‘Unparalleled Times’ in Hematology, but Workforce Issues Persist

In this exclusive video, Jane Winter, MD, of Northwestern University’s Feinberg School of Medicine in Chicago and the 2022 president of the American Society of Hematology (ASH), discusses the organization’s priorities and some of the challenges facing the field of hematology.

The following is a transcript of her remarks:

We are at a critical point in terms of the hematology workforce. The pandemic has made it even more evident how shorthanded we are. A survey we did in 2019 found that nearly half of all hospitals and practices were in need of additional hematologists, and the pandemic, with many hematologic complications associated with SARS-CoV-2, made that even more evident. So, fostering and growing a workforce, and especially providing a diverse workforce that reflects the kinds of patients we all treat.

To that end, ASH has committed nearly 20 million [dollars], which for us is a large chunk of change, to the Hematology-Focused Fellowship Training Program. This is a program that we created to establish 10 new focused tracks within existing fellowship programs. These tracks will train highly skilled academic hematologists, and hopefully in 5 years time, by 2030, will have produced an additional 50 hematologists.

What we found in a survey of our trainees is that mentorship and having mentors is the most important factor when it comes to choosing a career path. So, we need these mentors, as well as we need these individuals to actually take care of patients and do the research, but we also need them to mentor the next generation.

Our members are a very diverse group, ranging from basic scientists who never see patients to those of us who spend nearly all of our time providing care and those who do clinical research. So it’s a very diverse group.

One thing that brings us all together is the need for education. ASH has an agenda for hematology research, which points to the key cutting-edge research areas. Our members are all focused on being up-to-date, knowing it all, learning about the latest and greatest. So I think that at the annual meeting, the latest breakthroughs are usually the focus of attention.

We are very much invested in diversity, equity, and inclusion. To the point about the workforce, we have for 20+ years been funding a minority recruitment initiative to recruit, retain, and support minorities to become hematologists. A big focus at our meeting, and an area of growing interest for our members, is that of equity and inclusion. We will have a host of different mini-symposia workshops, programs to help us all do better.

Although, I have to say that as a society we’ve been there for many years, but we can always do better as evidenced by the demographic among hematologists, which is not adequate to care for our patient population.

On the downside, what are our challenges? Fragmentation of medical care is one, support for research is another. The budget goes up a little bit all the time for research, and ASH funds a huge amount of research, but research is extremely expensive, as are the drugs. These new exciting therapies are phenomenally expensive.

So these are challenges that we all face. We struggle so hard to get approval for many of these therapies through a patient’s insurance and so on, figuring out how to pay for things that will really bankrupt the majority of our patients.

On the positive side, there has never been a more exciting time to be a hematologist in terms of the new drugs and therapies that have become available that have really changed the lives of our patients. It is so rewarding to be part of that.

I have had my own incredible experiences recently in developing a new approach to all patients with Hodgkin’s lymphoma, but seeing what some of these new therapies can accomplish is just absolutely incredible.

I have patients alive today who 7 years ago when a new drug was approved had no other alternatives and now have been through multiple new drugs. Many of us say that all we need to do is get the patient to the next clinical trial, the next new agent.

These are really unparalleled times, and I’ve been at this for a very long time. This is the most exciting time ever.