- With which professional societies/organizations (e.g. AACC) are you involved?
I am currently primarily involved with AACC, specifically the critical and point of care division; and the College of American Pathologists (CAP). Within CAP, most of my time has been spent on laboratory accreditation. I am currently chair of the Continuous Compliance Committee and a member of the Commission on Laboratory Accreditation. Earlier in my career when I was more involved in transfusion medicine, I was involved with AABB. I am also a member of a number of other organizations including ACLPS, ASCP, NACB, and have volunteered for a few CLSI committees.
- How did you get started in these organizations and what advice do you have for young people wanting to get involved?
I got involved in the various organizations by pursuing my interests and seeking out opportunities to network and learn from others with similar interests. My advice for young people is to seek out many different organizations that may help foster your interests early in your career, but try to avoid getting extensively involved in too many of them. In other words, experiment with different professional groups but be cautious about which groups you commit significant time to. At least for those pursuing an academic career, it is easy to over-commit to professional societies early in your career to the detriment of your academic career.
- What area(s) do you specialize in and what initiated your interest in this (these) area(s)?
I am primarily interested in critical and point of care testing, though I also study platelet function testing and biochemical and biophysical changes to red blood cell membranes during blood bank storage. My interest in point of care stems from my responsibilities here at Mayo, but also was stimulated by what I thought was a silly question I asked my mentor about glucose testing in the ICU during my first week of employment at Mayo. Glucose meter use in the ICU and glycemic control remain among my primary interests.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
My most significant contributions have been to understanding glucose meter performance criteria for use during glycemic control, and the use of transcutaneous bilirubin as a tool for universal screening of infants for hyperbilirubinemia. My work on transcutaneous bilirubin has received more attention in Pediatrics than in Laboratory Medicine, but my collaborator Walt Cook and I have developed a novel universal newborn screening algorithm which we demonstrated improves patient safety while avoiding increased healthcare resources. I have also contributed locally through my efforts in education, serving as Vice-chair for Education in my department and Associate Program Director of the Pathology residency.
- What were some of the most rewarding and/or challenging moments of your career?
Designing studies to address the use and limitations of point of care tests is both challenging and rewarding. Participating in departmental leadership, as Vice-chair for Education, presents nearly constant challenges because of the size and scope of education in my department (18 graduate medical education programs, 7 allied health programs, and ongoing continuing medical education). Leadership challenges are immediately less rewarding than academic ones, so you have to take a long view and find satisfaction in the accomplishment of others.
- How would you recommend achieving an optimal work/life balance?
That is a tough one, and of course will vary with individual circumstances and stage of life. You certainly have to love what you do, and understand that there will be times when your career will demand a lot from you, but these need to be balanced by other times when you focus on things outside of work.
- What are you predictions for advances in laboratory medicine and/or your area over the next 10 years?
Healthcare reimbursement and reform will play an increasing role in defining value in new technologies. The question will shift from whether the technology exists to accurately measure something at the bedside, to what outcome benefit stems from bedside measurement. Concepts from outcomes research, epidemiology and population health management will become increasingly important.
- What do you see as the challenges facing young scientists in laboratory medicine?
I am sure there are many, but to me the uncertainty on how efforts to control the cost of healthcare will impact technological and scientific innovation loom largest. I don’t know that young people focus that much on this question, but perhaps they should.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
Seek out questions that are interesting to you, and be proactive and aggressive in finding resources to answer those questions.
- Do you have any specific comments or advice that you would like to provide to the members of SYCL?
Focus your career on what interests you most, and you will never be disappointed in your career choices.
- If you could start your career again, what would you do differently?
I really can’t think of anything. My career path has been very different than I imagined 15 years ago, having spent time in community practice as a clinical pathologist and coming back to academics to focus on point of care testing and education. However I love what I do and the various activities (clinical lab directorship, clinical research, education) I am involved in are each highly satisfying.
- What is strangest occurrence you've encountered in the lab?
I was a lab director in Las Vegas for five years. I could tell you some very strange stories, but none appropriate for this column.
- What is your most effective time management skill?
During my first year on staff at Mayo, the institution put all new consultants through a leadership development course that included a half day seminar from Franklin Covey. I have used the Franklin Covey time management planner ever since and it keeps me focused on my long-term goals while minimizing time spent on distractions and falsely urgent daily issues. I’m sure there are plenty of other systems out there, but when I use the Covey planner effectively it makes me more productive.
- What analogy would you use to best describe point-of-care lab testing to someone not familiar with laboratory medicine?
Despite the many years I have spent in Point of Care, I still consider myself a skeptic. Here are at Mayo we speak of the quality equation in healthcare, where quality equals patient outcome divided by cost of care. I consider every point of care request as potentially inverting the quality equation, that is increasing the cost of testing while not changing or even worsening patient outcome. In the discipline of Point of Care Testing we strive to develop tools to allow us to predict when a POCT application will increase quality by improving patient or institutional outcomes.
- What event or happenstance do you think led you to your field of study as well as the geographical area where you practice?
My interest in Laboratory Medicine developed during a medical school clinical pathology rotation with Fred Apple at Hennepin County Medical Center. After that rotation I was certain that I wanted to do CP training, and I have never regretted that decision. I was born, raised and educated (through medical school) in Minnesota, and we Minnesotans always seem to return to the nest.