5 Questions with Dr. James Malone

Summary

Podcast Summary: Blood, Sweat and Smears – “5 Questions with Dr. James Malone”

Date: October 23, 2025
Host: Bjorn Stromses (with possible co-host Dr. Brad Lewis)
Guest: Dr. James Malone, Clinical Associate Professor of Hematology, Stanford Medicine; Colonel and Command Surgeon, US Army Reserves

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Overview

This episode of Blood, Sweat and Smears features a dynamic conversation with Dr. James Malone, a leader in both classical hematology at Stanford Medicine and as a Command Surgeon in the US Army Reserves. The hosts pose five focused questions—plus a bonus—exploring Dr. Malone’s unique blend of clinical, administrative, military, and laboratory medicine experiences. Listeners gain insights into the importance of systems-based practice, the impact of laboratory medicine, the value of teamwork, and the critical role of classical hematology across the healthcare spectrum.

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Key Discussion Points & Insights

1. Physician-to-Administrator: How Doctoring Informs Administration

[01:08 – 02:31]

• Dr. Malone details the transition from clinical practice to hospital administration, drawing parallels with leadership experience gained in the Army.
• Importance of Clinical Continuity: Remaining an active clinician while serving in administrative roles helps ensure credibility and influence with medical colleagues.
  • Quote: “It was really important to be present clinically to your colleagues in order to be able to influence what they do and don't do relative to hot operations, quality and safety and service.” (Dr. James Malone, [01:56])
• His passion for hematology drives his continued involvement in patient care, despite administrative demands.

2. How Administration Shapes Clinical Hematology

[02:31 – 04:07]

• Emphasizes “systems-based practice”—the need to understand and navigate the full complexity of hospital systems.
• Extensive time spent learning hospital operations improved his clinical teaching and patient care.
  • Quote: “A hospital...it's got all these different departments or organs that work together, hopefully sometimes don't. And the better we understand its strengths and weaknesses, the more we can help others do the same.” (Dr. James Malone, [03:35])
• The COVID-19 pandemic underscored the critical, sometimes underappreciated, role of laboratory medicine.
  • Malone is proud to identify as a laboratory professional at heart, citing early career experiences in transfusion services and coagulation labs ([04:12 – 04:39]).

3. Dual Roles: Army vs. Academia

[04:40 – 06:17]

• Discusses contrasts and surprising similarities between military medicine and academic practice.
• Core competencies in both roles include understanding complex systems, leading small teams, and maintaining mission focus.
  • Quote: “You have to be able to know what your mission is and what your desired end state and goals are....there's nothing that substitutes for just being in the trenches with each other.” (Dr. James Malone, [05:27])
• Highlights the irreplaceable value of in-person teamwork within both military and medical contexts.

4. Case Highlight: Applying Hematology in Combat Zones

[06:17 – 08:58]

• Dr. Malone recounts a recent high-stakes deployment during military conflict, where his specialized hematology expertise was called upon.
• Case involved a young US service member with suspected thrombotic microangiopathy (TMA).
  • He worked with Machaon Diagnostics to perform rapid TMA genetic testing to confirm a diagnosis of an inherited proclivity.
  • Quote: “It was really clear to me that this poor individual had a severe, life-threatening thrombotic microangiopathy....I was able to draw blood specimens from him and Bjorn, with your and your team's help able to rapidly get a TMA genetic panel done.” (Dr. James Malone, [07:07])
• Despite the patient’s passing, the genetic diagnosis brought critical closure and informed family care.
  • “It was critical to be able to tell his family...why we thought his 26 year old brother died...and to be also share with them that yeah, there is a genetic predilection...” (Dr. James Malone, [08:08])

5. Elevator Pitch: Why Classical Hematology Matters

[08:58 – 11:03]

• Dr. Malone highlights the centrality of hematology: the CBC is the most commonly ordered test in the US.
• Classical hematology is foundational, intersecting with every corner of medicine and enabling effective care in diverse scenarios.
  • “There's no corner of patient care where classical hematology doesn't touch. And we're a huge enabler of all these other important life-saving services.” (Dr. James Malone, [10:15])
• Stresses the necessity of on-site hematology and laboratory diagnostic expertise for tertiary and quaternary centers.

Bonus Question: Advice for Listeners

[11:03 – 11:54]

• Dr. Malone encourages listeners to “make yourself uncomfortable” and regularly seek experiences beyond their comfort zones.
  • “Life begins at the end of your comfort zone...It's only when I do that that I start to learn about myself, about others and about the world.” (Dr. James Malone, [11:20])

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Notable Quotes & Memorable Moments

• Systems as Organisms:
  “A hospital...it's got all these different departments or organs that work together, hopefully sometimes don't. And the better we understand its strengths and weaknesses, the more we can help others do the same.”
  — Dr. James Malone, [03:35]

• On Teamwork and Presence:
  “There's nothing that substitutes for just being in the trenches with each other. And that's the same whether I'm over there in the desert or...at Stanford.”
  — Dr. James Malone, [05:29]

• On Laboratory Medicine:
  “I've always told everybody I'm a laboratory professional at heart...That's often where my heart lives.”
  — Dr. James Malone, [04:12]

• Why Hematology:
  “There's no corner of patient care where classical hematology doesn't touch....Classical hematology and systems-based hematology is critical to the ability to run tertiary and quaternary care centers.”
  — Dr. James Malone, [10:15]

• Personal Growth:
  “Life begins at the end of your comfort zone....get out there, get a little bit uncomfortable and you'll actually be better off because of it.”
  — Dr. James Malone, [11:21]

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Timestamps of Key Segments

• Transitioning from Clinician to Administrator: [01:08 – 02:31]
• Operations and Systems-Based Practice: [02:31 – 04:07]
• Laboratory Medicine’s Value: [04:12 – 04:39]
• Military vs. Academic Medicine: [04:40 – 06:17]
• Combat Zone Hematology Case: [06:17 – 08:58]
• Defending Classical Hematology: [08:58 – 11:03]
• Bonus: Advice to Listeners: [11:03 – 11:54]

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Closing Sentiment

Dr. Malone closes by praising the synergy between his military philosophy—“mission first, people always”—and the values of Machaon Diagnostics, emphasizing dedication to both task and team ([12:08]).

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For listeners seeking an inside look at the intersections of hematology, hospital administration, and military medicine, this episode offers practical wisdom, deeply held values, and memorable stories from the front lines of patient care and leadership.

Transcript

[Bjorn Stromses]

Hello and welcome to Blood, Sweat and.

[Podcast Co-host (possibly Dr. Brad Lewis)]

Smears, your Macheon Diagnostics podcast with tag.

[Bjorn Stromses]

Team hosts including Our medical director, Dr. Brad Lewis, senior director Bjorn Stromses.

[Podcast Co-host (possibly Dr. Brad Lewis)]

That's me.

[Bjorn Stromses]

And other guest hosts.

[Podcast Co-host (possibly Dr. Brad Lewis)]

We hope you find these podcasts interesting and informative.

[Bjorn Stromses]

Thank you for listening. And away we go. Hi, my name is Bjorn. Continuing our series 5 questions posing 5 questions to physicians in and around the disease areas we work in. Today we are joined by Dr. James Malone, Clinical associate professor of hematology at Stanford Medicine. That's right, straight on classical hematology. We are also joined by Colonel and Command Surgeon James alone of the US Army Reserves. Hua and thanks for joining us today, Dr. Malone.

[Dr. James Malone]

Mega Hua to you, Bjorn. Thanks for having me honored and pleasure to spend some time with you and answer a few questions hopefully that are of interest to our neutral audience.

[Bjorn Stromses]

Okay, on to our first question. I know you've done a shift in hospital administration in your career and I'm wondering how being a physician informed how you approached your work as an administrator now.

[Dr. James Malone]

Thanks for asking that question. It's increasingly common career path or way to blend both sides. I learned a lot about leading small teams and leading hospitals in the army and found it a natural transition to blend what I did in hematology with what happens in the hospital and healthcare system. You know, one of the things that I found was key was to continue to do both things. It's challenging to do that. You know, when one becomes a chief medical officer of an acute care hospital, the bandwidth, the time to then being an active clinician still diminishes greatly. But I found it was really important to be present clinically to your colleagues in order to be able to influence what they do and don't do relative to hot operations, quality and safety and service. So I never stopped being a clinician, mostly because of that. Also because of just pure love for hematology. I can't imagine giving it up in any fashion.

[Bjorn Stromses]

That's what we like to hear. So second question is how did your time as an administrator inform your work as a practicing hematologist?

[Dr. James Malone]

That's also a great question. You know, when we train residents and fellows, we always focus on things that we call systems based practice. And that really means how well does one understand and use all of the tools of healthcare? You don't really understand and learn that until you start dipping your toes into the operations side of how healthcare runs and particularly a hospital. So I spent countless hours in every department of a hospital understanding how they work together and how they don't work together. And one of the things I really learned, and this was cemented home during COVID is that people didn't understand how the laboratory works and how important laboratory medicine is, how useful it can be, how much it can be misunderstood and misused and misunderstood. So I really became a much better clinician and particularly able to train the next generation of hematologists by really understanding how a hospital works as an organism. And that's really how I, how I see a hospital. It's no different than the human being. It's got all these different departments or organs that work together, hopefully sometimes don't. And the better we understand its strengths and weaknesses, the more we can help others do the same. So those two have really gone hand in hand.

[Bjorn Stromses]

And we didn't pay you to hype up the lab there. So just so everyone knows that.

[Dr. James Malone]

No, negative. I've always told everybody I'm a laboratory professional at heart. You know, a good portion of my early career at Stanford was as the associate director of the blood bank and transfusion service, as well as special coag lab. So I've always been a kind of half clinician, half clinical laboratory specialist and always, always tell everybody I work with. That's often where my heart lives.

[Bjorn Stromses]

Fantastic.

[Dr. James Malone]

Yeah.

[Bjorn Stromses]

All right, third question. So you split your time between Stanford and the US army, and what do you experience as the strengths of those two? And I'm assuming here very different worlds.

[Dr. James Malone]

Yeah, it's an interesting shift. I was, you know, just recently over in an area that the army has a big role in, which is called Central Command or centcom, which is the traditionally what people know as the Middle east, basically being a chief medical officer there or army health care assets. And people might think that there's not really any parallels, but really the day to day key tasks and skill sets are exactly the same. You have to understand how complex systems work. You have to be able to lead small teams. You have to be able to know what your mission is and what your desired end state and goals are. Otherwise you can really get lost out there and put in a lot of effort, a lot of work and not accomplish a lot. So I think really the key things that tie the two together are the importance of teamwork and particularly in person. This world of remoteness that you and I are doing right now is great for a lot of things, but there's nothing that substitutes for just being in the trenches with each other. And that's the same whether I'm over there in the desert or whether I'm on the Inpatient consult service at Stanford. Being present to develop relationships, to lead teams is the thing that you need to develop acutely to be able to succeed in either of those. Those realms.

[Bjorn Stromses]

Great. We recently were able to assist in a case you had while deployed. Can you share any of that experience?

[Dr. James Malone]

Yeah, I sure can. You know that I can say in my 30 years in the army, I've probably been used as a hematologist less than a handful of times. People always ask me when I show up at a, at a new base or a new location, well, hey sir, what's your specialty? And I, I joke around, I say combat hematology is what I do and once in a while I do get called for that. So. In the midst of the conflict and the war between Iran and Israel, recently I was notified that one of our US service members was gravely ill in a civilian hospital in the Middle East. And it just so happened that everything I was told over the phone made it sound like a typical HUS or TMA that was going on. So right when the conflict ended, six hours after that, I was on a plane to the country where this soldier was to go to the bedside and help diagnose what was. What was happening. And it was really clear to me that this poor individual had a severe life threatening thrombotic microangiopathy. And it wasn't clear why this was. I spent a few days ruling out the things that I could rule out there. But then the thought came to mind that geez, I think I need some special teams players. And of course, you know, Meishan diagnostics came to mind of helping me understand did this gentleman have an inherited tendency to develop this problem. And I was able to draw blood specimens from him and Bjorn, with your and your team's help able to rapidly get a TMA genetic panel done. Which was very instructive in telling us that yes indeed this individual had known risk factor for developing this problem and we had the right diagnosis. Unfortunately, despite all of our best efforts, he died of his underlying illness. But it was critical to be able to tell his family and particularly his one surviving brother why we thought his 26 year old brother son died of while on active duty in the service of his country. And to be also share with them that yeah, there is a genetic predilection that we should pay attention to for his brother and also other members of the extended family. So it was, it was critical to be able to have that worldwide reach of the expertise and talent that Meishan presents. And I'm forever thankful to Be able to just reach out to you and your team by any means necessary and get that assistance.

[Bjorn Stromses]

Well, we were very honored to play a small role. All right, our fifth question, classical hematology often doesn't get the respect it deserves. So what would your elevator pitch be for your subspecialty?

[Dr. James Malone]

I would ask the person in the elevator tell me the most common laboratory test ordered in the United States annually and I bet you even if they didn't know, they could guess to cbc. Right. So therefore there's so many opportunities for classical hematology to get involved in the care of just about any patient because routinely you're going to find some abnormality there that needs some explanation and understanding and that's often the window into so many other disorders and diseases that the patient has. So it's, it's again, it's something that every practitioner looks at regularly in their patients, but understands often the least. The other pitch I would give them is that we are about the busiest consult service in the hospital. We routinely carry over 20 patients on our inpatient consult service ranging from labor and delivery to the emergency department, cardiac icu, pre op surgical area medical teams, solid organ transplant and bone marrow transplant. There's no corner of patient care where classical hematology doesn't touch. And we're a huge enabler of all these other important life saving services. We're constantly trying to tell Stanford Medicine how important we are. Of course we pat ourselves on the back every day and try to share with them our impact. But really, classical hematology and systems based hematology is critical to the ability to run tertiary and quaternary care centers. It's not possible to do it without expertise on site. And that also includes expertise in laboratory diagnostic services.

[Bjorn Stromses]

Fantastic. So if you're keeping score at home, that is five questions. Which brings us to our bonus question. And that is what is something you'd recommend? And it can be absolutely anything.

[Dr. James Malone]

Make yourself uncomfortable. Do things occasionally that are way outside your comfort zone. One of the sayings I heard a long time ago that I try to subscribe to is life begins at the end of your comfort zone. I constantly try to put myself in little situations that are not particularly of high risk to myself or others, but that make me uncomfortable because it's only when I do that that I start to learn about myself, about others and about the world. So I would say get out there, get a little bit uncomfortable and you'll actually be better off because of it.

[Bjorn Stromses]

That's great advice.

[Podcast Co-host (possibly Dr. Brad Lewis)]

And while this conversation was well within my comfort zone.

[Bjorn Stromses]

I'll look for an opportunity here shortly to get outside of it. Thank you very much for your time today, Dr. Malone. Really appreciated your your comments and your words.

[Dr. James Malone]

Bjorn, it was an honor and appreciate the partnership with you and your team at Mation. I'll just say in closing, you know, one of the things that I think we have in common in the army and your team has in common with us is our approach to our work. You know, we always say mission first, people, always. But that's also the same approach that you and your team take to your work.

[Bjorn Stromses]

Very much appreciate it. Thank you very much.

[Dr. James Malone]

Absolutely.

[Podcast Co-host (possibly Dr. Brad Lewis)]

That's it for us here at Blood, Sweat and Smears, a podcast produced by Matrion Diagnostics, your reference lab and CRO specializing in thrombosis, hemostasis and rare disease. Thank you for listening and if you have a question or comment or there's a topic you'd like Dr. Lewis to speak to, please send us an email to blood, sweat and smearsatriondiagnostics.com that's M A C H E D aondiagnostics.com you can follow Matrion at Twitter ationdx. Be sure to subscribe to Stay in the know. Share this podcast with clinicians you think might appreciate it, and we hope you'll join us next time here at Blood, Sweat and Smears.