I agree with the above statements. I will just add that we are involved in influencing a change of practice concerning any treatment decision that effects blood use. Please realize that changing practice comes under the catagory of a life change for our physician friends. Our Doctors are VERY busy people. They make decisions that effect life. They depend on standards and protocols to facilitate their practice. We are asking two tough things 1) do not settle into your SOP (standard operating protocols) with our patients and instead think outside the box 2) create protocols for our patients that will eventually become the accepted standard of care. Why is this difficult for some? Doctors are scientists and as such depend on research and proof. Some have the explorer mentality but many do not and will yield only when presented with unassailable proof. Our job is to provide them with reasonable alternative treatment options that in their opinion will not unduly expose their patient to danger.

The rule - Physician's listen to other physician's. If you can't find a paper supporting an alternate approach to anemia in a patient with a history of cardiac problems then look for a physician who can speak from their case history.

Resources include
PubMed - http://www.ncbi.nlm.nih.gov/PubMed/
Centers of Exellence
he Kay Group at Good Samaritan in Los Angeles - http://www.kaymed.com/medterms_bohs.htm (Manuel Estioko or colleagues)
University of Pennsylvania Bloodless - http://www.pennhealth.com/health_inf...ess/index.html

To name a few

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email