Teaching Good Transfusion Practices

To the Editor.  —The article by Soumerai et al¹ regarding face-to-face educational outreach to improve blood transfusion practices is an important contribution. At a 370-bed suburban community hospital, we accomplished similar results over a 15- to 20-year period, culminating in an article² documenting how our transfusion practices were better than those in comparable hospitals in Minnesota. More important than describing our ability to affect transfusion practices is our indictment of deficient surgical graduate education in teaching the importance of scientific transfusion practices. Surgeons and anesthesiologists unfortunately believe that anemia will contribute to myocardial infarction, when little or no information to support that thesis exists. How can 41% of surgeons believe that anemia compromises postoperative wound healing, when information to the contrary has been known for over 25 years? Indeed, the reason for our educational efforts in improving transfusion practices at this institution stemmed from the embarrassing lack of information