Why You May Need to See a Hematologist

Understanding the Role of a Blood Specialist

Researchers comparing slides in hematology lab
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A hematologist is a doctor who specializes in the diagnosis, treatment, and prevention of diseases of the blood. This includes cancerous and non-cancerous disorders that affect the components of blood (white blood cells, red blood cells, platelets) and/or the organs that produce them (including the bone marrow and spleen). Hematology is a distinct subspecialty of internal medicine that often overlaps with oncology, the branch of medicine associated with cancer.

Among the diseases a hematologist may treat or participate in treating:

If you have been referred to a hematologist, it is because a known or suspected disorder is beyond the skill set of your primary care physician and would benefit from a specialist whose sole focus is on the blood. A referral to a hematologist does not inherently mean that you have cancer.

Role of the Hematologist

Practically all medical conditions involve hematology to some degree, given that blood tests are commonly used to diagnose or monitor them.

If you have been referred to a hematologist, it is either because a blood abnormality is at the center of your condition or a treatment (such as a stem cell transplant) would benefit from the oversight of a blood specialist.

A hematologist can sometimes function as the lead physician (especially those who specialize in pediatric leukemia) or work as part of a team that may include a radiologist, surgeon, radiation oncologist, geneticist (a specialist in genetics), and rheumatologist (a specialist in autoimmune diseases).

In addition to diagnosing a disease, a hematologist will help you understand the diagnosis, develop an individualized treatment plan, and coordinate surgery, transfusions, chemotherapy, radiation therapy, or immunotherapy, if needed.

In addition to blood tests, a hematologist may perform other specific procedures:

  • Hemoglobin electrophoresis is a blood test used to confirm sickle cell disease or other inherited disorders affecting red blood cells.
  • Human leukocyte antigen (HLA) testing is a blood test used to determine if a bone marrow donor is a good match for a patient.
  • Positron emission tomography (PET) is an imaging test that uses a radioactive tracer to locate areas of cancer in the body.
  • Bone marrow aspiration is the extraction of the liquid part of the bone marrow to diagnose leukemia or lymphoma.
  • Lumbar puncture (spinal tap) involves the extraction of cerebrospinal fluid to establish whether there are blood cancer cells in the sample.
  • Stem cell and bone marrow transplants may be used to treat certain leukemias, lymphomas, and benign blood disorders.

Qualifications and Credentials

Hematology certification requires a four-year medical degree followed by three years of residency to train in a specialized area of practice, such as internal medicine or pediatrics.

Upon completion of the residency, candidates undergo two to three years of fellowship to train in a specific subspecialty, such as adult hematology, pediatric hematology/oncology, or hematopathology. (A hematologist oversees patient care, while a hematopathologist works primarily in the lab.)

Board certification in hematology is obtained from the American Board of Internal Medicine (ABIM) or the American Society of Clinical Pathology (ASCP). ASCP-certified hematopathologists can often be identified by the abbreviation "MD SH(ASCP)" (Medical Doctor Specialty Hematology) at the end of their name.

A Word From Verywell

A hematologist is a highly skilled specialist who is mean to work in collaboration with, not replace, your primary care physician so that the appropriate care is delivered within the context of your overall health. This is especially important if you have multiple chronic conditions, such as diabetes or cirrhosis, that can sometimes impact treatment decisions.

It is also important to understand that not everyone with a blood disorder needs a hematologist. For instance, if you are anemic and have blood in your stool, you may be referred to a gastroenterologist as the source of the anemia is likely from your digestive tract. The same may apply to hemorrhagic infections or HIV-associated blood disorders for which an infectious disease specialist may be more appropriate.

As with any doctor you may be seeing, it is important to ask as many questions as you need and to check and verify the doctor's credentials. If you're uncertain about the course of treatment, do not hesitate to seek a second opinion or ask that your medical information be forwarded to another doctor.

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