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Albert Vein Institute: AVI: Colorado’s First and Only IAC Accredited Vein Center Facility
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AVI: Colorado’s First and Only IAC Accredited Vein Center Facility

July 14, 2016

Albert Vein Institute has been granted accreditation in Superficial Venous Evaluation and Management by the Intersocietal Accreditation Commission (IAC). Dr. James Albert voluntarily underwent a thorough review of operational and technical components by a panel of experts. The IAC accreditation is granted only to facilities that are found to be providing quality patient care, in compliance with national standards through a comprehensive evaluation process.

 

With Dr. Albert’s unparalleled expertise, personal dedication to each patient, and highest quality of care, AVI is the first and only vein care facility in the state of Colorado to receive the IAC Vein Center accreditation!

 

What’s the difference between an IAC Accredited Vein Center and having an IAC Accreditation in Vascular Testing? A LOT!

If you are searching for vein care, you can be certain that you will receive the highest level of competence and care when choosing a vein specialist that has been recognized as an IAC Accredited Vein Center. This “Vein Center” recognition is a consumer’s best friend when trying to decipher the variety of vein providers today. The achievement of Albert Vein Institute (AVI) as an IAC Accredited Vein Center is in addition to the certification that AVI has previously earned with our IAC Accreditation in Vascular Testing. The IAC Accreditation in Vascular Testing means that AVI has the seal of approval from a reputable overseeing healthcare body for Ultrasound Interpretation and Testing. In order to receive the  “highest distinction” as an IAC Accredited Vein Center,  it is required for a vein clinic to also have the IAC Accreditation in Vascular Testing.  The Vascular Testing Accreditation is just one of many benchmarks of competence that an IAC Accredited Vein Center has achieved in its care and expertise.  Albert Vein Institute (AVI) is among an elite group of about 100 IAC Accredited Vein Center across the Country and the first and only one of its kind in Colorado which should be comforting for patients and referring physicians to know the difference. 

 

Please click here to read the official press release:

Albert-Vein-Institute-AVI-Receives-IAC-Vein-Center-Accreditation

Posted in Blog by Jen Johnson
May 10, 2016

When the Affordable Care Act (ACA) was introduced Americans were told, “If you like your insurance you can keep your insurance. If you like your doctor, you can keep your doctor.” For millions of Coloradans, nothing could be further from the truth.

Patients need to be aware of changes in the healthcare landscape if they want to choose and keep the Phlebologist of their choice. As discussed in our article “How to choose a vein specialist,” different physicians from extremely varied backgrounds and skill sets perform Phlebology procedures. Not all Phlebologists have the same experience based on their original medical sub-specialty, percentage of time they commit to Phlebology, and their case volume. Here are a few things patients need to consider if they want to have full choice to pick the most qualified Phlebologist.

Insurance Company Physician Network

It is becoming more common under the ACA for Health Insurance companies to promote limited physician panels under the disguise of improved patient care. The truth is, maximum patient choice provides opportunity to receive the best care. Frequently the most qualified physicians are removed from panels, as they are the most popular in delivering needed services. Excluding the most qualified physicians from panels decreases services provided for patients and limits Insurance Company expenditures.

Make sure the Phlebologist of your choice is included in the Insurance plan you choose

Frequently the least expensive plans are those companies who utilize a “physician employee HMO model” limit choice. Patients may be forced to make an unpopular decision between 1) utilizing a less qualified physician, 2) paying “out of network” cost, or 3) waiting prolonged periods of time to change insurance and thus being allowed to use the Phlebologist of their choice.

Referrals to Phlebologists from Multi-Specialty Plan Medical Groups and Hospital-Employed Physicians

Most patients assume that physician referrals to sub-specialists are based exclusively on the skill and expertise of the physician they are being referred to. Unfortunately that has changed as well. Physicians in multi-specialty groups or hospital-employed physicians are frequently encouraged by their employer to refer patients to sub-specialty physicians within their same network or institution. Referring patients to other physicians employed in the same network undoubtedly improves the fiscal health of the organization.

Patients need to be aware that, unfortunately, “business decisions” about sub-specialty referrals may come into play as equally as the quality and experience of the sub-specialist. In medical sub-specialties that have existed for long periods of time and for those for which there are numerous physicians practicing the sub-specialty, the issue is less critical. For Phlebology, which is an extremely new field, has few physicians exclusively committed to the field, and the expertise and is varied, choice of physician is extremely important.

Patients need to remember that they have a choice. The overwhelming majority of superficial venous problems involve elective decisions and patients have ample time to make decisions. Patients should have absolute confidence in their Phlebologist before initiating treatment and should consider second opinions if they have any concerns with the Phlebololgist to whom they were referred. Remember, not all “phlebologists” today are Board Certified. Make sure your phlebologist is a Board Certified Phlebologist.

Copyright 2016 Albert Vein Institute

Posted in Blog by Jen Johnson
May 10, 2016

Beware of false advertising claims – Are the Claims Provable?

You have probably seen claims from other Vein Centers such as, “We have performed the most procedures” or ”More patients in Colorado have been treated by us” or “Our ultrasound diagnostic accuracy is in the top 10% of the nation.” These claims should be considered suspect since there is no published data from other Vein Centers for comparison. And these types of claims should also be considered potentially illegal to make; prospective patients should be suspicious as to the need for a legitimate Vein Center to make these false claims. Malpractice Insurance carriers are very interested in monitoring false medical advertising.

Beware of false significance of credentialing.

There are no Board Accredited Phlebology fellowships in Colorado. The only accredited Phlebology fellowship is at New York University in New York City. Any reference to a Phlebology Fellowship in Colorado is unrecognized and non-accredited by the American Board of Venous and Lymphatic Medicine. Any statement suggesting completion of a non-accredited fellowship declares exclusive excellence (top % of nation) is false and misleading.

Board certification of any type is simply an admission ticket to allow a physician to prove his/her value to patients and referring physicians. Passing a test does not prove anyone’s capability to be a competent Phlebologist. It is a minimum requirement. A combination of a high level surgical skill set in combination with an extensive experience level in treating venous disease, supported by an exclusive commitment to Phlebology, is a good recipe for success.

Do I need an Ultrasound?

Other than identification of symptomatic suspected superficial or deep vein thrombosis, duplex ultrasound should be performed selectively. Duplex ultrasound reflux studies are only indicated in the presence of symptoms consistent with venous insufficiency (aching, burning, itching, heaviness, leg fatigue, and significant swelling associated with varicose veins). Asymptomatic patients with spider veins in most circumstances do not need ultrasound analysis to determine treatment.

Offering “free venous screening” to Medicare, Medicare Advantage patients or patients with standard insurance that follow Medicare guidelines is not indicated. It’s a violation of the Office of the Inspector General 2002 report delineating that it is illegal to offer a Medicare patient any services that are valued at more than $10.00 that may potentially influence where the patient pursues treatment. These offenses may result in a $10,000.00 fine per incident.

Medicare does not sanction vein screening since there are no unsuspected conditions in asymptomatic patients that would require treatment to improve quality or quantity of life. At this point in time there is only one vein treatment facility of the six total in Colorado Springs that offers free vein screenings.

Who is going to perform my treatment?

Vein Centers may provide you with a “bait and switch” approach, whereby you are told that one doctor will perform any needed procedures. You then discover that this physician is somehow providing services simultaneously at 7 different Vein Centers across locations 500 miles apart while meeting full-time obligations as a physician at a hospital in the region. Make sure to do your research about the credentials and employment responsibilities of the person actually performing your procedure. You may find yourself initially seen by an Interventional Radiologist and then have your procedure performed by a Family Practice Physician who has completed a non-accredited fellowship, or potentially by a Physician Assistant.

The Albert Vein Institute (AVI) has been providing state-of-the-art vein care since 2006. Initially established in Colorado Springs, AVI expanded to Lone Tree in 2012 to meet the demands of our Denver patients. Dr. James D. Albert RPVI is double board certified in Cardiothoracic Surgery and Phlebology, and he is exclusively committed to the treatment of venous disease at these 2 facilities. Although Dr. Albert is certified as a Registered Physician in Vascular Interpretation, and AVI’s vascular lab is IAC accredited for vascular interpretation, and AVI received Best Vein Care Premier Status when Best Vein Care was in existence, we feel no need to inappropriately boast about these credentials. We feel they are required as minimum standards for a state-of-the-art Vein Institute.

Albert Vein Institute (AVI) has No association and No relationship to an organization that uses any name or abbreviation similar to AVI. Albert Vein Institute as been associated with the abbreviation AVI since its inception.

We wish to clarify the issue, apologize for any confusion our patients have incurred, and let our patients know we will be using all methods under the law to protect our name and goodwill from this piracy.

Copyright 2016 Albert Vein Institute.

Posted in Blog by Jen Johnson
March 21, 2016

The Field of Phlebology (vein care) arose because Vascular Surgeons who traditionally treated patients with venous disease were not exclusively focused on veins. In fact, the majority of a Vascular Surgeon’s training is concentrated around the treatment of arterial disease rather than varicose veins. The original emphasis was on arterial surgical procedures leaving the treatment of venous disease as an after thought, which can lead to less than satisfactory results. Vascular Surgery Board Certification does not always mean expertise in Vein Treatment Care. Patients began looking for physicians who focus exclusively on venous disease (varicose and spider veins) and turned away from providers who primarily focus on arterial disease.

 

There are no Board Accredited Phlebology Fellowships in Colorado. The only accredited Phlebology Fellowship is through the medical program at New York University in New York City. Any reference to a “Phlebology Fellowship” in Colorado is unrecognized and non-accredited by the American Board of Venous and Lymphatic Medicine. The same applies to any claim of a Phlebology Fellowship that follows the guidelines set forth by the ABVLM.

 

This claim is not accredited by any overseeing medical organization. Any statement that suggests that completion of a non-accredited Fellowship declares exclusive excellence (top % of nation) is false and misleading.

 

Board Certification of any type is simply an admission ticket to allow a physician to prove his/her value to patients and referring physicians. Passing a written test does not prove anyone’s capability to be a competent Phlebologist. It is a minimum requirement. A combination of a high-level surgical skill set in combination with an extensive experience level in treating venous disease, supported by an exclusive commitment to Phlebology is a good indicator for success.

 

The advancement of minimally-invasive catheter-based ablation technology has radically changed the treatment of venous disease by eliminating the need for inpatient general anesthesia. In fact using general anesthesia for these procedures is no longer considered to be within the standard of care. The fact that general anesthesia is no longer necessary for vein treatments has allowed a variety of physicians with diverse primary specialties to “dabble” in the treatment of venous disease. In the state of Colorado, this includes General Surgeons, Interventional Radiologists, Vascular Surgeons, Family Practice Physicians, Anesthesiologists, and Cardiovascular Surgeons. There are even non-physicians performing vein care. The specialized Field of Phlebology is so new that all of these different specialties are allowed to sit for the Phlebology Board Exam. Since the exam is a didactic test and does not evaluate the physician’s technical ability or the quality of the services provided by the clinic, a false sense of security for patients may result.

 

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 ad provide inadequate follow-up treatment plans, resulting in less than satisfactory results.

 

ADDITIONAL FACTS ABOUT THE TRAINING PROGRAMS OF THE SPECIALITIES LISTED ABOVE INCLUDE:

 

  1. 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 patients with varicose veins. Those Cardiovascular Surgeons who obtain additional training including Board Certification in Phlebology and those who are certified for RPVI (Registered Physician in Vascular Interpretation) are experienced in Ultrasound Interpretation and techniques.
  2. 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. Not using micro-surgical Phlebectomy as part of vein care may result in clotted, painful varicose veins.
  3. SKIN LASER PHYSICIANS. Physicians who primarily do this work without previously having completed formal vascular or surgical residency programs would have had no formal training in Utrasound nor have any training in microsurgical procedures. They work on your skin (topical) versus where the veins are located inside of your body.
  4. ANESTHESIOLOGISTS have no Ultrasound or surgical experience.
  5. 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.
  6. 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 (Registered Physician in Vascular Interpretation) is now a prerequisite for vascular surgery Board Certification and should be obtained by Vascular Surgeons treating venous disease.
  7. FAMILY PRACTICE PHYSICIANS have minimal if any microsurgical training and no formal training in Ultrasounds Interpretation and techniques. Some Family Practice Physicians claim to be Phlebologists; however, look for a Board Certified Phlebologist if you are considering a Family Practice Physician for vein care.
  8. There are a variety of physicians and non-physicians claiming to be Phlebologists. Make sure your Phlebologist is Board Certified in Phlebology.

 

In conclusion, patients should consider choosing a medical provider who has Board Certification in Cardiovascular Surgery (which means surgical AND microsurgical experience as well as a comprehensive understanding of the cardiovascular system), who is Board Certified through the Registered Physician in Vascular Interpretation (RPVI) for respected Ultrasound accreditation, has been Board Certified in Phlebology for an extended period of time and is dedicated exclusively to the Field of Phlebology (otherwise, vein care, for the physician or practice not 100% working in the Field of Phlebology is just one of many other medical positions or responsibilities in a practice or hospital system). It is the combination of all of these Board Certifications and Accreditations and the dedicated practice of venous disease that make Dr. James D. Albert one-of-a-kind in the exceptional understanding and skill that he provides to patients at Albert Vein Institute (AVI).

Copyright 2016 Albert Vein Institute

Posted in Blog by Jen Johnson
February 24, 2016

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:

 

  1. 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.
  2. 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).
  3. 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.
  4. 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.
  5. 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Family practice physicians and anesthesiologists have minimal if any surgical training and no formal training in ultrasound interpretation and techniques.
  6. 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

Posted in Blog by Dr. James D. Albert
December 29, 2015

30 second Albert Vein Commercial.

Posted in Blog, Uncategorized by Jen Johnson