Despite the advances in technology, new patient populations, new medications, and multiple monitoring algorithms for anticoagulation, bleeding, and thrombosis complications remain high among those receiving extracorporeal life support (ECLS) [1,2]. Multiple consensus meetings and expert panels with rigorous evaluation of the available literature to develop “best practice” guidelines have appeared over the past several years, but none provide universally agreed upon or scientifically proven anticoagulation medications or monitoring regimens that convincingly lower bleeding and thrombosis [3,4]. Despite multiple efforts in this area, it has been of interest that the hematology physicians, who one might think would have both interest and expertise in dealing with anticoagulation, are often not included in any discussions regarding patients with ECLS. Recently, Regling et al. [5] reported the results of a survey from several organizations that deal with ECLS in an attempt to shed new light on practice and further delineate the role of hematologists in ECLS practice. While the actual number of surveys that were completed and analyzed is disappointingly low, they do add some data as to current practice. Most notably, variability in practice between centers remains high, and the use of hematology services remains low. While in some circumstances hematology may not be accessible to ECLS patients, this seems less likely than the fact that clinicians caring for patients with ECLS routinely do not recognize that hematology involvement may be useful. Additionally, to be fair, many hematology clinicians have no idea of what ECLS entails and the impact of the extracorporeal circuit on blood, platelets, and the coagulation cascade. Their practice may revolve more around primary hematology illnesses, focused on malignancies, sickle cell disease, or others. Nonetheless, education of ECLS care to our hematology colleagues may provide new insight into advances in anticoagulation, monitoring, and ways to focus research on means to reduce bleeding and thrombosis that they may bring to our multidisciplinary team.