Lab Medicine Rounds

00:00 Intro

01:15 What’s your origin story? How did you become a forensic pathologist?

03:53 What are some of the misconceptions about forensic pathology?

06:15 Is there a big public health component to forensic pathology?

07:29 Covid is a nice example on how you have partnered with public health, can you elaborate more on that?  

10:15 What other types of physicians are you interacting with periodically and what are those conversations about?

13:10 Do you approach autopsies differently depending on the case at hand?

17:30 In what ways is the field of forensic pathology continuing to evolve and grow?

20:50 Outro 

Timestamps:

00:00 Intro

01:29 Why is it really important for leaders in our practice to really understand quality for clinical practice?

03:13 What are the latest developments in your area of clinical laboratory medicine?

06:01 In recent years, what have we learned about quality and how we do quality in the hospital?

11:19 How do we actually implement this in clinical practice for success, for sustainability? You talked about putting together an interdisciplinary team. What’s the secret sauce for putting that together?  

15:36 You talk about recognition for these project successes. How do we do that when maybe the project is a failure, but still keep that motivation high in our community, make sure it’s normalized as sometimes it doesn’t work out, but not something we don’t talk about anymore?

18:12 What have you kind of learned from your experiences for what are ways to make projects successful and sustainable?

20:28 Can we kind of closeout with thoughts on where the future of quality improvement in medicine is headed? What are your thoughts on that?

 23:35 Outro

00:00 Intro

00:40 Can you tell us how your roles in these different laboratories support testing for patient care?

03:13 What are the latest developments in your area of clinical laboratory medicine?

07:22 Can you elaborate a little bit about this new approach that you have developed is able to bring both sensitivity and specificity along?

10:55 Putting the interpretation on the form, you are probably experiencing quite a few phone calls with our clinical colleges. Can you talk to us about how those interactions go between the laboratory and clinical professionals?  

15:10 How have your clinical consultations changed, based on feedback you’ve gotten from previous conversations?

18:15 You also serve as Vice Chair for Supply Chain Management in the Department of Laboratory Medicine and Pathology. This has been talked about a lot related to the Sars-Cov-2 pandemic. Do you have any reflections about key lessons you have learned as you try to stay ahead of supply chair issues?

22:06 Can you tell us more about resiliency in relation to supply chain management?

24:42 Outro

Timestamps:

00:00 Intro

01:07 Why is transfusion support an especially important component of patient care for patients that are on ECMO support?

03:24 Are there some principles that we can think about that will help us better understand transfusion decisions in these patients?

05:52 Can you take us through some specific situations that might help our listeners get our hands around (DO2 and VO2) from a practical standpoint? 

10:31 How can laboratory professionals add value to the clinical care of these patients?

12:35 How can we improve that interaction (between the clinical side and the laboratory side)? 

16:41 What are the different devices we need to keep in mind?

17:11 Outro

Timestamps:

00:00 Intro

01:11 As a critical care physician, why is laboratory testing important for your practice?

04:09 What do you wish lab medicine folks understood better about critical care medicine?

08:19 What would be your advice to a laboratory medical professional that’s interested in developing a better understanding of critical care medicine?

14:51 What do you see for the future collaboration between laboratory medicine and critical care practice?

16:44 Outro

00:00 Intro

01:15 From your perspective, why is cellular therapy an important topic for our listeners?

02:55 What is your origin story into this world of cellular therapy? 

06:20 Working in such a fast-paced area, what has been a unique challenge you have had to navigate and how have you done that?  

08:05 Keeping up with the literature can be a challenge, and once you are out of training you don’t have those deadlines of “have you read your recent articles for the month.” How have you approached keeping up with the literature?

11:53 There is so much potential with cellular therapy. What is one direction you see this field moving towards over the next 5 years? 

15:34 Outro

Timestamps:

00:00 Intro

00:58 How is cellular therapy contributing to the COVID effort?

04:42 Can you give us a little bit of an introduction about what’s so important about the cell (mesenchymal stem cell) or where it comes from?

08:19 What sort of work are you and your lab doing for patient care?

11:14 Once you figure out a successful cellular therapy, is there then opportunity for that to get brought to scale for a given patient population, or does cellular therapy need to exist as a very individualized treatment?

13:48 For our listeners who might be students or other clinicians or laboratory medicine folks, how can they get involved in cellular therapy or how do you recommend those first steps to learn more about this field and how they might intersect with it?

15:50 Outro

Resources:

https://stemcellsjournals.onlinelibrary.wiley.com/doi/10.1002/sctm.20-0472 

https://www.medrxiv.org/content/10.1101/2020.10.15.20122523v2 

00:00 Intro

00:45 Can you let our listeners know what we know about the vaccines at this point (December 2020)?

02:00 With using the mRNA approach, do these vaccines have similar performance characteristics?

03:00 What does this mean for people after they get vaccinated? Hearing this high numbers of efficacy that is protecting me from the virus, what does this mean for how I should be behaving after I get vaccinated?

04:25 What are your thoughts on if there should be post-vaccination serology testing?

07:10 From your standpoint in the laboratory, has the laboratory developed all the tests that are needed? With the vaccines coming out, is laboratory medicine’s job done regarding COVID-19? Or do the folks in research and development still have some things they need to get done in lab medicine?

10:15 Is the fact that we have a couple of variations out there a testament that this was testing that needed to be brought up in the moment, which is why there are a couple of different strategies, and maybe over time we will see a convergence towards one over the other? Or, is there a reason to continue keeping these assays up because it really needs to be a battery in order to be accurate?

11:35 Outro

Timestamps:

00:00 Intro

01:00 As Pathologists, we have a lot of competing priorities. Why is mentoring residents and fellows consistently a high priority for you?

03:27 Often what we are trying to do as educators is not transparent to our learners, for a variety of reasons. What do you wish that all residents, fellows, and learners understood about the process of their training?

05:00 How do you address someone who started out on the right food and then started a slip a little and stopped taking ownership of their cases? How do you readdress that with the learner?

06:25 Lately, there has been a lot of discussion about deliberate practice as the pathway to developing expertise. How are you deliberately becoming a better pathologist?

08:10 If you had one magic medical education wish, what would it be and why?

08:50 Have there been some things that you have done that have helped you be more successful at having that dedicated time for education? 

10:00 Last question, what has surprised you most about your professional journey so far?

Timestamps:

00:00 Intro

01:00 What is HIT and why is it important for clinicians to correctly diagnose HIT? 

03:30 What do we know about how laboratory testing may help clinicians get the diagnosis right?

07:25 How could the process of diagnosing HIT be updated or made better?

10:45 What does the future hold for HIT testing? In five years’ time what do you think HIT testing is going to look like in this country?

12:45 How has your relationship with your clinical colleagues helped advance your practice of medicine? 

15:30 Outro

Related Resources:

Conference: A Case-Based Workshop: Clinical and Laboratory Aspects of Hemophilia and Thrombosis

Article: National Symposium Focuses on Bleeding and Thrombotic Disorders