Jerry Spivak, MD, Johns Hopkins University School of Medicine, Baltimore, MD, outlines the unmet needs for polycythemia vera by discussing the current diagnostic tools and their challenges, as well as issues faced by patients who develop post-polycythemia vera myelofibrosis, an aspect which existing JAK inhibitors and interferons fail to address. Prof. Spivak also comments on the impacts of using hydroxyurea as frontline therapy. This interview took place at the Texas MPN Workshop: Second Annual Workshop and Meeting in 2021.