Not TM myself but have a lot of friends in it. Lots of variability. Some run apheresis services which is a full clinical service with patient contact and full consultations. Much of the work is administrative so lots of paperwork, signoffs, meetings, etc. if academic, teaching and research are a part of it. The most critical thing is the call. You always get called about everything. If you have residents, they handle some of it, but if not, it’s on you. It can be anything from donor issues and questions about unit processing if you have a donor center, questions about appropriate utilization, transfusion reactions, alternatives, etc. Some also oversee recombinant products like novoseven and kcentra which are often ordered emergently. These can come any time of the day or night and can take anywhere from 30 seconds to 3 hours to handle. Your day might seem easier than the guy with a stack of prostate biopsies, but he likely sleeps through the night.
It’s harder and more nuanced than most people give it credit for, including anatomic pathologists. You have to make big decisions quickly and decisively. Clinicians have very little understanding of transfusion outside ABO groups.