What Is a Hematologist?

Treating Cancerous and Non-Cancerous Blood Disorders

In This Article

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 individual components of blood (such as white blood cells, red blood cells, or platelets) or the organs that produce them (including the bone marrow and spleen).

Hematology is a subspecialty of internal medicine that often overlaps with oncology (the study of cancer). Hematology-oncology is combined fellowship program that prepares an internist to diagnose, treat, and manage a wide range of related blood disorders.

Some hematologists will maintain a split practice, seeing both hematology patients as a specialist and internal medicine patients as their primary care provider (PCP). Others may opt to pursue a career as a hematopathologist, a lab-based professional involved the evaluation and interpretation of blood, bone marrow, band other related samples.

Diseases Treated by a Hematologist
Verywell / Nusha Ashjaee

Concentrations

Hematologists work directly with patients who have blood-related disorders. If you have been referred to a one, it is because a known or suspected disorder is beyond the skills of your primary care physician and would benefit from an expert whose sole focus is on the blood. A referral to a hematologist does not inherently mean that you have cancer.

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

Procedural Expertise

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

A hematologist may sometimes function as the lead physician (especially those who specialize in pediatric leukemia) or work as part of a team that can include, among other things, a radiologist, surgeon, radiation oncologist, geneticist, 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 procedures:

  • Bone marrow aspiration is the extraction of the liquid part of the bone marrow to diagnose leukemia or lymphoma.
  • Bone marrow biopsy is the extraction of the solid core of bone marrow to aid in the diagnosis of leukemia and other cancers. 
  • 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 employs a radioactive tracer to locate areas of cancer in the body.
  • Lumbar puncture (spinal tap) involves the extraction of cerebrospinal fluid to establish whether there are blood cancer cells in the sample.
  • Magnetic resonance angiography (MRA) uses a magnetic field and radio waves to produce cross-sectional images of blood vessels to aid in the diagnosis of stroke and other vascular diseases.
  • Stem cell and bone marrow transplants may be used to treat certain leukemias, lymphomas, and benign blood disorders.

Hematologist-oncologists are also specially trained in the use of chemotherapy drugs and other treatments for blood cancers, including targeted drugs and immunotherapeutic agents.

Training and Certification

Hematology certification requires a four-year medical degree—as either a doctor of medicine (MD) or doctor of osteopathic medicine (DO)—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, hematologist candidates would undergo two to four years of fellowship to train in a specific subspecialty, such as adult hematology, pediatric hematology/oncology, or hematopathology.

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.

By law, doctors must be licensed by the state in which they practice. Although licensing laws vary by state, all typically require you to graduate from an accredited medical school, successfully complete a specialized residency, and pass the United States Medical Licensing Examination (USMLE).

Based on income data from the 2018 Medscape Compensation Report, a hematologist can expect to earn between what an internist ($230,000) and an oncologist ($363,000) makes.

Appointment Tips

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

Before meeting with a hematologist for the first time, prepare a list of symptoms that you've been experiencing, including their time, duration, and severity. It often helps to keep a symptoms journal to log whenever an adverse event occurs.

You should also prepare a list of any medications you are taking, whether they be pharmaceutical, over-the-counter, herbal, or traditional. Some of these could potentially affect your blood chemistry or complicate treatment.

Also, take the time to prepare a list of questions to better understand the nature of your condition and what to expect moving forward. Examples include:

  • What do my blood tests results mean?
  • What tests do you recommend?
  • What is involved in testing?
  • When can I expect to receive the results?
  • How controllable is my condition?
  • What are the benefits and risks of treatment?
  • What side effects might I expect?
  • What would happen if I don't pursue treatment?
  • What is the response rate to treatment?
  • When would I know if a treatment is successful?

It is also important to check that the hematologist and labs are in-network providers with your insurance company. If not, you may be well served to find someone who is, particularly if you suspect that testing or treatments may be costly or extensive.

To find a certified hematologist, ask your primary care physician for a list of referrals or use the online locator offered by the American Society of Hematologists.

A Word From Verywell

A hematologist is a highly skilled specialist who is meant to work in collaboration with, and 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 liver disease, that may impact treatment decisions.

Not everyone with a blood disorder needs a hematologist. If you have blood in the stool, a gastroenterologist may be more appropriate. The same applies to hemorrhagic infections for which an infectious disease specialist may be better suited.

As with any medical practitioner you may be seeing, it is important to verify the doctor's credentials with either the ABIM or ASCP.

If you are 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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