The proliferation of “Vein Treatment” medical advertising both through traditional media and the internet has illustrated the diversity of physicians who claim to be trained to deliver quality vein care. It has created confusion among the general public as to who is best qualified to treat varicose veins and spider veins.
Patients need to be aware that the top to bottom location that a vein practice finds itself on a google or yahoo site has NO relationship to the quality of care delivered by that practice. It is a function of how many dollars that practice has decided to spend on search engine optimization(SEO). Very simply one practice has paid to manipulate your search about a general vein topic toward their site. Even worse they may have paid to re-direct your search from a particular practice you were investigating to their practice without your knowledge.
Vein clinics owned by major hospitals with extremely large advertising budgets have a better ability to spend “endless dollars” to manipulate your search since they have multiple revenue streams unrelated to providing vein care. The internet has an unfortunate side effect to make ALL vein practices appear that they provide the same quality of care when nothing could be further from the truth.
At The Albert Vein Institute we believe the patient should understand the landscape of vein care in order to make the most educated decision when choosing a provider who best performs medical and or cosmetic leg vein treatment. Patients must be comfortable and have confidence in their vein care physician. Five important characteristics must be considered:
- Microsurgical training is a vital skill in order to treat varicose veins effectively and safely. Microsurgical techniques are required to safely remove the varicose veins. After an endovenous ablation that destroys the saphenous vein (the cause of the varicose veins), if the varicosities (the bulging veins which are the results of the problem) are not removed, they will either remain visible or at worst, clot after the procedure resulting in pain, skin discoloration, and making it virtually impossible to remove later.
- Experience in reading and utilizing ultrasound technology is obligatory to obtain good results. Precision is needed in reading ultrasounds to make a correct diagnosis and treatment plans. Additionally, your provider needs to have the skills to obtain access to veins in your leg accurately and quickly to decrease the time of the procedure. Look for accreditation in ultrasound expertise as in your physician having obtained the ultrasound accreditation of Registered Physician in Vascular Interpretation (RPVI).
- Many patients are under the impression that their varicose veins will recur after their venous treatment. Physicians who are exclusively committed to treating venous disease, and thus have the most experience, should have the best understanding of what is required to prevent recurrence. Patients should inquire from any potential treating physician what they do in their treatment regiment to prevent recurrences.
- The expertise of the authorization department in the particular vein practice you visit is very important. Authorization must be very complete to document specific areas of valve insufficiency and vein size in order to meet medical necessity that is required by the health insurance company. Patients should feel comfortable that the authorization department will be thorough and professional so that there will be no surprised unknown costs to the patient after vein treatment.
- Look for a vein physician who has been recognized by his or her medical peers for their specialty and also has been accredited or certified by a nationally accredited healthcare overseeing body that is concerned with the highest level of safety, operational and technical components of a vein physician and his or her medical practice versus any business recognitions that are only interested in reflecting business financials, number of employees or other business functions versus medical merits of excellence.
Additional facts about the training programs of the specialties listed above included:
- Interventional radiologists have no surgical training but are well versed in ultrasound interpretation and techniques. Many interventional radiologists perform endovenous laser ablation but do not perform the micro-surgical phlebectomy because they have no surgical training. This leads to clotted painful varicose veins.
- Skin Laser Physicians: There are no accredited residency training programs specifically for use of skin lasers. Physicians who primarily do this work without previously have completed formal vascular or surgical residency would have had no formal training in ultrasound nor have any training in microsurgical procedures.
- General surgeons have surgical experience but are not trained in vascular disease. Ultrasound interpretation or techniques, and vascular surgical techniques are not a part of their board certification.
- Vascular surgeons have vascular surgical training but in general focus on arterial disease. Recent graduates receive some training in ultrasound interpretation and techniques however RPVI certification is now a prerequisite for vascular surgery board certification and should be obtained by vascular surgeons treating venous disease.
- Family practice physicians and anesthesiologists have minimal if any surgical training and no formal training in ultrasound interpretation and techniques.
- Cardiovascular surgeons have extensive training and experience in vascular and micro-surgical techniques with special expertise pertaining to the saphenous vein which is used in coronary artery bypass surgery. This is the same vein that malfunctions in most patients with varicose veins. Those who obtain additional training and those who qualify for RPVI certification are experienced in ultrasound interpretation and techniques.
Advanced medical progress in minimally invasive venous disease has become a great advantage for patients. Unfortunately, the lack of regulation has created great confusion for patients in understanding the benefits of choosing a qualified physician. This has allowed many providers, with incomplete training, to perform the surgical venous procedures and provide inadequate follow-up treatment plans, resulting in less than satisfactory results.
In conclusion, patients should consider choosing a provider like Dr. Albert with the highest training and credentials who has cardiovascular surgical experience, who is board certified through Registered Physician in Vascular Interpretation (RPVI), and is focused and devoted exclusively to the field of Phlebology. Looking for these qualifications will help to ensure that patients receive the most advanced treatment options available.
Written By: James D. Albert, M.D., RPVI of Albert Vein Institute
Copyright 2016 Albert Vein Institute