Most everyone is aware that PBM programs involve things like improving physician blood ordering practices by "tightening up" approved thresholds for transfusing red cells and platelets, especially. Many have heard cute little phrases like, "Hey, why give 2 when 1 will do?" to describe current thoughts on transfusing one unit of red cells as a default instead of two units as a default. What I'll bet many do NOT know, however, is the fact that you can do all of those things and you can still miss what may be, in my opinion, pretty close to the most important part of PBM: Detecting and managing pre-operative anemia before the patient is ever admitted! Dr. Aryeh Shander wants you to know just how important it is.