- Joined
- May 30, 2008
- Messages
- 214
- Reaction score
- 46
I think the issue with seeing consults in hematology without having a certification in it is if a seemingly simple and straightforward consult, say thrombophilia, or VTE in a bleeder, goes horribly wrong. it would seem easy for a sharky mal practice lawyer to sue the medical oncologist stating he or she practiced outside of his scope of training as a medical oncologist in advising a patient on benign hematologic issue. (Now, to you or anyone else here, these issues could be more than covered by an internist with 2 brain cells; but SDNers won't be on the jury).
The other issue I could see this posing is on weekend coverage at a small AMC or community hospital. If the only partner that's on is a medical oncologist trained, then any management of a TTP, HLH, or hemophilia patient that goes wrong or becomes difficult could become awkward for the practitioner and hospital badly. So even in academics I see situations where being single boarding is limiting as you are the only weekend coverage for your group and would need to have a hematologist on stand-by. In large AMCs where they have multiple H/O hospitalists, maybe this is a moot issue (but even then the hospitalists don't work every weekend or do all the night calls).
The above isn't taken to be gospel -- perhaps this is not as limiting as I think -- just some thoughts I've had while researching the single vs. double board issue. Forget the marketability to PP entirely. See below for a relevant pp from The Hematologist on this issue.
The Future of Hematology in the Private-Practice Setting
Elaine Chottiner, MD
Published on: November 01, 2007
"We may now have come to the crossroads. In Michigan, we are seeing lawsuits involving benign hematologic disorders in which the defendants include not only the treating physicians but also the groups and hospitals that allowed members without hematology Board certification to practice hematology. In addition, the Joint Commission has decided to focus upon delineation of privileges. Our Chief of Medicine recently informed me that I must separate the privileges for hematology and oncology within our division. Our group has been fortunate in that all of us have had dual training and certification or were "grandfathered" in. However, the newest member will not be Board eligible in hematology, and this requirement would mean an inconvenient back-up system for handling patients in the hospital and complex hematology consultations. As I opened my mouth to protest, I realized that I couldn’t. Not only is it the right thing to do, but it validates the role of the hematologist in a tertiary-care teaching hospital such as ours."
Last edited:
