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I don’t want to take your Blood (blah, blah)

New medical procedures have significantly reduced the need for blood transfusions

Just today, I read a fascinating article, which I would not have even imagined reading a decade ago. The author stated right at the beginning that changes in medical practices have eliminated the need for millions of blood transfusions. Whether due to changes in policy as to when to transfuse, or due to the fact that many procedures are now done interventionally rather than by making an incision and exploring a body part, the need for actual blood to be given to a patient has dropped dramatically.. Considering how often I used to get notifications about the desperate need for blood, this revolution in medical practice should be welcomed as a blessing.

In absolute amounts, transfusions of blood are already down over 30% in the last five years.  One should also not forget that there is tremendous effort being made to find the ultimate blood substitute. Such a substitute would not require tedious but critical matching of a person’s blood to that stored in the blood bank [in order to avoid severe reactions during the transfusion]. The ultimate blood substitute would not cause any blood reactions and could be safely given to all people of all ages.

But as is often the case, there is a downside to this improvement in medical care. If a medical service’s blood products are maintained by a private blood bank interest, this dramatic drop in demand could easily lead to huge layoffs and even bankruptcy amongst such services..

So here is a classic example of how a clearly beneficial medical advancement will idle and then end a whole technical specialty in medicine. Of the children born today who will eventually become doctors, the concept of blood matching will very likely be treated as ancient history.

What happens to the 45-year-old blood bank technician who has already invested 20 years of his or her life in training and experience in this field? Retraining at the age of 45 and more, is not simple. Also, one expects that other equivalent technical jobs will be replaced by more advanced technology. The entire field of microbiology, where specially trained technicians determine the exact type of bacteria that is causing an infection in a patient, will likely be fully automated and/or replaced by a whole different type of testing that does not require a dedicated technician.So the same question will be asked – what happens to all of these technicians who must now retrain in a totally different field or simply become unemployed?

I’ve spoken at length of the need for doctors to consider future retraining, as medical technology causes major shifts in most if not all medical specialties. But basic medical training tends to provide the doctor with a broader foundation, such that switching specialties, while not easy, is still simpler than the equivalent for specialized technicians. In the examples above, the blood bank technician really does not share any training with the microbiology technician. And when x-rays and ultrasounds and CT’s and MRIs are also all eventually simplified to a point that no special technical training is required to run them, what will all of these specialty technicians do?

I imagine that there will be a period of time when there will be tremendous growth in the field of technical retraining, geared towards  all of these displaced technicians. Whatever technical fields will still be open, will be offered to these individuals as a new career opportunity. But there will likely be more technicians than demand. And this does not bode well for the salaries and general opportunities for these individuals.

I have no magic answers. Economists, again in a similar fashion to the future of physicians, will  claim that this is part of the remodeling of the professional world as technology advances. People will have to retrain in order to adapt to a world that is changing ever and ever faster. It is obviously very easy to speak of such things when they are graphs on a slide, being presented to other economists and financial specialists. Down on the street, there will be frightened people who will find themselves in a constant state of turmoil.

The one piece of advice that I can give mirrors the advice I offered to physicians facing a similar type of problem during their upcoming careers. The first thing is to maximize as much is possible the depth and breadth of your initial training. Secondly, never miss an opportunity to further train yourself, even if it is in a subspecialty that may not interest you. The idea is to broaden one’s CV in order to remain attractive to future employers. I personally believe that regardless of one’s technical training, one should strive to complete at least a full bachelors degree, if for no other reason than to be a candidate for a Masters in Business Administration [MBA]. Such individuals would have a greater chance of becoming directors of labs and other medical facilities. As such, they could stretch their period of business value to their employers.

Medicine, technology, economy, psychology – these all interact, and they will continue to interact even more intricately as time marches on. The only thing that any of us can do is to be as prepared as possible to meet the new challenges.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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