Hematologist

A haematologist is the physician who specialises in blood, bone marrow and lymph nodes. They handle both 'benign' conditions (anaemia, stubborn iron deficiency, low platelets, bleeding disorders, recurrent clots) and blood cancers (leukaemia, lymphoma, myeloma), the area where you hear the term haemato-oncologist. People call them the blood specialist, and in Israel you usually see 'the haematologist' (ההמטולוג) on referral from your family doctor after an abnormal blood test. The visit is built on your results (blood count, ferritin, clotting profile, sometimes protein electrophoresis), a careful examination of lymph nodes, liver and spleen, and where needed a blood smear or a bone marrow sample taken in clinic or in hospital. In Israel, certain inherited traits in specific communities (G6PD deficiency, thalassaemia, Gaucher disease among Ashkenazi Jews) are part of this specialist's daily work.

• ✓Anaemia that does not improve with iron, or whose cause your doctor cannot find.
• ✓Platelets or white cells abnormally low or high on several blood tests.
• ✓Frequent bruises without a knock, long nosebleeds, very heavy periods with anaemia, excessive bleeding after a tooth extraction.
• ✓A venous clot (deep vein thrombosis, pulmonary embolism) with no obvious cause, at a young age or more than once.
• ✓Lymph nodes growing for several weeks, night sweats, unexplained fever, weight loss.
• ✓A family history of a blood disorder: haemophilia, thalassaemia, G6PD deficiency, Gaucher disease, thrombophilia.
• ✓Advice on a complex anticoagulation plan, before surgery or during pregnancy.
• ✓An abnormal blood protein (monoclonal spike) picked up on routine tests.

In Israel, haematology is a sub-specialty: the doctor holds a specialist title in internal medicine and then a title in haematology (מומחה ברפואה פנימית ובהמטולוגיה), or, for children, a title in paediatric haemato-oncology reached from paediatrics. These titles and the licence to practise are issued by the Ministry of Health on the recommendation of the Scientific Council of the Israel Medical Association, and can be looked up on the public register (מאגר בעלי רישיון). A haematologist trained in Europe or North America must have obtained the Israeli licence and had the title recognised; the foreign diploma alone does not allow practice. In France and the UK the training route differs (a direct specialty in France, haematology training after core medical training in the UK), while the final standard is comparable. Do not confuse the clinical haematologist with the laboratory scientist or technician in a haematology lab, who runs the tests but does not see patients, nor with the oncologist, who treats solid tumours. Transfusions and heavy treatments (chemotherapy, stem cell transplant) are only done in licensed hospital departments, never in a private office.