Aaron Gerds, MD, is the deputy director for clinical research at Cleveland Clinic Taussig Cancer Institute and associate professor at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
In 2025, we marvel at the implementation of cutting-edge science in everyday practice, such as gene editing, single-cell sequencing, and even engineered T cells. Yet, I still walk over to the fax machine to get medical records with a cacophony of pagers going off in the background. What we now recognize as the fax machine was introduced by Xerox in 1964. In almost all other industries, fax machines have long since been phased out due to the growth of digital communication and the internet. However, six decades later, the health care industry still relies heavily on the fax machine as the most secure way to transmit important information from one location to another, even though it is no longer the most cost-effective or efficient form of communication.
Nonetheless, the role of some old-fashioned technology is evolving. Many health care systems are shifting toward patient-facing digital health solutions like telemedicine video visits, patient portals, and artificial intelligence (AI)-driven chat services. However, these adoptions are not entirely due to an embrace of technology for efficiency or better care delivery, but rather they are being driven in large part by reimbursement. We need to modernize, but for the right reasons.
Sometimes it seems like there is a certain reluctance in modernizing when it comes to health care delivery. But technology can be transformative. In ice hockey, for example, the shift from wood and aluminum sticks to the modern carbon fiber hockey stick has dramatically changed the way players shoot the puck, and the game I played as a kid is not the game that is played today. Modern carbon fiber sticks are flexible and have a faster release than their wood counterparts, so players release shots quicker and with more power. As a result, there’s been a shift toward more deceptive, quick-release snap shots. This has placed the vaunted slap shot on the endangered list, and what was the bread-and-butter shot of my day — the wrist shot — has all but become extinct. This evolution of the game is not a bad thing. Advancements in equipment have revolutionized shooting, resulting in the fast-paced, high-scoring game we see today.
Likewise, technologic advancements can evolve the ways we care for patients, and we need to evolve or we’ll risk obscurity, like the slap shots and wrist shots of hockey. The reality is that the health care landscape is changing rapidly. We feel the change every day. Hospital, university, and clinic margins are thinner than ever, with systems running in the red or even closing. In turn, we are tasked with doing more with less, and this can put significant stress on early- and mid-career hematologists who are trying to “make it.”
There are two changes we can make to meet the demands of today. One is to reevaluate the meaning of “making it.” The five-step plan for a career — 1) complete training, 2) publish papers, 3) secure grant funding, 4) become department chair, and 5) retire — may not be a good fit for everyone. We all have different talents and passions, and there are probably twice as many successful career paths as there are hematologists. This is not an easy change to make and requires both honest self-reflection and leaders who lead with heart.
The second is to embrace the change. For most of us, medicine is not what we thought it would be when we started our journey. Although some of that may just be due to a naïve lack of understanding, this feeling is also a result of the rapid changes that occur in health care and the world at large. It reminds me of a parable about a Chinese farmer. The story illustrates the concept that it’s impossible to definitively label an event as “good” or “bad” because you never know what the future consequences of that event might be. You shouldn’t rush to judge a situation as purely positive or negative; the key phrase is often “maybe,” and the farmer wonders, “Bad luck, good luck, who knows?”
To navigate the narrow fiscal straights that we, like many institutions, are in, my department leadership recently asked me to add more clinic time to my weekly schedule. Of course, my knee-jerk reaction was that this was “bad.” I’d have less time to work on studies, write papers and grants, or discharge my research administrative duties. These initial feelings felt oppressive, but this request gave me an opportunity to reframe how I’m working toward “making it” in my career. Hematology is first and foremost about taking care of patients, so seeing more naturally leads to that end. Secondly, as a clinical researcher, deploying clinical trials and caring for the patients on them is my academic lifeblood. Seeing more patients may ultimately lead to more academic productivity. So, was this extra clinic time a “bad” thing? Maybe, maybe not.
Technology, specifically AI, can help us change with the changing times. To make clinic time more efficient, we now have AI scribes that can translate patient visits into clinical documentation, hopefully freeing us from the burnout machine known as the electronic medical record. Natural language models can also summarize a patient’s history prior to their visit. Instead of pouring over records not knowing exactly what you’re looking for, a succinct and accurate summary can make your pre-charting more efficient. Additionally, image-powered algorithms can analyze medical images, pathology slides, and genomic data faster and more accurately than humans, and predictive analytics help in early disease detection (e.g., models spotting disease in radiology films). As the Longitudinal Knowledge Assessment reminds us on a quarterly basis, there is an overwhelming amount of information, and sifting through it to get the answer to a clinical question in less than four minutes is a challenge. While in clinic we have more time to read and interpret the literature, AI-driven clinical decision support systems can assist hematologists in making more informed choices quickly.
Technology is revolutionizing medicine in multiple ways, improving diagnosis, treatment, patient care, and overall health care efficiency. Embracing technology is not the only answer to weathering the storm of change in health care, but doing so can help us make it in our current environment and realize that new future.
Now, where are those labs that were faxed to my office …
Aaron Gerds, MD
Editor-in-Chief
Click here to read the parable about the Chinese farmer who responds to situations with “Bad luck, good luck, who knows?”
The content of the Editor’s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.
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