- What is your job title and affiliation?
Professor of Pathology, Director of Pathology Information Systems, Co-Director of Clinical Chemistry, Virginia Commonwealth University, Richmond, VA
- Briefly tell us about your educational and career background.
- BS, Chemistry, University of Santa Clara, 1969
- Ph.D. Biochemistry, University of Arizona, 1973
- Postdoctoral Fellow in Clinical Chemistry, Ohio State University, 1973-75
- Director of Clinical Chemistry, New Rochelle Hospital, NY, 1975-77
- Department of Pathology, Virginia Commonwealth University, 1977-
- What are your Board certifications?
ABCC, Clinical Chemistry, 1976
- With which professional societies/organizations (e.g. AACC) are you involved?
AACC, CAP, CLSI, NACB, IFCC, NIH/NKDEP, ADA, NGSP
- Just for fun, tell us a few interesting facts about yourself:
wife, two daughters; one son-in-law; two grandchildren
- Favorite activities/hobbies
sportscar and formula 1 racing
- Favorite places you have traveled
anywhere without internet and telephone
- Favorite book/movie
hang em high
- Most fun/adventurous thing you’ve ever done
vintage sportscar racing my Morgan 4/4
- What area(s) do you specialize in?
Automated testing, automated information management, quality control, proficiency testing, measurement standardization.
- What initiated your interest in this (these) area(s) and how did you eventually choose this (these) area(s) for your career?
I have always been interested in efficiency and workflow optimization. The most efficient laboratory service is provided when results are traceable to a common standard, that enables standardized clinical interpretive guidelines, and that provides optimal patient care. Efficient workflow requires automated information management and control systems. An interesting aspect to clinical chemistry is the routine methods required for high throughput are frequently compromised regarding specificity, thus achieving standardized results is a compromise between the ideal and the practical. Managing the compromise has been a very interesting aspect of laboratory medicine.
- What are your clinical and research interests?
Most of my recent work has been interlaboratory standardization activities in collaboration with various professional organizations, for example: method trueness assessment with CAP Chemistry Resource Committee Survey programs, creatinine method standardization with the NKDEP Laboratory Working Group, c-reactive protein standardization with a CDC work group, insulin standardization with an American Diabetes Association Working Group. I am also involved with an informatics project at VCU Health System to automate capture and processing of laboratory and clinical information for cancer registries.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
A number of consensus standards and guidelines in collaboration with colleagues through the Clinical and Laboratory Standards Institute (formerly NCCLS). I recently finished a 6 year term as chair of the Clinical Chemistry and Toxicology Area Committee that gave me an opportunity to contribute to the quality and practicality of several new practice documents and revisions of many existing documents.
- Are there specific aspects of practicing laboratory medicine that you find unappealing?
No; there is a great deal of variety in laboratory medicine, from technical execution to management of services and clinical consultation. The least appealing aspect is the healthcare institution bureaucracy but working the system has its own, arguably perverse, satisfaction.
- What were some of the most rewarding and/or challenging moments of your career?
The most rewarding experience has been training new clinical chemists and watching them join the profession and make contributions. Unfortunately our training program has been inactive for about 10 years. An interesting challenge was being the only clinical chemist, due to retirements, and then also being interim chair of Clinical Pathology for two years in the early 1990s. I learned how much fun it is to keep a bunch of balls in the air simultaneously. Installing a new LIS for Pathology in the late 1990s was an interesting challenge and very gratifying when we went live and significantly improved information management for the department. Reducing stat basic metabolic turn around times to 30 minutes took a lot of teamwork by everyone in the lab and had a real impact on physician satisfaction and patient care. Contributing to the profession through collaboration with colleagues in several organizations mentioned elsewhere has been rewarding.
- How would you recommend achieving an optimal work/life balance?
I am still trying to figure that out. It is important to recognize that you will perform better professionally when you are healthy and relaxed. So it is really a professional responsibility not to miss happy hour. It also helps to really enjoy your work because that is where most of the day is spent.
- What excites you about practicing laboratory medicine everyday?
The constant change in laboratory services that are required to keep pace with clinical medicine. There are new tests, the results are needed faster, there are less resources to get the work done, and yet we do; thanks to advances in technology and information management. Being able to provide the service to patients and contribute to advances in laboratory practice is a lot of fun.
- What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
Genetic testing, molecular technologies, pharmacogenomics, array based measurements and the information management needed to enable efficient services for these new technologies will be very interesting to participate in. The need to deliver results faster will continue to drive service requirements.
- What do you see as the challenges facing young scientists in laboratory medicine?
The ever increasing amount of knowledge that must be acquired is a challenge for everyone. It is important to develop perspective regarding the value of new laboratory tests that become available. The past two decades has seen many promising tests come and go. An example is myoglobin as an acute cardiac marker. One needs to avoid getting caught in the hype of early publications that may be based on inadequate experimental design. Critical assessment of pathophysiology, experimental design and clinical outcomes is required to avoid wasting resources on laboratory tests that ultimately add little value to the patient’s outcome.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
It is important to remember that laboratory medicine is a pragmatic discipline. Your goal should be to make yourself useful to the organization for which you are employed. You must be a resource to the medical technologists who perform the testing and always value and protect their interests. You must also be a resource to the physicians who use laboratory information and make it easy for them to get and use results. There is plenty of room for research in a wide range of areas from basic clinical investigations, to application of methods to clinical conditions, to management of laboratory services. Collaboration with colleagues is always a good way to proceed. There is a great deal of knowledge and productivity that comes from collaboration. Senior colleagues are usually looking for new talent to ensure the torch is passed appropriately to the next generation.
- Describe how you have been able to give back or contribute to the organizations and the profession in general through your involvement in AACC.
I became involved in the AACC Standards Committee, now defunct, by attending meetings and eventually became chair for a few years. I have been involved in local section activities, the Lipids and Lipoproteins Division, again becoming the chair, when cholesterol and other lipid tests were being standardized at the inception of the NCEP, and annual meeting organizing committees. I have been active in a number of CLSI committees over the years; and have been a consultant to the CAP Chemistry Resource Committee for a number of years. In addition, I have participated in several other committees and working groups most in the area of standardization of laboratory testing. I was privileged to join the board of editors of Clinical Chemistry this year.
- How did you get started in these organizations and what advice do you have for young people wanting to get involved?
Getting involved with professional activities is a great way to meet colleagues, increase your knowledge and contribute to the profession. The AACC Local Sections and Divisions provide an excellent entry to professional activities. It is necessary to attend the meetings, meet the people and volunteer when a project is forming. CLSI offers another excellent way to get involved. The subcommittees and working groups accept observers by simply asking to be one. Observers can contribute actively just the same as members, and it is easy to participate since most meetings are by conference call. You may not be asked to be a voting member initially, but contribute to the review and editing after a first draft is circulated; you will learn a great deal from the discussions and be positioned to participate in another project. If your organization is not a member of CLSI, it is easy to stay informed about upcoming projects through their web site. The Chemistry and Toxicology Area Committee meets during the annual AACC and is always an open meeting (July 26, 2006 at Hyatt McCormick 11:30 to 2:30). There are a number of volunteer opportunities at the AACC annual meeting that provide good experience and the opportunity to meet colleagues; stop by the AACC booth and ask the people representing next years meeting. The important thing is to volunteer and be persistent.
- Do you have any other specific comments or advice that you like to provide to the members of SYCL?
Your career is pretty much what you make of it. Laboratory medicine constantly changes and there are always new opportunities. Pick the areas that interest you and go make a difference.