right up my alley as an educator.

In a similar vein, I was glad I'd insisted on a whiteboard for my 'assman' office as it was well used when meeting with supervisors in the various sections of the patient services lab.

As an educator I had to give feedback over decades and some was difficult. For example, telling foreign students (English as a second language), whose parents had struggled and worked hard to send them to Canada that they were not going to pass their clinical rotation. For such students it was a total disaster, an incredible loss of face and shame. Frankly, it broke my heart and I know that whatever I said to lesson the blow (e.g., they could have great success in another career) wasn't heard and didn't lesson their reality in any way.

In giving more routine feedback, as a med lab technologist with an MEd, I knew the characteristics of effective feedback. On a personal level I believe that often what shapes us for good and bad in life are 15-60 second interactions with others. For example, I'll never forget the powerful effect of my Dad saying, 'Pat, don't be afraid to be different.'

As a teacher of med lab students I always kept that in mind when giving feedback. Meant I treated struggling students the same as high achievers. And in retrospect I see that many of those who struggled have gone on to be high achievers, leaders in their field. Why? Suspect it's because success depends on many factors, not necessarily getting the highest grades.

A good pal is a standardized patient at the University of Alberta and they have a particular take on feedback, called CORBS (Further Reading):

CLEAR – Give information clearly and concisely
OWNED – Offer feedback as your perception, not the ultimate truth. Talk about how something made you feel. Use terms such as “I find” or “I felt” and not “You are”
REGULAR – Feedback is offered immediately, or as soon as possible after the event
BALANCED – Offer a reasonable balance of negative and positive feedback. DO NOT overload with negative feedback.
SPECIFIC – Feedback should be based on observable behavior and behaviors that can be modified.

Not much to say. Health care teams are similar to politicians kissing babies. Everybody does it as it's the reigning orthodoxy, the cliché of how we love to see ourselves. Again, University of Alberta has a course on it. INT D410 - Interprofessional Health Team Development.

Like to think I've been a member of many teams in health care (my transfusion families over the years) but must admit that many who promote it most publicly do not walk the talk.

Will only speak to my recruitment to be 'assman' 21 years ago. Fact was the job was not quite as advertised. In retrospect I thought they portrayed part of the job almost as if it was what became hospital liaison specialists. I totally dug the part about the centre being the pilot site for a new information system and found it a worthwhile challenge.Our talented team of med lab professionals did a wonderful job in implementing the new IS.

Similarly, I loved the opportunity to change outdated lab methods, though don't think they hired me for that. It was just my 'value added' to the job I held for all of 9 months. When I tendered resignation I explained why in exit interview. They understood more money wouldn't make a difference and admitted they could not change what I thought needed changing most (head office, though it's more complicated than that).

So did CBS recruit the right person for the job? Yes and no. Yes, because I led the talented patient services lab team successfully through a difficult time of incredible change. No, because after years in academia at a university where dissent and free speech are cherished, I didn't fit in a national organization where adhering to head office directives was paramount. That's what made you a valued team member.

The radio consultant pointed out that managers need to prioritize their tasks and serve as role models for staff as they cannot work to 10 pm over the long term. I don't have much to say except that you obviously cannot help others if you're exhausted. See it as a Buddhist concept that you need to love yourself, be okay with who you are, in order to love and help others. Over my entire career I was often the first in and last out daily but that's another story.

Are AI, big data,new technology, precision medicine all important to health care and more crucial than the qualities of people in leadership positions? Perhaps. But not to me. As a human being on plant earth, I'll always value the human condition over technology. See excerpt from 2001, a Space Odyssey (Further Reading).😁

Chose this song because I've lived long enough to see transfusion medicine evolve from being people-focused to technology-focused. As  early adopter of technology (not a Luddite), I doubt we're on the right track (Further Reading). Also, admit that I love the songs of Canada's Joni Mitchell.

Saturday, August 31, 2019

Get back (Musings on transfusion medicine's future)

Updated: 1 Sept. 2019 (Learning pt 4, Further Reading)
August's blog was inspired by a blog I saw on the UK's BBTS website:
  • Transfusion 2024: What did we learn and where will we be? (Further Reading)
To me Dr. Nicholas Watkins' blog had 3 related themes:
  • How to replace retiring staff (and their experience) with new staff, including retaining them.
    • Innovation and technology can help 
    • As can big data (electronic donor and patient records)
The blog's title comes from a 1969 Beatles ditty.


Be aware I've worked in transfusion for decades. My views are biased by long experience as are the opinions of everyone.

In the 1990s I saw how regionalization and centralization of hospital transfusion service laboratories affected staffing, along with semi-automatic instruments. In Alberta, Canada (perhaps everywhere?) that meant many transfusion labs required fewer knowledgeable specialists and could get by with mostly medical technologists who were generalists,  plus lab assistants. Another factor was an AB conservative government that removed 40% of the province's lab budget to decrease a budgetary deficit.

Similar changes across Canada resulted in all medical lab educational programs closing in Western Canada except for the two in Edmonton, NAIT and the University of Alberta's MLS. I taught in MLS but as the University of Alberta Hospital's transfusion service clinical instructor I also taught  NAIT med lab students.

Automation came much earlier to blood supplier donor testing labs. In effect donor testing labs could be mostly staffed by technologists experienced in highly automated clinical chemistry labs.

Learning point #1:
To me, these events meant a huge loss of laboratory transfusion expertise in immunohematology. In Edmonton, Alberta, for example, experienced technologists had to compete for the few remaining jobs based on seniority and many left the field. Those with a BSc in Med Lab Science (who wrote ASCP exams) were able to move to USA (and overseas to countries such as NZ) and work for years.

I don't see 'innovation and technology' as truly helping the loss of expertise except in the sense it means:
  • Med lab profession can be 'dumbed down.' With increasing technology no one needs much expertise to perform routine tasks. And I don't mean generalists and lab assistants are 'dumb', I respect them for their skills, just that their lack of transfusion expertise is the new normal in many labs. 
  • We can only hope so long as serology survives, there's a safety net in all workplaces where the few knowledgeable staff catch any errors.
Learning point #2:
Today the biggie is molecular testing, which means immunohematology expertise will eventually become passé. Presumably, if biotech manufacturers succeed with marketing campaigns that promote matching blood donors and transfusion recipients for antigens with known genes, not just in multi-transfused patients but as the gold standard for ALL transfusion recipients, serologists will no longer be needed.

Transfusion recipients will no longer develop alloantibodies from transfusion, except for ones the DNA PhD gurus haven't identified. But let's hype the hell out of precision medicine to increase profits of commercial interests.

Sounds like a perfect world, no? Local med lab staff numbers shrink to a precious few. Their pesky staff benefits are greatly reduced as an employer cost. Instead of supporting a local economy, money is funneled to foreign biotech companies, who thrive by pleasing their shareholders who grow richer and richer.

Big Data
Yep, big data can provide insights and feed into artificial intelligence (AI) to further remove error-prone humans from healthcare decisions. The downsides include patient privacy and the reality that machines make mistakes. GIGO rules and AI is only as good as human input.

Learning point #3: Privacy is big data's greatest challenge and if it fails (as is likely), big data will become just another failed trend. As to AI, I suspect it's decades away from filling the skilled worker shortage in the transfusion world. But it's already got niche roles in medicine (Further Reading).

Learning point #4: Presumably one day in the distant future AI, automation, and robotics will make human work passé. It's already started and not just on car manufacturing assembly lines. Have you seen the Android robots from Japan or those providing robotic nursing care? With an aging population and worker shortage, robots can fill the bill. (Further Reading)

My vision for the future includes humans who cannot communicate with other humans by talking and have developed enormous thumbs for texting and perhaps sexting. 😉

Choose this Beatles ditty for blog's title song
  • Get back (Paul McCartney, Live in Lisbon 2004)
It's my attempt at a joke as we can never get back to the days where oldsters like me once belonged. 😄

As always, comments are most welcome. And there are some - see below.


Wednesday, July 31, 2019

Look what they've done to my song Ma (Musings on invisible health professionals)

July's blog, another short one, was stimulated by an editorial in the Archives of Pathology; Laboratory Medicine, August 2019: Emerging From the Basement: The Visible Pathologist. (Further Reading)

The editorial reminded me that a hematopathologist I once worked with told me, "Pat, just like medical laboratory technologists/scientists (biomedical scientists in UK, Australia, NZ) feel invisible, at the bottom of the health professional pecking order, so do pathologists of all specialties."

Also on the local scene in Alberta, Canada, a new provincial government just cancelled a needed planned hub lab in Edmonton, with the new government implying they wanted to concentrate on patient care (as if clinical laboratories didn't affect patients) and the centralized superlab/ hub lab was a waste of money best spent elsewhere. The new Premier Jason Kenny argued the changes (new consolidated hub lab) would do nothing to improve patient services.

The blog's title derives by a 1970 song by Melanie Safka.

My take has always been that most folk don't have a clue what medical laboratory technologists/ biomedical scientists do. Suspect they assume we are merely the vampires/blood suckers who draw their blood samples for lab tests. Generally, folks do not realize we are highly educated and trained professionals who play an critical role in assisting physicians to diagnose and treat patients.


Fact is med lab science and clinical labs need to be more visible to the public. In this section I'm going to include tweets of colleagues and former students (my beloved 'kids') who are using Twitter to promote med lab science and make the case for why clinical labs merit respect as playing an as important in patient care.

Tweets and News

Folks you can see tweets without being on Twitter. If you are asked to join, just ignore the dialogue box asking you to join and click on the tweet off the dialogue box. All tweets are short, please read them.

1. Thanks to all who came out to the CSMLS open forum last night

2. AHS Newborn Metabolic Screening program

3. Cancelling superlab undermines foundation of patient care

4. Finally - someone took a look at what's going on

5.  Short-sighted decision to halt ongoing construction of the Edmonton Clinical Lab Hub

6. Yet another example of the importance of lab medicine

7. Pictured here are very passionate medical lab professionals seeking to educate Albertans of the critical role med lab plays in quality patient care 

8. Clinical labs save lives. We have no space & aging equipment. Cancellation of Northern AB Hub Lab leaves us wondering how will this crisis be addressed?

9. Thank you for helping champion the voice of the medical lab profession and its critical role in effective quality patient care.

I chose this song because I'm disappointed that medical lab technologists (biomedical scientists) still have to fight to be visible to the public, including some politicians, after all these years. I came to the med lab science field by a non-traditional route 55years ago and still we face the same challenges.
Look what they've done to my song, Ma
Look what they've done to my song
Well, it's the only thing I could do half right
And it's turning out all wrong, Ma
Look what they've done to my song

Harrold IM, Bean SM, Williams NC. Emerging from the basement: the visible pathologist. Arch Pathol Lab Med. 2019 Aug;143(8):917-8.

Health Quality Council of Alberta: Provincial Plan for Laboratory Services in Alberta (February 2017)

Leaning into the challenge of medical science (4 June 2019)

The UCP government scrapped Edmonton's 'superlab'. Medical experts say Alberta needs an alternative and fast (24 July 2019)

Medical lab group pushing Alberta government to address gaps after cancelling superlab (24 July 2019)

Alberta government keeps promise to cancel construction of medical superlab (20 June 2019)

Lab Tests Online: For anyone interested in what medical lab professionals do and information on your lab tests results

Sunday, June 30, 2019

I will remember you (Musings on Marion Lewis, an extraordinary Canadian)

On June 27 Julie Payette, Governor General of Canada, announced new appointments to the Order of Canada. Included in the honours was Marion Lewis of Winnipeg, who at age 93 was named an Officer of the Order of Canada (Further Reading).

As my early career was in Winnipeg I was well familiar with Marion Lewis and Dr. Bruce Chown. In 1944, she and Dr. Bruce Chown opened the Rh Laboratory to study and eradicate Rh hemolytic disease of the fetus and newborn (HDFN).

The blog's title is based on a 1995 ditty by Sarah McLachlan.

In 1943 Marion Lewis graduated from high school and trained as a 'medical technician' at Winnipeg General Hospital (now Health Science Centre). In those days there were no post-secondary institutions training what today we call medical laboratory technologists/scientists ('biomedical scientists' in UK and Down Under). As noted, only a year later she was at Winnipeg's Rh Laboratory with Dr. Bruce Chown.

With a Bachelor of Arts degree she became a Full Professor in the Dept of Pediatrics and 2 years later a Professor in  Dept. of Human Genetics. Normally that's reserved for those with MD or PhD degrees. In 1971 Marion shared AABB's Karl Landsteiner Memorial Award with Dr. Bruce Chown in 1971. To me, it's AABB's most prestigious award. And it's not the only AABB award she received.
  • Karl Landsteiner Award
  • Past recipients (Check these TM giants out: Levine, Wiener, Race, Sanger, Morgan, Watkins, Mollison, Dausset, Blumberg, Crookston, Bowman, Issitt, Gallo, Montagnier, et al.)
It's fascinating that in 1950-51 Marion Lewis needed a break and spent four months at an Italian university studying Italy's language and culture. Then she spent another three months studying in London with Dr. Robert Race and Dr. Ruth Sanger of 'Blood Groups in Man' fame. In 1951 Marion returned to Winnipeg and the Rh Lab. And the rest is history (See her University of Manitoba biography in Further Reading).

Please read Further Reading for Marion's unique career.

Of course, I knew Dr. Jack Bowman of Winnipeg's Rh Lab well as he was the Medical Director of Winnipeg's Can. Red Cross BTS while I still worked there. Wrote a blog when he died in 2005 (Further Reading).

Chose this Sarah McLachlan song because I will always remember transfusion medicine giants and especially folks like Marion Lewis who rose from humble beginnings to great accomplishments on the strength of intellect, skills, and hard work.
As always, comments are most welcome.


Saturday, June 01, 2019

We can work it out (Musings on transfusion association annual meetings)

Last revised: 2 June 2019  (See ADDENDUM below)

As the CSTM annual conjoint meeting with CBS and Héma-Québec is now on May 29 to June 2, I thought I'd muse on annual meetings in general. As readers of this blog will know, I've had a long career in transfusion starting at the bottom without qualifications but being incredibly fortunate in my employers.

I'm an outlier of sorts with atypical views and being an oldster gives me the freedom to say things that colleagues likely would not. Perhaps many may disagree with me on this blog's points. That's okay too as I'd be concerned if all, even most, agreed with me. Included are tidbits I think contribute to quality presentations at meetings.

Professional associations exist to serve and represent the interests of their members, which applies to the three associations I belonged to during my long career as a medical lab technologist turned educator: AABB, CSMLS (includes IFBLS membership), CSTM. The latter two are Canadian organizations, the first American but AABB has branched out to become international, though its headquarters remains in the USA as does its primary focus.

The blog's title is based on a 1965 Beatles ditty, We Can Work It Out.

Over the years I've attended many meetings, aka conventions and congresses. With a few exceptions most of all those attended were held in Canada by CSMLS or CSTM. One memorable one (IFBLS) was held in Oslo in 1996. Why memorable? Most of all it was because I met a Norwegian med lab technologist who worked in transfusion and we've been good pals ever since.

To me, that's Lesson #1 of what's important at annual meetings. It's not so much the scientific presentations you hear and what, if anything, you learn from them (commit to long-term memory). Face it, if you read professional journals you're pretty up-to-date on the latest and greatest. During my career the AABB journal Transfusion and similar were kept in the bathroom as a welcome distraction or read while basking outside in Canada's all too short spring, summer, fall.

Of course, I suspect not many transfusion technologists and nurses in the trenches regularly read journals. Take a peak at the index of Transfusion 2019;59(5). How many articles would you read let alone understand?

Today, keeping current also applies to those on social media platforms like Twitter where journals and associations alert folks to the latest developments. But how many of you use Twitter?

LESSON #1: The most valuable benefits of meetings are the interactions with peers, sharing experiences and knowledge that's not in journals or textbooks, including the friendships made. Often such interchanges are shared during a night-out over a meal or glass of wine/beer. Typically, chitchat involves practical and tacit knowledge only gained from experience.
Pretty certain that Lesson #2 will be familiar to medical lab technologists/scientists world-wide, at least those lucky enough to attend meetings:
  • So many of the presentations at transfusion association meetings are by physicians and researchers, though it's slowly changing. 
What this means is the information and research presented, though significant, is often not particularly meaningful nor of immediate use to those in the trenches, whether transfusion med lab techs, nurses, physicians without university appointments. And being able to use new meaningful learning right away is important to busy adult learners. In continuing education and professional development courses it's critical because 'adults vote with their feet' as the cliché goes.

Indeed, I wonder in the age of the smart phone how many meeting attendees during presentations  spend most of the time checking e-mail, texting and browsing. Suspect it's far too many. Best take is they're live tweeting but no, that's not it.

Reality is that much transfusion research is esoteric, of interest mainly to those involved in similar, narrow research.  Kudos to CSTM for its full day of workshops relevant to front-line professionals.

LESSON #2: Many presentations at scientific meeting are of minimal value to attendees, especially those who work in the trenches on the front-lines of transfusion, those in the lab and those on the wards. If you're a PhD or MD/PhD researcher and the topic coincides with your interests, the talks are no doubt fascinating.
Lesson #3 relates to a sad fact of life for many in the trenches. Years ago funding for CE/CPD was scaled back significantly. The result is fewer and fewer attend national meetings (unless local), let alone international ones. Today the cost of airfare and hotels is increasingly exorbitant.

Who can afford it? My guess includes
  • Physicians and researchers who get funding support or earn large salaries, along with those in senior positions. 
    • Bench technologists and front-line transfusion nurses not so much. 
  • Educators and those in health profession unions who get discretionary funds to use for CE/CPD but the funding wouldn't come close covering travel and hotel costs to attend meetings outside their locale. 
  • Some associations fund invited presenters, but not all.
  • An association's board of directors, whose members are volunteers and put in much dedicated time and a tiny perk is funding to attend meetings.
Many transfusion associations/organizations now offer local CE/CPD events across the country or provincially, including CSTM's Education Days. And thanks to the Internet, technology makes webcasts and podcasts possible.

LESSON #3: To what extent have annual meetings become a place for the 'elites' to meet and interact?  By elites, I mean those professionals fortunate to have funding or be wealthy enough to attend if the meeting is not in their locale and schmooze with other elites? It's a question to which I do not have an evidence-based answer, yet suspect it may be true.
Lesson #4 has been a pet peeve of mine for ages and relates to the quality of presentations at meetings by the biggies, the so-called 'thought leaders' of a profession. My experience is presentation quality is often awful, bordering on pathetic.

It's one reason I'm so glad that Medical Laboratory Science at the University of Alberta has a communications course that includes how to give presentations and gives students opportunities to practice the skills, including presenting their research projects.

Wish all MSc/PhD graduate and medical education programs included such a course. About physicians, my experience is, if a communication course or any professional development program, is not given by a physician, they devalue it. Apparently only physicians can teach physicians.😞

To me the biggest, common presentation failures include NOT doing the following, relevant to physicians, especially. BTW, the points are basic, equivalent to Presentation 101 courses.
  • Begin with a personal anecdote to grab audience attention immediately and get them to appreciate your authenticity, that you've 'been there, done that,' and dig their professional realities.
  • Explain up-front why the talk is relevant to the audience.
    • For gawd sake, don't keep it a secret.
  • Briefly outline what the talk is about, perhaps even say, if that's not what you expected, feel free to exit now. 
    • Shows you  respect the needs of audience.
  • Mention there will be time at the end for questions, if the person who introduced you did not.
  • Distribute handouts at the end and say that up front. 
    • Include your speaker notes in handouts so the audience has something substantive to take away.
    • In the early days of Powerpoint I don't know how many handouts I brought home from meetings, including making notes on each slide myself, that were all but useless and eventually tossed in a trash can.
    • Fact: If you distribute handouts at the start of a talk, the audience will concentrate on them, not what you are saying.
  • Use mostly graphics in the presentation vs bullet points. It's a way to get folks to listen to what you say.
    • If you use a few slides with bullets, do NOT use complete sentences and, regardless, NEVER read the points word for word unless you want to put the audience to sleep.
  • Forget about using any busy slides you have where the writing is minuscule and unreadable.
    • Just don't, no matter what.
    • Saves you the trouble of cynically apologizing for it being busy.
    • Because obviously you included the slide anyway, thus disrespecting your audience's intelligence. 
  • Throughout the talk refer to the experiences of colleagues and audience members you recognize, and sprinkle the presentation with their work.
    • It's not all about you, it's about those who helped you succeed.
    • Self-deprecating humour, if sincere, is appreciated by listeners.
  • Focus on key points only.
    • Though tempting, do not succumb to presenting all your data and conclusions.
    • Few viewers are as obsessed with the topic as you are.
    • The fewer key learning points, the more they will be remembered because of info overload.
  • At talk's end, briefly tell the audience what you told them and reinforce why it's significant and relevant to them. 
  • Thank the audience for their attention and thank conference organizers for inviting you.
  • With questions at the talk's end, even if you get snarky questions (yep, there are always all-about-me colleagues), try to be gracious, realizing that to most in the audience, the asker is showing themselves in a bad light and you are better than them.
    • Taking the high road always wins.
LESSON #4: Physicians and researchers, at least try to learn how to present well. I realize you could care less as you've gotten away with pathetic presentations forever and have zero motivation to change. But please try to be better because it has many rewards, adds to your reputation.
First a disclosure. Folks, for most of my career I was one of the fortunate 'elites' I referenced earlier, mainly by virtue of volunteer positions for professional associations, being an invited speaker at conferences where organizers funded travel and hotel costs, or as a perk of being an educator at a university. 

One thing I noticed in those days of yore versus today's national meetings is that now there seem to be fewer young attendees. Perhaps it's my imagination or just that all professions are aging and those in senior positions are older than before. Or maybe not.

While I hesitate to mention this, one reason could be that younger med lab technologists/scientists may not be as keen as we were in what I call the 'golden age of immunohematology.' Perhaps when considering annual fees, younger folks and many older ones too, wonder if it's worth it, questioning the benefits of membership. That is, they first ask 
  • What will the association and being a member do for me? vs
    • What can I do for my association?
    • How can I give back to my profession?
Or it could be that membership for some has become a financial burden. For example, in Canada registration with provincial regulatory colleges is compulsory for med lab techs,e.g. CMLTO annual fees. In contrast, membership in professional associations is voluntary and annual fees are a bargain in my opinion, e.g., CSTM $120 and CSMLS $167. But if you worked in Ontario and belonged to all three, the total would be $671.20. To me, that's just a tiny percentage of annual salaries and the benefits are many. 

Which brings me Julie Hendry's presentation. Julie is this year's recipient of the CSTM's  Buchanan Award, who included this slide at the end of her talk (click to enlarge - Julie's slide was tweeted by Geraldine Walsh and Clare O'Reilly on Twitter): 

Julie's challenge is a great one for CSTM members and members of all professions. We in the health professions are so lucky. 

I chose this Beatles song because its lyrics fit the blog's content.
As always, comment are most welcome (and there are some below).

Tuesday, April 30, 2019

The thing called love (Musings on folks who work in medical labs)

Last updated: May 3, 2019 (See ADDENDUM below)
Another short blog, this one about National Medical Laboratory Week (NMLW), April 21-27, 2019. My story is one that's hardly ever told because oldsters like me don't normally write blogs,

Folks, I came to work in a clinical lab by an atypical route. To test myself, as an individual who was terrified of being asked a question in high school, I followed some of my pals into unusual UManitoba teacher training. We were to spend several summers in Faculty of Education and get BEd.

My most vivid memory was the Dean telling me I'd never be a good teacher because my handwriting was poor. Hard to believe but the dude said it to my face. Regardless, after the first 3-month summer session I was hired by a HS in Baldur, MB. That experience was wonderful and I'll never forget it. Many students were older than 20-yr-old me and their parents totally supported teachers.

However, when the opportunity arose to move back to Winnipeg and be near to my family, I took it. The opportunity came from a university pal who told me that Canadian Red Cross Blood Transfusion Services (CRC-BTS) hired BSc grads. In retrospect that was crazy as folks like me knew nil about blood and laboratory medicine.

Note: Winnipeg's CRC-BTS was unique in Canada, a combined blood centre and transfusion service for Winnipeg and the province of Manitoba and beyond into northern Ontario. BSc grads were hired because training for med lab technologists in Winnipeg was poor. CRC-BTS was the only show in town and the training community college students received was inadequate. Most were afraid to work in transfusion labs. Hence they hired untrained innocents like me.

Fact: When hired in 1964, I well recall asking CRC-BTS colleagues what the yellow stuff was after the whole blood donation had settled. My knowledge was NIL. Today I would never be hired and that's a good thing.

To flesh out the above tale of my start at CRC-BTS an excerpt from a 2014 blog, Bridge over troubled water (Musings on what to be thankful for as TM professionals):
The reason Canadian Red Cross Blood Transfusion Service hired BSc grads because most med lab tech grads from Red River Community College (RRCC) were afraid to work there.' I later learned the fear was largely because the clinical rotation was pathetic. Students spending most time labelling tubes and similar scut work in between being told by technologists to get the ABO group right or they could kill a patient. Did I mention the clinical rotation was only 2 weeks then? 
Soon I started work in a large combined blood centre and transfusion lab, the latter doing compatibility testing for all city hospitals and beyond, plus prenatal testing for northwestern Ontario. At first, I did not even know what the yellow stuff was when the red cells settled. 
I'm so thankful for the mentoring of generous colleagues. And for wanting and needing to read the 'bibles' of TM from front to back (every word). The books were penned by such icons as Issitt and Mollison, and included the AABB Technical Manual and a 'little red book' written for Red Cross staff by Dr. B.P.L. (Paddy) Moore (and others), National Director of the Red Cross Blood Group Reference Laboratory, who died in 2011. I wrote about Dr. Moore in a 2007 blog, 'My life as a blood eater.'  
I worked in Winnipeg for 13 years, got Subject certification in Transfusion Science (no longer offered) from what is now CSMLS. My last 3 years were as the clinical instructor for new laboratory staff, RRCC students, and medical residents doing a transfusion medicine rotation in the only show in town. How crazy is that?
Looking back, I'm thankful that I worked in a busy laboratory where you never knew what to expect. Besides the routine of pretransfusion testing for scheduled surgery and anemic patients, at any time 24/7 patients might need massive amounts of blood in a hurry from a ruptured aneurysm to a GI bleed to a placenta previa during delivery. Often the lab was chaotic but it was organized chaos, even if that's an oxymoron.
Moreover, I'm thankful that in those days work was mostly hands-on and issues arose daily that required problem solving. For example, I worked with Dr. John Bowman when he did the first trials of antenatal Rh immune globulin and was involved in the work that led to this paper (I'm the Pat mentioned in the paper):
Which is why I'm so privileged to have worked in transfusion for more than 50 years. Why I love my kind Med Lab Sci colleagues at the University of Alberta who overlooked my weaknesses and generously taught me what I didn't know. Why I love my students, who were smarter and more knowledgeable than I was, who tolerated me calling them 'kids.' And so many went on to become leaders in many areas.

Chose Bonnie Raitt ditty because I'm a fan and it's how I feel about medical labs, especially transfusion services.
As always, comments are most welcome. See some below.

Sunday, March 31, 2019

I heard it through the grapevine (Musings on value of Twitter)

The idea for March's blog was stimulated by 'Social media use for pathologists of all ages' (Further Reading). The article begins as follows:
Pathologists have shown an increasing acceptance of professional social media use in recent years. There are currently more than 4700 pathologists and pathology-related accounts on Twitter per an online list maintained by one of the authors.
Based on personal experience, my guess is that few medical laboratory technologists are on Twitter, especially those working in transfusion. Perhaps because it came after Facebook (founded 2004), Twitter (founded 2006) is a mystery to many. Find that sad but understand why. Blogged on Twitter before (Further Reading). 

Back in 1994 I founded a mailing list (MEDLAB-L),early social media. Delighted that many med lab technologists and physicians from all over the globe subscribed.  
Blog's title derives from 1966 ditty recorded by Marvin Gaye and later Creedence Clearwater Revival. 

Signing up on Twitter is easy. Tidbits:
  • Language: Twitter is the software platform. You are a tweep. When you post a message, it's a tweet. 
  • If not on Twitter when accessing a tweet and asked to join, just click on another part of the screen and you can see direct tweets. 
  • Be aware you don't need to tweet. Just as on earlier mailing lists, you can lurk.  
  • By being on Twitter you can see the replies given by tweeps to other tweeps. If not, you can see only their direct tweets (not replies). 
  • Twitter gives you quicker access to important professional events and issues, allows you to share resources with colleagues.  
  • As a citizen Twitter is the place to be because you get news about anything well before it appears on mainstream media, e.g., disasters, latest weather, political events. All media and reporters are on Twitter.
  • Twitter hashtags are key (Further Reading) For example, they can be used to identify who to follow. And you can also see who others follow for more suggestions.
As always, comments are most welcome.

Chose this ditty because Twitter is a good grapevine,
Gardner JM, McKee PH. Social media use for pathologists of all ages. Arch Pathol Lab Med. 2019 Mar;143(3):282-6.

Twitter hashtags | Transfusion hashtag

Prior TM blogs about Twitter

My Twitter accounts