- What is your job title and affiliation?
As a tenured Professor of Pathology, University of Utah, my service assignment the past 7 years has been the position of Chief Medical Officer/Laboratory Director, ARUP Laboratories. In July 2009, I will give up the CMO position to become President and CEO for ARUP Laboratories.
- Briefly tell us about your educational and career background.
My father practiced and taught medical technology. From an early age I spent many weekends in his laboratory at the microbiology bench. During high school, I excelled in chemistry and mathematics. These aptitudes lead me to a college engineering education. I earned a bachelors of science in Chemical Engineering in 1975 and an M.D. in 1979 both from the University of Colorado. I completed a clinical pathology residency at the University of Washington and was on the faculty of the Department of Laboratory Medicine for 3 years. In 1985, John Matsen and Harry Hill convinced me to move to Utah to join the faculty of the Department of Pathology and ARUP Laboratories. I’ve been at Utah for the past 24 years.
- What are your Board certifications?
I’m a diplomate of the National Board of Medical Examiners and licensed to practice medicine. I hold a certificate in Clinical Pathology and a subspecialty certificate in Chemical Pathology, both from the American Board of Pathology.
- With which professional societies/organizations (e.g. AACC) are you involved?
A member of AACC since 1983, I’ve been active at the local and national levels. I’ve served as chair of the Rocky Mountain Section twice (1989 and 1993), hosting meetings in Salt Lake City and Banff, legislative liaison from 1990-1995, delegate to the House 1999 to 2004. I’ve lectured at 11 local section meetings. Service nationally has included the contributed papers committee (1987), nominating committee (1995-1996), A. O. Beckman Conference Committee (1995-1999, chair 1997-1999), Meeting Management Group (1997-1999), Program Planning Committee (1999-2001), and the annual meeting organizing committee for 2005. At annual meetings I’ve lead 19 round table discussions, delivered 6 platform lectures, and introduced 4 plenary speakers.
For the College of American Pathologists, I have served on the Informatics, Chemistry, Instrumentation, Graduate Education, and Biochemical/Molecular Genetics resource committees, chairing Chemistry for 4 years. At annual CAP meetings I’ve given 26 presentations.
Finally, I am past president of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS) and served as the ACLPS secretary-treasurer for 6 years. I currently represent ACLPS as one of the cooperating societies for the American Board of Pathology.
- Just for fun, tell us a few interesting facts about yourself:
My wife, Candice Johnson and I enjoy music, food and wine, the mountains and our two Labrador retrievers. She is a trial attorney with a solo practice. We are both from Gunnison, Colorado.
- Favorite activities/hobbies
Fly fishing is our passion, mostly clear, small streams close to timberline in Utah and Colorado. We also enjoy the beaches, swimming, and snorkeling.
- Favorite places you have traveled
Memorial trips include skiing/winter camping the Ute trail from east to west over the continental divide in Rocky Mountain national park, camping in Seven Lakes Basin in Olympics national park, luxuriating on Orpheus Island in the barrier reef of Australia, attending IFCC in Melbourne, a road trip around south island New Zealand, beaching at Kauai, Maui, Hawai’i, and Oahu, fishing in Katmai national park Alaska, fishing the Bow near Banff, attending IFCC in Kyoto, visiting Greece three times, attending IFCC in London, sailing on a 5 mast clipper ship from Venice to Rome, and hiking into Powde1rhorn Lakes Wilderness area in Colorado.
- Favorite book/movie
My den contains over 200 science fiction books, favorite authors are Heinlein, Pohl, Benford, Brin, Sawyer, Robinson, Niven, and Asimov. In addition to science fiction, I also enjoy books by Jared Diamond, such as “Guns, Germs, and Steel,” “Collapse,” and “The Third Chimpanzee.”
- Most fun/adventurous thing you’ve ever done
I spent 13 summers on a Colorado cattle ranch working for my grandparents and uncle. In addition to cattle management on horseback 3 days each week, I became proficient at large equipment repair and maintenance, fence building, horse training, lumber sawing, and harvesting natural hay. Likely because of my impatience, I became only marginally adequate at irrigation.
- What area(s) do you specialize in?
Clinical laboratory tests that assist with diagnosis and management of pregnancy are my main focus. I also have an interest in viral hepatitis, HIV, and informatics.
- What initiated your interest in this (these) area(s) and how did you eventually choose this (these) area(s) for your career?
Interest in informatics came early as an outgrowth of my engineering education. I soon realized that publishing in informatics was much more difficult and less useful than in clinical chemistry, so I decided to focus on clinical chemistry.
Unexpected was my interest in viral hepatitis and HIV. In the early days at ARUP, the only section staffed during the evening was the clinical chemistry laboratory. In those days, blood donated for transfusion needed to be tested in a more timely fashion than the next day. The obvious choice was to perform this testing in the laboratory staffed during the evening, i.e. clinical chemistry. Thus was born my interest in that testing.
My interest in the clinical laboratory management of pregnancy has an amusing beginning. As a laboratory medicine resident I was anxious to find an area with tests that needed improvement. During national lab week, the UW staff voted on the best and worse laboratory test from the point of view of the technologist. L/S ratio had won three years running. What better area to choose than a test that needed the most help?
- What are your clinical and research interests?
As I would tell any lawyer at a deposition, asked and answered. I find the most synergism in aligning my research and clinical interests. Currently I have active work on prenatal assessment of Down syndrome and diagnosis of histoplasmosis infection. As medical director of ARUP Special Genetics, I sign out maternal serum screens every other week.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
Co-editing the Tietz Textbooks with Carl Burtis has been my most important contribution. Other notables have been mentoring many residents and fellows over the past 28 years. Finally, being part of team of faculty and laboratory professionals that created the best reference laboratory in the world has been fun and fulfilling.
- Are there specific aspects of practicing laboratory medicine that you find unappealing?
Listening to “pathology experts” lament the death of clinical pathology for 30 years has been irritating, especially when the future has never been more promising.
- What were some of the most rewarding and/or challenging moments of your career?
The most rewarding moment was being honored by ACLPS with the Evans award, named for Gerald Evans, the father of laboratory medicine in this country. Conducting a memorial service for my friend and colleague of 20 years, James Wu, was my most challenging.
- How would you recommend achieving an optimal work/life balance?
Focus intently on work when working either at the laboratory or at home. When not working, bring the same intensity to activities you enjoy. Get involved with community activities. I am a trustee of the Utah Symphony and Opera. In addition to helping philanthropically, I am delighted to attend numerous summer salon events where the highlight is meeting and talking with musicians from around the world.
- What excites you about practicing laboratory medicine everyday?
The number of significant new laboratory tests during my career astounds me. HIV, HCV, factor V Leiden, CFTR gene, HER-2/neu, ADAMTS13, and JAK2 to name but a few. Many more tests are coming.
- What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
Maternal serum screening for Down syndrome will radically change with the introduction of cell-free DNA/RNA techniques that use maternal blood specimens. Full genome sequencing will lead to requests for periodic reinterpretation of already known sequence, considering the rapid advances in the knowledge of gene functions. This reanalysis will force the development of a new reimbursement model.
- What do you see as the challenges facing young scientists in laboratory medicine?
I hope that the laboratory medicine community can convince the federal government that laboratory testing is the best medical bargain available. Proper testing leads to correct diagnosis. Incorrect diagnosis is the major cause of waste in healthcare spending.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
Join two to five professional organizations and be an active member in two (don’t neglect your day-job). Volunteer for committees and submit meeting speaking proposals. If you struggle with public speaking, take a class. Carefully prepare each presentation and practice it orally. Conduct a dress rehearsal with an hour-long feedback session.
- Describe how you have been able to give back or contribute to the organizations and the profession in general through your involvement in AACC.
AACC has allowed me to contribute at the annual and regional meetings, on committees, and by publishing in Clinical Chemistry. Attending AACC meetings allows one to network with the best experts in the field. Time spent on AACC activities lead to my recruitment in my present job and has helped me recruit colleagues to ARUP. Contributions to Clinical Chemistry are always pleasing because I know that this journal is read widely.
- How did you get started in these organizations and what advice do you have for young people wanting to get involved?
I joined AACC to get Clinical Chemistry but quickly realized that the annual meeting and instrument exposition was just as valuable. If you want to be involved, volunteer for committee work. Remember not to promise what you can’t complete.
- Do you have any other specific comments or advice that you like to provide to the members of SYCL?
I encourage SYCL members to practice their craft with passion. While doing so, remember the three A’s: availability, affability, and ability. The first two A’s are, in my opinion, slightly more important than the last A. To practice a profession like clinical chemistry one must first be professional.