The discipline of hematology relates to the care of patients with disorders of the blood, bone

marrow, and lymphatic systems, including anemias, hematologic malignancies, and other clonal

processes, and congenital and acquired disorders of hemostasis, coagulation, and thrombosis.

The general internist should be competent in 1) the detection of abnormal physical, laboratory,

and radiologic findings relating to the lymphohematopoietic system; 2) the assessment of the

need for bone marrow aspirate and biopsy and lymph node biopsy; 3) the initial diagnostic

evaluation and management of the hemostatic and clotting system; 4) the assessment of the

indications and procedure for transfusion of blood and its separate components; 5) the

management of therapeutic and prophylactic anticoagulation; 6) the diagnosis and management

of common anemias; 7) the pharmacology and use of common chemotherapies; and 8) the

management of neutropenia/immunosuppression.

The range of competencies expected for a general internist will vary depending on the

availability of a hematologist in the primary care setting. For example, in some communities a

general internist may be responsible for bone marrow examination and administration of

chemotherapy for certain disorders in conjunction with consultative assistance from appropriate

hematologist and pathologist colleagues.

(N.B. Leukemias and lymphomas are found in the Oncology section.)

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