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Melissa R. George, DO, FASCP, serves as Medical Director of Transfusion Medicine for Penn State Health Milton S. Hershey Medical Center, in Hershey, PA.

A 2024 recipient of the ASCP Mentorship Award and 2025 H.P. Smith Award, Dr. George is committed to teaching and mentoring the next generation of laboratory professionals.

Here Dr. George offers insightful examples of successful collaborations with other colleagues from different disciplines, shares the positive influence a leader can have on workplace dynamics during time-sensitive processes, and reflects on the profound impact laboratory professionals have on patient care.

Pathologists often collaborate with other healthcare professionals to provide comprehensive patient care. Can you describe a situation where you effectively collaborated with colleagues from different disciplines to optimize patient management?

Communication is often the biggest hurdle in obtaining blood products quickly. When I first started in my role, we frequently encountered issues with not receiving all the necessary patient information to initiate the massive transfusion protocol (MTP). Activation of the MTP for heavily bleeding patients is always a stressful situation in which seconds count.

I worked closely with the trauma service to map the MTP process and identify areas for improvement. We conducted cross departmental tours—the trauma team visited the blood bank, and I toured the trauma bays—to better understand each other’s workflows. Together, we developed a proposal for a “blood vending machine,” a remote blood storage refrigerator stocked with a limited supply of emergency-release blood products for use prior to initiating the MTP or while waiting for products to arrive.

We also experience inefficiencies due to multiple individuals calling the blood bank, rather than having a single, consistent point of contact. Together we jointly advocated for assigning a nurse resource coordinator and a transport aide to every MTP activation. This established a consistent point of contact and ensured that someone outside the immediate care team was responsible for transporting blood coolers.

We continue to refine the process and audit each case for ongoing improvement. This collaboration has been highly meaningful and ultimately serves the best interests of patient care.

How do you handle the emotional aspects of your work, such as delivering difficult diagnoses or dealing with patient outcomes?

In transfusion medicine, I frequently engage in high-stakes, emotionally charged conversations, particularly when patients require emergent transfusion support for trauma or complex surgical procedures.

In these situations, clinical teams may sometimes come across as urgent or even aggressive toward the blood bank, often due to the critical need for blood products and a limited understanding of the processes required to ensure safe and appropriate transfusion.

In these moments, I make a concerted effort to empathize with the clinical team and acknowledge the significant stress they are experiencing. At the same time, I am committed to maintaining a respectful and professional environment for my staff. If interactions become inappropriate or abusive, I intervene directly.

I prefer to assume responsibility for those conversations and work to de-escalate the situation, rather than have a member of my team subjected to unprofessional behavior. During these discussions, I remain calm and measured, avoiding escalation while clearly communicating that inappropriate conduct is unacceptable and counterproductive.

When patient care is time sensitive, I focus on resolving the immediate issue without prolonging conflict; however, I make it a priority to follow up with individuals after the critical event has passed to address any unprofessional behavior. These follow-up conversations have often resulted in acknowledgment and, in some cases, direct apologies to my team. 

Can you share a moment when you felt especially connected to patient care through your work?

One of the most challenging cases I encountered occurred when I reviewed a gastrointestinal biopsy that had been diagnosed by an outside institution as a mycobacterial infection while signing out hematopathology. The sample was largely necrotic, and I was not convinced by the acid-fast stain purported to demonstrate mycobacterial organisms.

On closer examination, I identified a very small focus suggestive of ‘starry sky’ morphology. Fortunately, the consulting institution had provided the paraffin block, which allowed me to have the suspicious area microdissected and sent for molecular testing targeting mutations associated with Burkitt lymphoma. The results returned positive.

In the interim, the lesion that had been biopsied was rapidly enlarging, consistent with this diagnosis. Because definitive testing had been initiated early, the patient was able to begin treatment promptly and ultimately achieved a good clinical outcome. Subsequent, better-preserved and more extensive tissue samples further confirmed the diagnosis.

Although I never met the patient, I know that my diagnostic work contributed to getting them the care they needed as quickly and effectively as possible.

That experience was deeply meaningful and remains one I reflect on during difficult days as a reminder of the impact of our work.

*This interview has been edited for clarity and length.